1. Physical Therapy Interventions Following Total Ankle Replacement
Presented by
Dennis Conlon, PT

2. Patient History 55 year old female Divorced, lives alone
Chronic Left ankle pain
Previous Surgeries and PT
Failed conservative management

3. Patient History Occupation: Realtor PLOF: Active Lifestyle
CLOF: Limitations with standing, walking, up/down stairs, difficulty with unlevel surfaces
Patient Goals for Physical Therapy: Be able to walk better and have less pain.

4. Examination Deficits in ROM, Especially Dorsiflexion LEFS Score: 17/80
FABQ Score:
Physical Activity = 9/24
Work Subscale = 0/42

5. Examination AROM: Left Ankle DF: 5 /4 Right DF: 20/20
Left Ankle PF: Right PF: 45
Left Ankle INV: Right INV: 43
Left Ankle EV: Right EV: 25

6. Examination Ambulates short community distances with cam boot, WBAT
Patient non-compliant with wear of boot, current restrictions
Pain: 8/10 at worst
Edema in left ankle

7. Interventions
Therapeutic exercises: AROM, AAROM, PROM, progressive resistance exercises, isotonics, eccentric and concentric
Manual Therapy: Joint motion for toes, metatarsals, subtalar joint, talocrural joint, gentle graded mobilizations

8. Interventions
Aerobic conditioning: Recumbent bike, Elliptical, Treadmill
Gait Training: Cam boot, out of cam boot in II bars, in clinic, Treadmill
Modalities: PRN, for control of edema, pain

9. Outcomes
Patient seen for 12 visits over 8 weeks (3 week lapse in attendance)
Pain at worst from 8/10 at Eval to 3/10 at last session
AROM: DF to 6/8 degrees
PROM: DF to 10/10 degrees
LEFS Score: From 17/80 at Eval to 46/80 at last session

10. Discussion
Patient demonstrated improvements in all subjective and objective outcome measures.
Focus of interventions on impairments and functional limitations related to patient goals
Clinically meaningful changes for pain, LEFS; small improvement in ROM

11. Questions?
Thank You!