Standard ankle joint replacement procedure is usually carried out under a general or spinal anesthetic. An incision is made on the front of the ankle, and any overlying tendons, blood vessels and nerves are moved out of the way. The ankle joint is then opened through a second incision, before the surgeon prepares the ankle joint by cutting and shaping the bone to fit the new prostheses. The prostheses consist of two parts: the ‘tibial’ component that replaces the socket (tibia), and the ‘talar’ component that replaces the upper part of the bone in the foot (talus). These are made of a mixture of plastic and metal. Once the replacement bone and socket are fitted, they are tested for friction and mobility. To help prevent any loosening of the prostheses, bone is grafted between the tibia and the bone that sits next to it – the fibula. Finally, the prostheses are then screwed into place. After the surgeon has finished implanting the prostheses, the incisions are closed using sutures or staples. A splint is then bandaged onto the ankle to help keep the new joint in place during the healing period.