Deciding to have ankle surgery is never a choice to make lightly. Every procedure has risks, and you don't want to rush into surgery if your body is able to heal without intervention. However, not every injury or condition can be treated with conservative measures. With that said, here are some situations where ankle surgery may be your only solution to restore pain-free walking and get you back to your normal routines. End-Stage Arthritis When arthritis reaches end-stage, the cartilage is entirely worn away and bone is rubbing against bone. Not only is this intensely painful, it can leave you susceptible to fractures in the weakened bones. There are multiple surgical techniques used to treat this, including a total ankle replacement where the joint is replaced with prosthetic components. End stage arthritis doesn't heal itself and will only worsen with time. If you've end stage in your ankle, surgery is likely the only option. You've Torn Ligaments, Tendons, or Both While some soft tissue tears can heal on their own, the're plenty of situations where they cannot. For example, if you've torn a ligament or tendon so badly that it's detached on one end, surgery is the only way to repair the damage. If you've torn multiple ligaments or tendons at once, you may not have enough support left in the joint to allow for proper healing without surgery. If you've severely damaged these soft tissues, surgery may be the only way to correct the problem. It's also important to note that soft tissue injuries in your ankle can force your knee and hip to do the ankle's job, leading to more discomfort and, possibly, injuries to those joints as well. You're Experiencing Extreme Pain Rehabilitation for severe ankle injuries can be both long and excruciating. It's not uncommon for patients to scream during physical therapy, and some patients simply cannot handle the pain. If you're in too much pain to rehabilitate your injury, you may want to consider surgery to do some of the work for you. Physical therapy after surgery can still be painful, but it's faster and less painful than PT alone, for some injuries. Your physician can advise you as to whether or not surgery would decrease your pain and recovery time over just PT alone. Deciding to seek surgery for your ankle is an intensely personal choice, but it's one that can't always be avoided. Talk to your doctor about your options and discuss whether or not conservative measures are likely to work for you. If your prognosis for conservative success is poor, consider scheduling surgery before your knee and hip begin to hurt as well.