Total Ankle Arthroplasty

Massachusetts General Hospital · MGH Sports Medicine / Foot & Ankle Service

Weight-Bearing

NWB on crutches in splint wks 0-2; NWB walking wks 3-5 (may WB in boot standing only for ADLs); WBAT in walking boot wk 6; wean to supportive sneaker wks 7-8

Key Restrictions

Elevation 'toes above nose' critical (max 2-3 hrs below heart first 2 wks); swelling normal up to 6-12 months; keep boot on at night; if tendon transfers: no F/A strengthening against resistance or stretching of involved musculature until 3 months; procedure not expected to increase ROM significantly; NO return to high-impact activity ever

Timeline & Phases

7 phases: Phase I (0-2 wks), Phase II (3-5 wks), Phase III (6-10 wks), Phase IV (11-13 wks), Phase V (14-16 wks), Phase VI (4-6 months), Phase VII (6+ months return to sport)

Notes

Criterion-based; detailed intrinsic foot exercises in Phase II (arch doming, toe piano, toe spreads); Heel Rise test >90% uninvolved for Phase VII; SL balance >30 sec level surface; I-PRRS psychological readiness scale included; Y-Balance and Star Excursion for return to low-impact sport; MGH explicit recommendation: no return to repetitive high-impact sport/occupation/activity. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2025-12-19.]

Surgeon / Author

MGH Sports Medicine / Foot & Ankle Service

Published

Revised January 2023