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Artificial Ankles Go A Step Further

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The Associated Press

Published: November 18, 2008

Updated: 11/18/2008 12:23 am

WASHINGTON - A new generation of artificial ankles, designed to work more like the joint you're born with, has specialists hoping they will offer less pain and more function to thousands who hobble - although it's too soon to be sure.

"These third-generation prostheses really mimic a natural ankle, which is really what makes them different," says ankle specialist Steven Haddad of the Illinois Bone and Joint Institute and an orthopedic surgery professor at Northwestern University.

If the newer implants pan out, it's a market ripe for growth. More than 200,000 people seek care for ankle pain annually, with few options for the severely damaged ankles. More than 8,000 a year get their ankle bones fused, a last-ditch treatment after years of suffering, while surgeons perform between 2,000 and 2,500 ankle replacements.

Although Medicare pays for ankle replacements, which Haddad says can reach $50,000 including a three- to five-day hospital stay, many insurers don't. A review in September's Journal of the American Academy of Orthopedic Surgeons also cautions that so far, there is little research to tell how long newer versions will last, and that few hospitals have much practice in implanting them.

For patient Dan Sivia, however, the surgery restored an ability to walk that the 39-year-old thought he had forever lost. His leg was crooked from a series of breaks beginning in childhood and included a crushing ankle fracture at 28. A decade of pain later, he sought out Haddad. Then he spent 17 months on crutches, with external pins holding bones in place, as Haddad rebuilt his leg. The last surgery, the ankle implant, came in July.

"When I got to rake my own lawn - I've done it three times just because I can," the Waukegan, Ill., man said with a laugh. "I'm riding my bike, I'm doing all the things everybody else is doing."

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