Private Ankle Replacement

Ankle replacement surgery (total ankle arthroplasty) is a procedure where a damaged ankle joint is resurfaced and replaced with artificial parts so the joint can move smoothly again. Your ankle is a hinge where the shinbone (tibia) meets the top of the foot bone (talus).

When arthritis or injury destroys the cartilage—the slippery tissue that lets bones glide—the joint becomes painful and stiff.In an ankle replacement, the surgeon removes the worn-out cartilage and a thin layer of bone from the tibia and talus. They then fit specially designed metal components onto those bones, with a tough plastic spacer between them. The metal acts like new joint surfaces, and the plastic works as the “glide” layer, letting the ankle bend up and down more naturally. The parts are aligned using guides and X-ray imaging so the new joint matches your leg’s mechanics and foot position.

Unlike a fusion (which permanently joins bones), a replacement aims to keep motion, helping with walking on uneven ground and everyday activities. It’s used mainly for severe ankle arthritis when non-surgical treatments haven’t helped and maintaining joint movement is a priority.

Shorter wait times

Time matters when every step hurts. Instead of waiting months (or longer) for consultation and OR time, private centres can often schedule surgery within weeks—reducing time spent with severe ankle pain and helping you return to daily life sooner.

Choice and control

Going private gives you more say in your care. You can:

• Choose a high‑volume ankle arthroplasty surgeon with proven outcomes.
• Select the clinic location (often out‑of‑province).
• Plan surgery around work, family, or sport schedules.

Peace of mind

Patients value knowing exactly who will operate, when it will happen, and the detailed plan (implant options, approach, rehab milestones). Clear timelines reduce anxiety and help patients coordinate time off, support, and physiotherapy.

Preventing further decline

• Function and quality of life: Limits months of pain, limping, and reduced mobility that disrupt work and sleep.
• Joint and overall health: Prolonged immobility worsens muscle loss, balance, weight, and cardiovascular fitness; earlier surgery helps avoid deconditioning.
• Surgical complexity: Progressive deformity, stiffness, or bone loss from waiting can make later surgery longer and more complex, with tougher rehab.
• Mental load: Shortens time living with uncertainty, restricted activities, and ongoing night pain.

1. ‍Confirm your diagnosis. Most patients start with a family doctor or specialist who confirms that ankle replacement is needed.
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2. Research. Explore surgeons who specialize in private ankle replacement.
   • You can find surgeons in Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec on our app, and review qualifications, as well as pricing.
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3. Schedule an initial consultation. Most surgeons offer in-clinic and online consults.
   
   • Consultations are usually booked within days or a few weeks.
   • Note: expect a consultation fee between $150 - $350.
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4. Consultation. The surgeon will review your condition, symptoms, and any previous treatments or diagnostics, such as x-rays or MRIs.
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5. ‍Post consultation. The surgeon will then review your case and provide surgical options based on your needs; review the risks and expected outcomes; and present pricing and scheduling options.
   
   • Because the procedure is not covered by your provincial health plan when done privately, you’ll need to review the quoted cost and consider payment options (out-of-pocket, private insurance, or financing).
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6. Schedule your surgery date. Once you confirm the procedure and payment, the clinic will schedule your surgery—generally within a few weeks.
   
   • Plan for travel and accommodation, since the surgery will likely take place outside your home province.
   • Expect pre-surgery preparation, and possibly some pre-surgery tests.

Operating time: about 2–3 hours (can be shorter or longer depending on anatomy and complexity).Total visit: plan for most of the day with check‑in, anesthesia, and recovery.

Basic steps

• Check‑in and planning: You meet the team, review imaging, and confirm the plan. The surgeon marks the ankle.
• Anesthesia: You go to sleep (general anesthesia), or regional (nerve blocks).
• Position and prep: Your leg is positioned, the skin is cleaned, and sterile drapes are placed.
• Incision and exposure: A careful incision is made at the front (sometimes side) of the ankle to safely reach the joint, protecting nerves and tendons.
• Bone cuts and cleanup: The damaged cartilage and a thin layer of bone on the tibia and talus are removed using precise cutting guides.
• Trial components and alignment: Trial (temporary) parts are placed to check fit, alignment, and motion. Adjustments are made so your ankle tracks straight.
• Implant placement: The real metal components are fixed to the tibia and talus, with a tough plastic spacer snapped in between to act as the glide surface.
• Final check and closure: The surgeon tests motion and stability, rinses the joint, closes layers with sutures, and applies dressings and a protective splint/boot.
• Recovery room: You wake up, the team reviews instructions, and you head to recovery before going home or to a ward (depending on the plan).

Your plan comes from your surgical team and can vary. Take rehab seriously—the more consistent you are, the better your outcome. Some private clinics offer virtual follow-ups or coordinate physio near home.

In general, what to expect after ankle replacement surgery:

Week 1

• Reality check: pain, swelling, stiffness, weird sleep. Not fun.
• Goals: control pain/swelling, protect the new joint, prevent blood clots.
• Activities:
  
  • hospital stay 1–3 days (varies)
  • leg elevated above heart
  • ice (as allowed)
  • ankle pumps/toe wiggles
  • deep-breathing, short assisted walks
  • non-weight-bearing or very limited weight (follow your surgeon)
  • wound care and meds
  • ideally get a helper for the first few days

Weeks 2–4

• Still swollen but improving.
• Goals: safe mobility and gentle range of motion (ROM) as cleared.
• Activities:
  
  • stitch/suture removal if needed
  • boot on
  • walk short distances with aids (walker/crutches), increasing time up but lots of elevation
  • start gentle ankle ROM (up/down, side-to-side) if allowed
  • light daily tasks

Weeks 5–12

• The work phase.
• Goals: more ROM, begin strength, progress weight-bearing in the boot per your plan.
• Activities:
  
  • physio ramps up (calf, foot intrinsics, balance, hip/knee strength)
  • transition from two crutches to one, then none in the boot
  • practice normal walking pattern

Weeks 13–52

• Building back real-world function.
• Goals: near-full ROM, strength, and endurance; steady gait without the boot; return to most daily activities.
• Activities:
  
  • progressive strengthening, balance, and low-impact cardio (bike, pool—only if cleared)
  • many people return to desk work earlier; heavier jobs take longer
  • Keep listening to your body and your physio

Red flags anytime

• Fever, wound redness/drainage, calf pain/swelling, chest pain/shortness of breath, sudden severe ankle pain or numbness—contact your care team.

Ankle replacement is a major surgery. Private clinics in Canada typically charge $10,000 to $25,000.

In the United States, the average cost is between CA$20,100 and CA$55,200.

Costs vary so much because of location, surgeon experience, facility type, scope of potential treatments, complexity of the issue, and included services (some clinics offer all-inclusive, while others charge separately for anesthesia, followup care, etc.).

What’s included

• Surgeon fee (and assistant if used) and anesthesiologist/general anesthesia
• Facility fees (OR time, nursing, supplies, equipment)
• Ankle replacement implant hardware (standard components)
• Immediate post‑op recovery and routine early follow‑ups
• Basic post‑op boot/brace and standard dressings (varies)

What’s usually not included

• Pre-op imaging (X‑rays, MRI/CT), lab work, and extra specialist consults
• Travel and accommodation (if surgery is out‑of‑province/state)
• Long‑term physiotherapy after the initial session(s)
• Prescription medications after discharge
• Specialized or custom implants beyond the standard bundle

Insurance and financing options

• Private health insurance: Some plans may cover part of the costs, such as hospital fees. It’s important to check your policy directly.
• Financing plans: Many clinics offer monthly payment options to help spread out the cost. Learn more about your financing options here.‍
• Medical Expense Tax Credit (METC): This is a non-refundable credit that reduces your taxes when you pay out-of-pocket for eligible medical expenses. Learn more about how to claim METC for private surgeries.

Choosing your surgeon is one of the benefits of going the private route. Here’s what to consider and the key questions to bring to your ankle replacement consultation.

What to look for

• Experience and volume
  • Ask how many ankle replacements they perform each year, primary vs revision, and how many complex cases (deformity correction, prior fusions, bone loss).
• Credentials and training
  • Confirm licensure with the provincial college (e.g., CPSO in Ontario, CPSBC in BC, CPSA in Alberta).
  • Look for FRCSC-certified orthopaedic surgeons with fellowship training in foot & ankle or sports/ankle reconstruction.
• Safety
  • Ask about infection rates, unplanned returns, stiffness rates, return‑to‑sport timelines.
• Technique and anesthesia‍
  
  • Which ankle replacement system(s) they use (e.g., fixed- vs mobile-bearing; cementless vs cemented; options for patient anatomy) and why that system for you.
  • Strategy for ligament balancing, alignment, and soft-tissue management; plan if there’s deformity, arthritis in adjacent joints, or prior hardware.‍
• Facility accreditation‍
  
  • Make sure the clinic is accredited by national bodies such as Accreditation Canada or the Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF).‍
• Rehab integration‍
  
  • Access to ankle-savvy physiotherapy, clear phased protocol, and communication with your local therapist if you’re traveling.

Questions to ask during your ankle replacement consultation

Surgeon and surgery plan

• How many ankle replacmeents do you perform yearly? Primary vs revisions? Outcomes over the last 12–24 months?
• Which implant do you recommend for me and why (bearing type, fixation, expected longevity, evidence)?
• What is your rate of wound complications and infection, and how do you minimize those risks?
• Will I need adjunct procedures (Achilles/gastrocnemius lengthening, ligament reconstruction, calcaneal/tibial osteotomy, subtalar/forefoot procedures)? How would that change recovery and cost?
• What anesthesia do you recommend (regional block + sedation vs general) and your pain-control plan (nerve blocks, multimodal meds)?
• Same-day surgery vs overnight stay—what determines this? If an emergency occurs, do you have a hospital transfer agreement?

Recovery and aftercare

• What’s my timeline to: partial vs full weight-bearing, out of the boot, driving, desk work vs manual work, and low-impact activities?
• Expected ROM goals and long-term activity restrictions (impact sports, running, heavy labor).
• Physiotherapy: frequency/duration, home vs supervised; do you provide a written protocol?
• DVT prevention: what blood thinner and for how long?
• Red flags that should trigger a call/ER visit (fever, wound drainage, escalating pain/swelling, calf pain, shortness of breath, new numbness).
• Who is my post-op contact (direct phone/email), typical response time, number/timing of follow-ups?

Costs and logistics

• What exactly is included in my quote (surgeon, anesthesiologist, facility fees, implant components, nerve block, in-house meds, imaging review, brace/boot, scheduled follow-ups)?
• What could add cost (custom components, grafts, adjunct procedures, extra nights, unexpected imaging, blood transfusion, complications/re-operations)?
• If intra-op findings require additional procedures, how are consent and pricing handled?
• If I’m traveling from another province, which follow-ups can be virtual? Will I receive the operative note, implant labels, and the rehab plan for my local care team?