Total Ankle Replacement Restores Function

Roger Dunn battled chronic ankle pain for decades, an unwelcome side effect of playing college football and repeat injuries over the years. Finally tired of “dragging it along,” Roger got an appointment close to home with foot and ankle surgeon Matthew Williams, DPM, at the Virginia Mason Kirkland Medical Center. Dr. Williams discussed a treatment option Roger never knew existed: total ankle replacement.


Roger Dunn

“For years the gold standard for ankle arthritis was permanently fusing the joint, which relieves pain but decreases motion, leading to arthritis in nearby joints over time,” says Dr. Williams. “While earlier ankle replacement devices had high failure rates, recent advances in design and materials have significantly improved longevity and decreased complications.”

Roger needed no convincing to undergo the surgery, with his bone-on-bone ankle joint — the worst kind of daily grind. He scheduled the procedure, bracing for a long recovery and some next-level pain, but he was in for a big surprise.

“It just amazed the heck out of me that I never experienced any pain in the joint or in the surrounding tendons,” says Roger, who had the procedure in November 2018. “Once out of a cast I was religious about wearing my boot and not taking any chances. I went back to work on a knee scooter in two weeks, where I could also ride my desk chair around a bit.”

Soon Dr. Williams eased Roger off the scooter and into walking with a brace. Physical therapy helped keep Roger’s mobility on track, steadily improving his strength and balance. X-rays confirmed successful realignment of Roger’s foot, ankle and leg, something Roger never imagined possible with such an old, gnarled body, as he put it. What he didn’t know is everything that made his case unique informed a treatment plan designed for the best possible outcome.

“Before performing an ankle replacement, we use advanced computer programs to plan the surgical approach, building in correction for any existing deformity,” says Dr. Williams. “Sometimes it’s necessary to make corrections in stages to achieve the best function for patients. I also take great care when selecting patients who are likely to benefit from ankle replacement. Things like recreational activity level, age, occupation and body mass are all critical considerations for success.”

Roger wrapped up physical therapy a few months after surgery, feeling balanced and confident on his new ankle. A recent X-ray showing everything healed as expected told Roger he’s good to go. Now when it’s time to get a knee replacement on the other leg – another troubled joint destined for a fix – he’ll have the stability on the right to take whatever comes.

Would Roger recommend total ankle replacement to other people who wonder if it’s worth the time, bulky boot, scooter-cruising and physical therapy visits? Absolutely, he says.

“I was careful to follow all the rules of the road and was lucky I didn’t have any falls,” says Roger. “The no-pain part is what really worked for me. It wasn’t something Dr. Williams guaranteed going in, it’s something that happened because he’s an excellent surgeon.”

A version of this story also appears in the Virginia Mason Health System 2018 Annual Report.  


  1. Hi there. This article certainly reminds me of my aunt who recently just discovered that she has ankle arthritis. Thank you for informing us about the need to inquire about the limit in terms of physical activities we can perform. I’ll tell her to keep this question in mind when she makes an appointment later.

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