When to Consider Total Ankle Replacement: A Guide to the Paragon 28® APEX 3D™

Ankle joints damaged by rheumatoid or degenerative arthritis or past injuries are the most common culprit behind chronic ankle pain. 

The feet and ankles are complex structures composed of 33 joints, and arthritis can strike any of them. As the condition progresses, and pain becomes chronic, and impacts your quality of life, total ankle replacement may offer a road back to comfort and restored function.

At Alpine Foot and Ankle, with locations in Idaho Falls, Idaho, and Alpine, Wyoming, Andrew McCall, DPM, provides advanced surgical solutions, including the state-of-the-art Paragon 28® APEX 3D™ Total Ankle Replacement system. Here, learn when you might want to consider this procedure and what sets the APEX 3D apart.

Why chronic ankle arthritis becomes debilitating

Ankle arthritis can develop from years of repetitive motion, a history of sprains or fractures, or conditions like rheumatoid arthritis. As the cartilage wears away, bone rubs against bone, causing pain, stiffness, swelling, and limited movement.

Many patients rely on bracing, anti-inflammatory medications, physical therapy, or activity modification. These approaches often work well early on. However, when arthritis progresses and the joint becomes more worn, conservative care no longer provides meaningful relief. You might notice the following signs that arthritis has advanced:

• Increased pain when walking or standing
• Difficulty navigating uneven surfaces
• Swelling that worsens with activity
• Reduced range of motion
• Limits on work, exercise, and daily tasks

If these symptoms are affecting your quality of life, it may be time to discuss surgical options.

What makes the Paragon 28 APEX 3D different?

Not all ankle replacement systems are the same. The APEX 3D system is designed with advanced engineering that supports more natural movement and long-term durability.

This implant is created using detailed 3D imaging to match each patient’s anatomy with remarkable precision. The components are shaped to mimic the ankle’s natural curves and allow smoother motion after surgery. 

The design also focuses on stability, which helps reduce the risk of loosening or implant failure over time.

Because of its innovative structure, the APEX 3D can help patients achieve better alignment, improved mobility, and a more comfortable walking pattern compared with older ankle replacement technologies.

When to consider total ankle replacement

Total ankle replacement isn’t the first step in treatment. It’s generally recommended when:

• Ankle arthritis is severe or advanced
• Pain persists despite nonsurgical treatments
• Ankle motion is significantly restricted
• The joint is unstable or deformity is present
• Daily activities and mobility are becoming difficult

In many cases, patients choose ankle replacement when they want to preserve movement. Unlike ankle fusion surgery, which eliminates joint motion, total ankle replacement allows the joint to bend and flex. This helps maintain a more normal gait and can protect the surrounding joints from extra stress.

What to expect from recovery

Recovery from total ankle replacement includes a period of rest, gradual weight-bearing, and physical therapy. Most patients return to comfortable daily activities in several months, with continued improvement over the first year. The precision and stability of the APEX 3D system support smoother healing and strong long-term outcomes.

The road to lasting ankle relief

If ankle pain is limiting your lifestyle, the right treatment can help you regain your mobility and confidence. Dr. McCall and our supportive team at Alpine Foot and Ankle specialize in evaluating complex ankle conditions and recommending personalized solutions, including the Paragon 28 APEX 3D ankle replacement system.

To find out whether you’re a candidate for total ankle replacement, contact us to schedule a consultation today.