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Foot & AnkleSecond Opinion Guide

Should you get a second opinion for ankle replacement?

Ankle replacement is a less mature surgery than knee or hip replacement, with higher complication rates and more variability in surgeon experience. For ankle arthritis, the main surgical alternative is ankle fusion, which has different trade-offs. A second opinion is strongly encouraged to ensure you understand both options and to confirm you are seeing a surgeon with significant ankle replacement experience.

Red flags - consider a second opinion if you notice these

  • The surgeon could not tell you how many ankle replacements they perform per year
  • Ankle fusion was not discussed as an alternative
  • You are significantly overweight, which increases ankle replacement complication risk
  • Your ankle deformity is severe, which complicates replacement and may favor fusion
  • Non-surgical options including bracing, injections, and activity modification were not tried

Questions to ask the second surgeon

  1. 1Am I a better candidate for ankle replacement or ankle fusion, and why?
  2. 2How many ankle replacements do you personally perform per year?
  3. 3What implant system do you use, and what is the data on its longevity?
  4. 4What are the risks specific to my anatomy and degree of deformity?
  5. 5If the replacement fails, can I be converted to a fusion?
  6. 6What is the expected range of motion after ankle replacement?

What to expect from a second opinion visit

For ankle replacement, seek a second opinion from a foot and ankle surgeon at a high-volume center. This is a specialty within a specialty, and surgeon experience correlates strongly with outcomes. Bring weight-bearing X-rays of both feet and ankles, and any MRI or CT scans that have been obtained.

Common questions

What is the difference between ankle replacement and ankle fusion?
Ankle replacement preserves motion but has higher short-term complication rates and may need revision after 10-15 years. Ankle fusion eliminates ankle motion but is more durable and has a lower revision rate. Fusion patients often compensate well with motion from surrounding joints. The right choice depends on age, activity demands, deformity, and bone quality.
How active can I be after ankle replacement?
Moderate low-impact activity (walking, cycling, swimming) is generally encouraged. High-impact sports and heavy manual labor are discouraged because they accelerate wear on the implant. Your surgeon should be specific about what activities are safe given your implant and surgical result.

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