ankle fusion

[amandah]

I am 34 years old and I broke my ankle two years ago. Once out of plaster, the ankle never got better - always in pain. I had an
Arthroscopy in September which revealed I had also broken the corner off my talus bone - this had come free into my ankle joint and wore away a large section of my cartilage (and a hole in my shin bone!). My surgeon says I am facing a fusion in 1-2 years time. I am in constant pain and although try various methods of pain relief - find it very hard to be pain free. I am obviously very scared about the prospect of a fusion - feels like a very negative 'step' to take. Although the prospect of being pain free does appeal. Does anyone know if a fusion can be replaced later on in life with an ankle replacement? Should I wait as long as possible to see if there any any advancements in cartilage replacement technology? Most of the stories on the site about a fusion seem very positive - but I am still worried about the long-term affects of a fusion on the rest of my foot and also the limitations a fusion might place on my movement (swimming especially). Help!!!

[Sharonmacd]

Hi Amandah,

I had fusion surgery 7 weeks ago, but am still not walking on it, so I don't have lots of information yet. It took me a year and a half to make the decision, hoping to be rid of the pain. My doctor told me my fusion can be converted to a replacement later, but some say that's not possible. There's a lot of guessing in this.

I have started a Yahoo Group on this subject, with 50 people (from Europe and North America) discussing all these issues. Go to http://health.groups.yahoo.com/group/anklefusion to join.

Sharon

[amandah]

Thanks so much Sharon, I have just joined your yahoo group. I saw my surgeon yesterday and we are going to try various things to buy me time before I have to have the fusion - another athroscopy and seeing a pain management specialist this week. How did you make the final decision to have the fusion? I am in constant pain (that no pain kilers seem to help) that gets worse with activity and I can really only do one day on my feet before I have to take a break because the pain is so bad. I am trying to delay the inevitable fusion as I am only 34. I would be very interested in how you came to your decision. Amanda

[Unregistered]

Amandah,

Have you discussed ankle replacement? I'm not sure if they are performing these on people as young as yourself but my Dad held off on a fusion for years and years eventually getting a replacement which has maintained his range of motion and completely cured his pain. Not sure where you are but in Melbourne Mark Blackney or Tim Schneider are both orthopeadic surgeons specialising in foot and ankle. Mark did Dad's op but both these guys are 1st class performers. Hope that helps

[Unregistered]

i just joined the group listed in here waiting for an answer anyway. im 41, had a talus bonegraft job in 2003, a knee to talus cartliage transplant done in june 2005. im still in pain. saw dr. enyi okereke at the university of pennsylvania. i was denied a replacement because of age, and lack of range of motion. ( dorsiflexion).? i dont ubderstand the 2nd reason, but i was asked to either have fusion. or a procedure where the ankle is seperated and held open by pins for a few months. it would also be totally resurfaced. he didnt say anything about it being reversable, but a girl from jersey told me of a surgeon that does a fusion so the intent is to prep for a replacement down the road. he is in pittsburgh, pa. http://www.allaboutarthritis.com/AllAboutArthritis/layoutTemplates/html/en/contentdisplay/document/condition/arthritis/clinicalArticle/Ankle_fusion_surgery.htm has anyone out there had this done??? i dont want a fusion, and the other option sounds very painful, again.. well i hope to see you in that other forum soon. i need some help .. thanks, jeff

[desperado]

I am Thinking of having amke fusion done can anybody tell me the final result hows the walking etc thank you Kevin

[Unregistered]

I had a ankle fusion 10 weeks ago and I am in a fiberglass cast with a walking boot. It is feeling real good except when I try putting all my weight on it. At first it felt likr my heel was standing on a rool of quarters with two spikes in my heel. That was two weeks ago now it hurts on the back of my heel and achilles tendon. I see my Doctor in a couple of days and he said he wanted me off my crutches by then but I do not think so. Is there anyone one else with this heel pain.

[Unregistered]

About a year and a half ago, I had ankle fusion surgery. I had broken the ankle several months earlier and it was very painful. The surgery went well and the ankle fused. Now the pain is severe in the ankle. I take pain medication and can only walk a short distance. My doctor gave me a prescription for steriods, but they only helped about 10% I have severe arthritis in the ankle and foot. Any suggestions what might help?

[Unregistered]

I had my ankle fused about ten years ago when I was 30. Prior to that I wasn't able to walk more than a block before the severe arthritis kicked in, as I'd smashed my ankle four years earlier in a rock climbing accident. I lived on ibuprofen and in constant pain, often walking with a cane. In the surgery, the surgeon fused my talus, fibula, and calcanius together. At my request, he tried to get the ankle fused in a position of 5 degrees of dorsiflection, though it actually ended up more like 2 degrees when all was said and done. I requested the dorsiflection so that I could continue to ski.

Ten years later, I can ski (almost as well as I could before, both telemark and alpine), bicycle unaffected, hike, and even "run" (though though it never seems to get much faster than a brisk walk) using Zcoil shoes. Three weeks ago I was able to do an 18 mile hike. I have basically no pain in that foot. Once in a while it gets a little swollen (though not really painful), especially if its hot or I am dehydrated. I will say that I am perhaps not quite as agile as I was prior to the accident, and I 'm not really able to jump or play sports such as basketball. All and all, I'm not sorry I had the surgery, the pain was aweful. My fusion was a partial fusion, as the talus still articulates at the joint with the bone towards the fore-foot, and my fore-foot developed lots of compensatory motion. Most people don't notice my barely discernable limp, though it gets more severe when I'm tired.

Clearly not everyone has such positive results from ankle fusion, but in my case it worked out well. I had been afraid to have the surgery done because of the permanent effect is would have on my physiology, though in retrospect I feel it was somewhat silly to spend three years in cronic pain rather than having the procedure.

I hope someone finds this information helpful.

[Hillbilly]

I had an ankle fusion in October 2004. I now have severe arthritis in the ankle and can only walk a short distance. I take Cellebrex and pain meds every day for the pain. The orthopedic surgeon said there is nothing else that can be done. Any advice would be appreciated.

Hillbilly:)

[Unregistered]

I had an ankle fusion in October 2004. I now have severe arthritis in the ankle and can only walk a short distance. I take Cellebrex and pain meds every day for the pain. The orthopedic surgeon said there is nothing else that can be done. Any advice would be appreciated.

Hillbilly:)
so hillbill you wauld not recomend a fusion?

Yakuza

[Hillbilly]

Yak
I can't recommend having an ankle fusion. You could have one and completely be pain-free or be in a lot of pain like me. You should check out all the information you can find and make a decision that is right for you.

Hillbilly

[Hillbilly]

I am Thinking of having amke fusion done can anybody tell me the final result hows the walking etc thank you Kevin
Desperado
I had an ankle fusion in October 2004. Since the fusion I have had constant pain and walk with a bad limp. The doctor said there is nothing more that can be done. I don't mean to sound so negative about the fusion. Many people have had an ankle fusion and are almost pain-free once the fusion heals.
Sincerely
Hillbilly:)

[Ashleigh]

Hello Amandah

I am only 18 years old, and sudying to be a nurse. I was told that I only have 2 choices left for my ankle and that was to have it amputated or fused, I have been very emotional about this as I don't know what to do, also the fact that my surgeon doesnt really want to perform either of them. I have broken it only 2 years ago and already had 3 operations on it, I am not sleeping much any more and there was always constant pain like what you are feeling. I have completly worn away all of my cartilage in my joint and now just have bone rubbing on bone. Recently I travelled to Perth again and had a meeting with about 5 specialists about what to do with my ankle. After a discussion with them they had suggested that a fusion is going to be the best option, they then said to me that it depends on how much longer I can put up with the pain as to how long it is till I have the operation to have it fused. This week I am going to Perth again as my specialist suggested that I get it put in plaster for a week to see how it feels to have it fused. There are issues that I am worried with regarding the fusion and that is whether it is going to work or if infection is going to occur etc...but if you ask me I think that although you are worried about the fusion, the same thing about me with you is that it depends on how much longer you can live with the pain for before you just have to do something about it. Also after to speaking to different people and researching fusion it seems that we should be able to do a lot of what we already can do. Goodluck with your choices and it would be good to hear back from you!

[confused]

Have you considered a replacement or amputation. I know that these may seem daunting but what about if they were to give you movement back and allow you to be pain free??

[amandah]

Ashleigh, I am originally from Perth but now live in the UK! It made me sad to read your reply - your so young and I am sorry nothing has worked for you. I am now 6 weeks after a second operation (so one behind you!) and still really stuggling to walk any distance without swelling and pain. I have to wait 3 months post op. to see if it has made any difference. I hope it does as I have lived with so much pain for so long and getting pretty tired of it now. Let me know what your specialists say and if you do go with a fusion. I have heard so many mixed things about fusions now - I just hope if you do go with it you are one of the people who have no problems and that it solves your pain.
Amanda

[Gwen]

Hi there. Has anyone ended up with a stress fracture of the tibia following ankle fusion? I would like to find out how long it took to heal.
Gwen

[joanne]

I am 34 years old and I broke my ankle two years ago. Once out of plaster, the ankle never got better - always in pain. I had an
Arthroscopy in September which revealed I had also broken the corner off my talus bone - this had come free into my ankle joint and wore away a large section of my cartilage (and a hole in my shin bone!). My surgeon says I am facing a fusion in 1-2 years time. I am in constant pain and although try various methods of pain relief - find it very hard to be pain free. I am obviously very scared about the prospect of a fusion - feels like a very negative 'step' to take. Although the prospect of being pain free does appeal. Does anyone know if a fusion can be replaced later on in life with an ankle replacement? Should I wait as long as possible to see if there any any advancements in cartilage replacement technology? Most of the stories on the site about a fusion seem very positive - but I am still worried about the long-term affects of a fusion on the rest of my foot and also the limitations a fusion might place on my movement (swimming especially). Help!!!
Hi I would also like to know the answer to this question.

[unregistered]

A fused ankle can be reversed at a later stage as long as the end of the fibular hasn't been removed. The fibular needs to be intak so the artifical ankle can be fitted properly to the ankle. I have had my right ankle fused and I am considering the possibility of it being reversed into a replacement as a fused ankle puts alot of stress on joints further down the foot including the big toe. Often when other joints start to get full of arthritis and pain, a good foot and ankle surgeon will reverse it. I would suggest visiting a surgeon who has done a reversal of a fusion and who also takes the appoach of fusing the joint so that it can be reversed at a later stage. There are some very good specialist foot and ankle surgeons in Australia should you live in Australia. Most of the top foot and ankle surgeons are located in Sydney and Melbourne.
I hope this helps
Judy

[Mischap123]

Hi all,
On the topic of fusion vs anything else. I have found a hospital that has done some autologous cartilage transplant work in Sydney. It's Holroyd Private (near Parramatta) and I'm going to see a Dr Kuo in the new year to see what he can and can't do for me. Hopefully I'll report back

[shirleyf81]

i had my right ankle fused in october 2006 for arthritis following an injury in 1979. I had 7 weeks non wt bearing and a further 7 in a walking plaster. Reviewed this week and cast has been removed. there is some evidence that fusion is starting to take place on xray however i am still getting an incredible amount of pain on wieght bearing and mostly heal pain, which is at rest and wakes me up. Am I just being impatient? has anyone else post fusion suffered from intense heal pain and does the pain reduce with time? Some days it feels better than others but on a bad day i am starting to question my decision even though i felt i had little option with the pain i have suffered over the last two years and the difficulty walking.

[ninikirri2]

hi shirley, i had rt ankle fusion in october 2006 for chronic oesteomyelitis and septic arthritis following a trimalleolar in january 2004 and like you i'm experiencing a lot of pain but mainly over my lateral malleolus radiating down to 3rd, 4th &5th toes, also i'm plagued by excessive swelling from my knees to toes and my toes are numb. I am led to believe that the pain will lessen with time but It may be too soon to tell. what does your ortho specilist have to say about the ongoing pain? try hydrotherapy and please remain positive. Niniki

[painful_ankle]

6 months back I underwent surgery for ankle injury. But after 6 months of surgery and 4 months of plaster the pain seems to remain. So the doctor has replastered my ankle (for another month and half). The doc has adviced ankle fusion if the pain persists after a month and half. I am looking for alternative options that people have tried. I also came to know about prolotherapy. Has anyone tried it? Does it help?
Also if the prosthesis could help reduce strain on the ankle and be able to avoid ankle fusion.

[gowie77]

Hello. I have not read every post in this forum so forgive me if I am mentioning something that has already been bought up. Have any of you guys tried treatment with Scenar? I myself broke my talus bone in 2001 whilst snowboarding. It was in a cast for 6 months and when the doctors eventually took it off I was told it was all fine and no need for any follow ups. It took me a long time to be able to walk again and over the years it has got better. Sometimes if i stress it too much, maybe too much exercise or dancing, the next day it is sore. I have been to a foot specialist and he told me the cartilage is badly damaged and maybe in 5 - 10 years i will need ankle fusion. I am only 30 and was told i can either take it easy and extend that maybe out to 15-20 years or still keep active and have a fun life. I have not change my lifestyle and am still snowboarding, doing weights, bike riding and running and jetskiing etc. My friend then told me about Scenar and I did my research and found a very similar device called Diadens/Denas. It is all based on the russian space program technology and there has been reported cases of people using it as an alternative to knee reconstructions with great success. I also read there is cases where patients have even had cartilage regrowth. I emailed the company which sells the device and was adviced that with my condition then the device can be used with great success. I purchased the device about 4 months ago and have been using it for 16 days, then having a 10 day break and then repeating treatment, which takes me 30 minutes a day. I have had nothing but success from the device, no longer get sharp pains up my leg and when i get up in the mornings, its good to go, no stiffness or soreness. Over time I am also positive that the cartilage will regrow and I will get scans possibly after 1 year of treatment to see if this is happening. I was also watching a documentary the other night about human guinea pigs and noticed they are using similar devices to help people who are paralyed from the waist down. They are implanting an eletrical stimulating device to the spine and it stimulates the good and damaged sides and the person who has it implanted can now move his toes and ankle a little. This gave me great hope as he had not been able to do this since his accident... Even though I bought the Diadens, I have a complete therapy manual for the Scenar so if anyone would like a copy then feel free to email me as this device has so many everyday uses...

[lmc1972]

Hello to you all, what a fantastic website this is! I read quite a few messages on this site and felt like crying my eyes out, finally im reading stories of people who are likely to understand the pain and frustration ive been going through. Im humbled to read of cases that are so much worse than mine and feel bad that ive winged and moaned about my ankle pain when there are so many of you out there much worse than me.
I live in the UK so have to rely on the local hospital for treatment and am unable to afford private treatment, i managed to scrape together enough weekly cash to pay for some private physiotherapy treatment but after spending over £500 i had to stop as it wasn't having much affect. There is no way i can afford an operation privately so have to hope when i see the consultant tommorow he will agree to fusion.
I tripped in Aug 2005 and suffered a full dislocation and triple fractures to my right ankle, i spent a week in hospital and had it pinned and plated, after coming out of the cast i had little movement and underwent alot of physio to no avail, a year later i had an arthroscopy which removed alot of scar tissue and was told by the consultant that my ankle was severley arthritic, my doctor was reluctant to perform a fusion because of my age (i am now 34years old) but after a course of Lithotripsy, and spending loads on different braces and supports i am now at the end of my tether. The pain is unbearable, iam woken at night by it and have to constantly take painkillers to get through the day, my job is getting affected along with my sanity!
Can anyone help me? i am afraid im not going to get any support from my consultant, how can i get him to agree to fusion? Also can anyone tell me what kind of movement they have in their Achilles heel? I get a very severe pain from this area when my ankle is moved just a fraction side to side, an MRI scan has not shown anything untoward in this area and i need to know that a fusion operation will stop this movement, just the slightest knock to the side of my ankle brings excrutiating pain.
Im sorry to have gone on and on but you guys seem the best people to ask as many of you have the experience to help me. Many thanks.

[gowie77]

Have you considered getting the money together and having some Scenar therapy treatment? I feel the 500 you spent on physio was a waste of money and personally think they ripped you off. You should be able to find someone in the UK who performs treatment and a fusion should be your last resort... Try all other avenues before you resort to surgery and I think Scenar would be very belificial....

[lmc1972]

Thank you for your advice, ive read about Scener and had a similar method used during my physio treatment, it wasn't your usual run of the mill treatment, i saw a soft tissue therapist who uses lots of other treatments different to NHS treatment, so i dont feel i wasted my money. It worked on alot of the problems in my ankle, it removed alot of scar tissue and i regained alot of movement in the main joint but could not repair the damage to the Subtalar joint, this is irrepairable. Im a single mum of 2 young children so it is virtually impossible to raise the sort of money needed for any more treatment, im at the NHS' mercy. Thank you for your reply.

[KiraB]

Hi everyone,

Just for those who are considering fusion...there is also replacement (even for young people I am only 26).

I just wanted to say that I had my ankle replaced instead of fused, and am really happy about it so far (I was weightbearing straight away) and have a walking boot, and only use a walking stick outside, nothing inside. I was totally off pain meds after 2 weeks and have no pain. I do exercises without my walking boot on twice a day where I stand up (FWB) and bend my knees, then stand up, 20 times. I have only a little pain from my achilles which was very short pre-op due to reduced ROM. I couldn't even put my foot flat on the floor pre-op.

I don't know how things will go down the road, but I met a guy who was in for his 5 year check up, and he hikes and ski's and all sorts of things and doesn't even notice his ankle at all...so fingers crossed that is me in 5 years!

Anyway I can swim and cycle the day I get my cast off at 6 weeks, and should be playng golf shortly after, and can almost certainly go skiing at christmas!! Awesome!

All the best with everyones recovery!

[Don Nerren]

Amanda
I have had two total ankles done since the age of 19 and many surgeries to work on them for some reason or another. I have had nothing but pain and finally I am going to have this ankle fused on Dec. 5
The Dr said they should not put a replacment into anyone younge than 34. Hed said they will not work and I can say yes to this after having two of them
God bless
Don

[Kandy]

Hi I would also like to know the answer to this question.

I have RA and after a childhood accident where I broke my tibia and fibia bones have got osteoarthritis in that ankle and rubbing bone on bone. I have so many questions as to the after effects and the pressure on other joints. As I have RA in all joints, this is a very scary thing but I can no longer cope with walking even to do the shopping and am about to resort to a wheelchair. It would be an easier decision I guess if I knew for certain that I woud be pain free in that ankle anyway. I guess driving may be a problem as well - with it being my right ankle??? I would appreciate any help?

[Dan ankle]

Thank you for your advice, ive read about Scener and had a similar method used during my physio treatment, it wasn't your usual run of the mill treatment, i saw a soft tissue therapist who uses lots of other treatments different to NHS treatment, so i dont feel i wasted my money. It worked on alot of the problems in my ankle, it removed alot of scar tissue and i regained alot of movement in the main joint but could not repair the damage to the Subtalar joint, this is irrepairable. Im a single mum of 2 young children so it is virtually impossible to raise the sort of money needed for any more treatment, im at the NHS' mercy. Thank you for your reply.

Please let me know how you got on with Nhs or scener tratment, as your problem sounds very much like mine, so I understand how hard it is to get the Nhs to address any problem seriously unless you are dying.
And I know its hard to keep up with the kids, I also have 2 young children and my one year old moves quicker than me!!
You can get a referral to a different Surgeon at a different Hospital, If anyone knows of a good one in the uk????

[andrew1991]

hi my name i andew and i am only 17 and i am having ankle fusion surgry in just under 2 weeks and i was wondring if anyone could give me insight on to how it is going to affect my everyday life and what limitatons and restrictions it will give me

[KiraB]

Hi andrew, I had an ankle replacement, so I am not of much help to you, but I recommend you join the yahoo Group "ankle fusion" the people are really helpful and there are lots of good resources there.

Good luck with the surgery and recovery!

[shedofsteel]

hello everyone i am a 20 year old Engineering student from Warwick university. i stumbled upon this forum while researching for my biomedical materials project. i recently viewed a medical journal on the decision making process doctors take with regards to end-stage ankle arthritis and other ankle related injuries. in the study it was found that ankle replacement the results are much better than ankle fusion but the replacement has a finite life expectancy. the ankle replacement usually last about 10 years and for this reason doctors don't usually proscribe such a treatment for young patients as many repeat replacements would be needed later in life. the usual age at which this proceedure is applied is 55 becuase of the life ecpectancy of the patient in question. if anyone would like more information on this subject please email me and ill be happy to share with you any research i have available, as well as the decision tree used in medical practise. hope this post help out anyone who is considering options for ankle treatment. Dean

[injuryupdate]

I am surprising a lot more people don't go with amputation if young. It sounds like a massive call, but you can run a marathon or a world class 400m time with a prosthesis, and you certainly can't do it after an ankle fusion or replacement. For cosmetic reasons you would go a replacement or fusion but for function an amputation/prosthesis is undoubtedly better.

[Ash82]

Hi everyone,

Just for those who are considering fusion...there is also replacement (even for young people I am only 26).

I just wanted to say that I had my ankle replaced instead of fused, and am really happy about it so far (I was weightbearing straight away) and have a walking boot, and only use a walking stick outside, nothing inside. I was totally off pain meds after 2 weeks and have no pain. I do exercises without my walking boot on twice a day where I stand up (FWB) and bend my knees, then stand up, 20 times. I have only a little pain from my achilles which was very short pre-op due to reduced ROM. I couldn't even put my foot flat on the floor pre-op.

I don't know how things will go down the road, but I met a guy who was in for his 5 year check up, and he hikes and ski's and all sorts of things and doesn't even notice his ankle at all...so fingers crossed that is me in 5 years!

Anyway I can swim and cycle the day I get my cast off at 6 weeks, and should be playng golf shortly after, and can almost certainly go skiing at christmas!! Awesome!

All the best with everyones recovery!
When i read your msg i really felt a big sigh of relief. I have been told that an ankle fusion is the way for me, im 26 and a little worried of the effect this will have on my everyday movement. I hope you still get replies to your msg and after your note i think ill consider the replacement instead. Where did you go for the consultation and how are you going with it now?

[KiraB]

Hiya,
I love my ankle, it was fantastic, I go for walks, go rowing, swimming, play golf, horse-ride, cycled across cambodia at 4.5 months post op. I'm just past a year post op now, it is like I have a 'normal' ankle, but I can't run or jump, which is fine, I have no pain and have found new sports.... I have a thread ankle replacements on here, or check out the ankle replacement group on yahoo groups, is interesting. I ended up going to switzerland, but I live in hk now so that is partly why.
All the best
Kira

[unregistered]

Hi Ash82,
I have had an ankle fusion and will have it reversed in the next couple of years b my surgeon. He has already told me it can and will be reversed into a replacement in the next couple of years. I had a tibiotalar fusion which stops up and down movement. However, I have developed further problems from it as my subtalar joint (causes ankle sideways movement) has severe degeneration at the heel end and there are several bone spurs. The talonavicular joint which is in front of the ankle joint has also developed degeneration. My surgeon is waithing for the mobility ankle replacement to become available in Australia. I have cortisone injections into the foot every 3 to 4 months and had one just before my holidays. I have just come back from Singapore and Hong Kong and the cortisone do help. However, I did alot more walking than normal and become quiet sore. I would ask your surgeon if anything can help put the fusion operation off like cortisone and if possible a replacement, but if your surgeon says you are too young make sure he does it in a way so that it can be reversed and also aski him has and how many ankles he has reversed from a fusion to a replacement.
Judy

[Nessi]

Greetings! This is my 1st post on this forum. I had an ankle fusion 4 1/2 months ago (ankle replacements are rarely done in the US - never at my age). My surgeon said my Xrays look great and that I should be much further along in my recovery than I am (based on my Xrays). I can't wean off the crutches due to severe pain when I try. Surgeon referred to a Pain Management specialist. Pain MD said that there is absolutely nothing that can be done for my pain except narcotics. He told me to consider getting on a long term daily program of Oxy. I said No Thanks!!! Does anyone have any suggestions for pain management other than narcotics? Injections? Blocks? Help!!!!! By the way, I'm currently awaiting approval for a 2nd opinion to pain mgt.

Thank you for reading,

Nessi

[unregistered]

Hi Nessi,
I think you should be off crutches 41/2 months after a fusion, unless something is wrong. I think you should get more x-rays and a ct scan to make sure the ankle has actually fused. I would also be looking for a second orthopaedic surgeon opinion. Do not resort to narcotics unless absolutely necessary, I found it very hard to function at work with narcotics so I use hydrotherapy, and heat pads as much as possible and also try not to over do it with weight bearing.
I hope this helps
Judy

[Nessi]

Thanks Judy!

I've got a call into my surgeon (he's on vacation right now). If he doesn't want to take a further look into why I'm still on crutches, I'm going to consider a second opinion. Ironically, my current ortho is THE surgeon all the other orthos in my area depend on for second opinions and surgical advice. Anyway, thanks for the advise!

Nessi

[Willow]

Hi Nessi,

I am 12 weeks post Fusion and I was off crutches 6 weeks ago. I moved into a cam walker after 6 weeks and I have been walking around without any assistance in normal shoes for 2 weeks. I take a while to get going but when walking now I don't even have a limp. There has been no pain at all throughout recovery. I would request a MRI scan as this looks into the fusion more closely, it may look fused on a an xray, but a MRI looks more closely at the fusion. Don't put up with the pain, I certainly think this is a sign something is wrong.

[millimeter]

I'm new here, just thought I'd tell you that my surgeon kept me on crutches for 3 months after total fusion. It's 10 years now and I have no trouble and no pain.

[millimeter]

Yes, at your age a fusion can be replaced by an ankle joint of course depending on your specific case. I have a fusion (10 yrs od) on my right ankle and a replacement( 4 months old) on my left ankle. At this point I would say that I prefer the fusion but that is not a fair assessment at only 4 months.
Re the fusion, I can walk without a limp, swim, ride my bike, and do almost anything that does not require running. Apparently some people ski but I also have a knee replacement so I can't risk skiing.
My fusion, which was a complete fusion, seemed to take forever to feel "normal" I wore boots, laced up tight for over a year but now I can werar any flate shoe, boot or sandle. My doc floored me when he asked me on the surgery table how high the fusion should be. I didn't even know what he meant but he answered for me and said ,"most are 3/4 "). This means I need to wear a shoe with a 3/4" heel, no higher and no lower. Be sure to discuss this with your doctor.
Today, 10 years later, I am very pleased with my fusion, no pain at all. Before it I couldn't walk a step without sever pain so it would depend on what stage you are at. Please feel to email me at millie.h@hotmail.com at any time. My ankle replacement doctor is world renowned and is in Canada.

[brandonpar4]

HI im 21 and had a shattered ankle about 2 years ago and they tryed to fix it and no go so i had an ankle fusion and its been about 1 year now and i still have very bad pain everyday like 5-6 on a 1-10 scale and the doc says there is nothing can be done i dunno wat im going todo for the rest of my life they say a ankle replacement is 75% failure any ideas on this one

[KiraB]

Hey Brandon, Go and get some more opinions. I had my ankle replacement and it rocks! I have my life back. I don't know where they got the 75% failure from, that just isn't right. It is harder to reverse a fusion than to just do a replacement first, but definately an option to explore. Find 3 of the best ankle specialists who do replacements you can find and talk to them about it. It might not work out for you but you have nothing to loose looking into it.

I'm 27, had my replacement at 26, I had one of the top surgeons in the world, I can have multiple replacements.

Good luck

[ibewman]

I just had my second double ankle fusion surgery! It sucks! I can email the pictures just ask at dogtickman@aol.com.

[bazhulk]

I am 34 years old and I broke my ankle two years ago. Once out of plaster, the ankle never got better - always in pain. I had an
Arthroscopy in September which revealed I had also broken the corner off my talus bone - this had come free into my ankle joint and wore away a large section of my cartilage (and a hole in my shin bone!). My surgeon says I am facing a fusion in 1-2 years time. I am in constant pain and although try various methods of pain relief - find it very hard to be pain free. I am obviously very scared about the prospect of a fusion - feels like a very negative 'step' to take. Although the prospect of being pain free does appeal. Does anyone know if a fusion can be replaced later on in life with an ankle replacement? Should I wait as long as possible to see if there any any advancements in cartilage replacement technology? Most of the stories on the site about a fusion seem very positive - but I am still worried about the long-term affects of a fusion on the rest of my foot and also the limitations a fusion might place on my movement (swimming especially). Help!!!

Hi I am concidering a below knee amputation,its not as bad as it sounds,prostetics will give me 90% mobility again as for this ankle fusion,well the fact i want my leg choped of
must tell you something.If you are ready to retier from life then get the athrodesis.

[fabiocury]

I dont see any reason to consider an amputation without trying the fusion. There are many positive cases in this forum related to the fusion. Besides, depending of the procedure, you will have the replacement option in the future. No need to mention the having your lag amputation cant be undone.

[TashaL]

Hi,

I was hit by a car about 10 months ago and severely fractured my tibia and fibula and shattered my ankle. I've been in an ex fix frame for the last 9 months, so it is hard to be certain, but I think my ankle is pretty much immobile. I am 23 and reliant on the NHS so I'm fairly certain that an ankle replacement won't be an option for me but should I leave that option open for later life? Do you need some movement in order for the replacement to work?

Alternatively should I just jack it all in and go for amputation and a prosthesis? I love to ski, hike and mountain climb. How would an ankle fusion affect me?

Thanks for all the messages. As I'm sure all of you would agree, this is a ridiculously tough decision and I appreciate all the advice.

Tasha

[roseanningeorgia]

Hillbilly I hope you got another doctor and arent still living with that pain..You can have a TAR..the DR. was wrong!

[ibewman]

I have had 4 ankle surgeries including 2 fusions! Im still in horrrible pain!

[KiraB]

FYI for those considering the two options

Better function seen in total ankle replacement vs. ankle fusion at 2 years <http://www.orthosupersite.com/view.asp?rid=41980>

[Blinkybee]

I am so happy to have found this forum. While reading everyones stories I felt like I was reading my life story. This is my chance to share my own story with other people who will understand how I feel.
I broke talus bone into 3 parts as a result of a car accident in 2005. Since then I have had to give up my career as a primary school teacher due to the pain of standing most of the day. Not to mention the change pain had on my overall personality and patience levels.
I have spent the past 4 1/2 years in constant pain, that no one seems to understand expect my surgen.
In May this year I made the decision to finally get the fusion my surgen has been talking about after surgery to remove my screws and remove arthritis did not go well to ease the pain. Now 5 weeks out from surgery I am begining to feel nervous about surgery that will change my life, hopefully. The one thing I am most scared about is the recovery process. I am not sure if I have the mental strength to cope without feeling sorry for myself and effecting the people around me. :(
I guess only time will tell and hopefully all the pain and frustration will be worth it in the end.
BTW I still stand by my opinion that it would have been better to amputate 41/2 years ago.

[peterm]

Blinkybee,

Good luck. I know the recovery process is lengthy but as in all these things just try to accept that
that is your situation and improvement will be slow but will occur. I know it is easy for me to say but
just concentrate on the things that will help your rehab rather than dwelling on the negatives of your misfortune. Whatever it is, it could be worse. Chin up, be strong and smile!

[Blinkybee]

peterm,

Thankyou for your words of encouragement :) The day of my last post I was just having one of those woe is me kinda days. Most of the time I am all good and just go about things as normally as I can. What I have done since the the last post is make an appointment to be my doctor, just to ask all questions that I have found in this forum. So thanks to everyone here, I have questions I would never have thought to ask before, like what angle is my ankle going to be fused at. :P I am sure thats a question most people ask first. Not me, I asked my doctor If he knew what he was going. Needless to say his answer was satisfactory.
I will kept everyone posted on how the operation and recovery goes.
If anyone has any questions they need answered let me know and I can ask them when I see my doctor.

[peterm]

Hey we all have those days! I am nowhere near down the road as you are as far as pain is concerned although I am looking at fusion long term ( or tibial osteotomy!) unless radically new treatments are developed soon. I look forward to hearing about your progress. I know the rehab will be long but just gut it out.

[jean]

Hi folks,
I too am really happy to have discovered this forum. I badly sprained my ankle in 1964. Fast forward to 2004 when I had surgery to remove a loose piece of cartilage that had originated as a cut in 1964, and debride it (clean it up and create the microfractures that would help generate cartilage growth). In 2008 the surgery was declared a success but 2 weeks or so later, I started having sharp stabbing pains that would suddenly disappear (30-45 seconds of pain - severe enough to make me almost fall as if my ankle gave way). Since the consultant dismissed me, I was sent on to another doctor where I was told it was just my flat foot. A year later and constant "deprovement" in physio, I insisted on being sent back to the first consultant, where I presented a written list of the problems over the past year. More MRIs were ordered, and I was later told a cyst (yes, a non-cancerous tumor) had developed in the bone/tibia below where the surgery took place. Now I'm told that the cyst is a "not uncommon" risk or side effect of the surgery. I'm now give the choice of a) 3 extremely expensive procedures (probably in the US, costing 6 figures at least, consisting of removing the tumor and stuffing it with bone grafts, sending samples of my cartilage out for growing and reinserting them, screwing them in place, and then 14 months later, removing the screws) or b) fusion.

Its wonderful to hear that some folks have done well with the fusion - I'd been told by some that hills, ramps & inclines were impossible, and that stairs were very difficult. Unfortunately if that is the case, I will not be able to get into the building where I work -- it is situated in a very hilly area and the entrances either have stairs or small slopes to negotiate.

At present, I'm surviving, and trying to do this without meds -- after so many years on anti-inflammatories, my skin breaks out in hives, and we can't seem to control it at... the foot gets plucked in very icy water 2x daily to try to control the swelling, and so forth. I'm told to try and wait 1-2 years before proceeding on either path.

Any advice or suggestions would be super welcome. I'm really quite frustrated and need to travel 10,000 miles in order to see anyone who might have an inkling of experience in the matter.... Jean

[lynn]

I wish I had found this forum a year ago! My path to having the fusion surgery started last october when I was having a lot of ankle pain and woke up one morning not being able to walk because of a popping in my ankle. Now I know that the popping was because my ankle had fused itself together and for whatever reason that day the self fuse ankle broke apart. After being told by countless doctors that I just had flat feet and need orthotics I found a doctor that quit looking at me like I was nuts and this past march I under went my first surgery. Not the fusion surgery though. The first surgery stitched up a torn tendon- but the doctor assured me this would fix the pain I was having- still I did not know about my ankle fusing on it's own and there was no mention of any other problems with my foot other than the tendon needing fixed. after 2months of recovery I went back to work only to realize the pain was still there only worse than before. At first I was reassured that my foot was healing and I just needed more PT. After being back at work for a mere three weeks my doc told me I had degenerative arthritis and since nothing else was working I needed to have the fusion surgery. (I still think he should have cut it off instead) so in june I had the surgery and I have just been released to walk in a tennis shoe and without cruthes. I've been doing ok this past week but the pain, although not to terrible in teh ankle as long as I'm careful, in the top and side of my foot is almost unbearable. My doc keeps saying it is because the bones in the top of my foot are soft after little to no use since the first surgery in march- but I'm worried. If I am up doing normal household chores during the day, then as soon as I sit down (no matter how long) I can't barely put pressure on my foot because of the pain. I understand that it stiffens up but this is ridiculous! I go back to work in a few weeks and I'm worried about not beign able to do my job. I work in a warehouse and am up for 10-14 hours on my feet. my doc has no plan of sending me for more pt so I'm kinda on my own with this one.
I guess I'm hoping that someone else who had that surgery had similar pain after the surgery and that after a few months it went away? It's just frustrating!

[Blinkybee]

As I promised, here is the latest update. I am now 2 days out from surgery and suprisingly very calm about it. This feeling is due mostly to my recent visit to my doctor. I went armed with all the questions I had from reading this forum and he patiently answered all of them. Asking him to tell me blow by blow what was involved in the operation answered alot of questions on its own. So I highly recommend doing this before surgery or making any decision. Unfortunately for me, once my ankle is fused it is permanent, so no chance of a replacment in the future. My ankle will be fused at 90 degrees, a reflief.
What I wasnt aware of is the muscle deteriation that is going to happen in my calf. So again something to think about.
While in the waiting room I started talking to other people who had recently had thier ankles fused and this made me even more calm as I was able to see how others were doing months down the track. I was glad to hear I would be able to drive after 3 months, meaning I would be able to return to work. I also learnt it is still painfull to walk after 4 months, due to having to learn to walk differently, however the pain gets better each week. I highly recommending talking to others around you in the waiting room, even if it just to have someone else know how you feel.
I will kept you all posted how the operation and recovery goes. If you have nay questions let me know and I will try to answer as best I can.

[crestiksa]

RE: surgery. The ortho said that since it pulls itself back into place that I probably wont need surgery. Well re-evaluate in 3 weeks. Although if I do go the surgery route Im thinking of going for the cadaver ligaments because mine are obviously not working.


Also, anyone please answer, if my ankle isnt swelling or swollen or anything like that should I still ice it? I thought of this question a little late for the ortho and hes only in the office once a week...the big jerk.

[Blinkybee]

Here I am 2 weeks post op and doing quite well with recovery. The op went well apparently, the only set back was my doctor was unable to fuse my ankle at 90 degrees due to my ankle being too stiff. I have to settle for 95 degrees. Pain for the first 3 days was fairly good, pain killers kept it under control. The pain that I found the hardest to handle was when I put my foot down from days 4-12. The blood rushing to the wounds was painful. I have just had my temp cast changed to a fiberglass, much more comfortable. The wounds are healing well and my doctor is very happy with the healing in terms of swelling. I am adjusting quite well to life on crutches and a wheelchair again, however doing much better with going up and down stairs this time. My doctors appointment is in 4 weeks and Will get the remaining stitches removed and a new cast. Will update when there is something new.

[ouch12]

Need info please anyone, after ankle inversion completed 6 months of proprierceptor training only resulting in more pain finnaly mri done and showed 5.5mm bruise on talar, surgery then performed and this is the part i need some help with. His note reads removed quite a significant osteochondral defect in the central and lateral aspect of the talas. How much trouble should i expect in years to come.
Any advise greatly appreciated.

[Blinkybee]

Need info please anyone, after ankle inversion completed 6 months of proprierceptor training only resulting in more pain finnaly mri done and showed 5.5mm bruise on talar, surgery then performed and this is the part i need some help with. His note reads removed quite a significant osteochondral defect in the central and lateral aspect of the talas. How much trouble should i expect in years to come.
Any advise greatly appreciated.

The only advise I could give is you is you will probably be looking at arthritis in the ankle.
I would also get regluar x-rays of your ankle to show any significant changes and to monitor what is happening. I have had regular x-rays and most of the time I knew there were significant changes before I looked at the x-ray because your body tells u when things have changed. Good luck with everything and hope nothing major happens down the road.

[jean]

Need info please anyone, after ankle inversion completed 6 months of proprierceptor training only resulting in more pain finnaly mri done and showed 5.5mm bruise on talar, surgery then performed and this is the part i need some help with. His note reads removed quite a significant osteochondral defect in the central and lateral aspect of the talas. How much trouble should i expect in years to come.
Any advise greatly appreciated.

Hi Ouch12, I wish you the greatest of luck on all this. There are a lot of variables. In Dec 2004 I had an osteochondral defect on the inside area of the ankle removed, got through the period of physio (9 mo), and proceeded to be monitored with annual MRIs. At about 3.5 years after surgery, I was declared a success and "released" by the OS, everything going like clockwork. 2 weeks later sharp stabbing pains developed, occurring irregularly but so strong I nearly fell and would "unconsciously" scream out with pain. Since I'd just been released, the local doctors were not willing to send me back to the specialist, so I was diagnosed as having pains from flat feet and given physio. After 12 months of "deprovement" in the physio, I finally screamed and was sent back to the OS. Another MRI, and I was told I'd developed a cyst in the bone near the original site; other doctors told me this development "was not uncommon" and that it often occurred about this time - but mine had grown extremely fast and now occupied nearly 1/3 of the talar dome. Went to the US and saw famous specialists and other reliable clinicians. Lots of experimental treatments are possible (with huge costs not covered by any insurance available to me), but fusion was the "gold standard". Now I'm hearing that fusion often requires multiple surgeries/attempts to get it so there is no pain. I don't know your situation, but please be sure to ask about the possible risks and possible future developments or side effects from the problem and surgery you've had.
You might ask what started all this? In the mid-1960s I had a bicycle accident and "badly" sprained my ankle - it took 2 weeks to heal but I didn't know then that I'd probably cracked the cartilage in the inside of the ankle. Over the next 40 years that tear or crack worked into a loose piece inside my ankle which was removed in 2004 and debrided at that time.
Right now, I'm just waiting to see what happens. The cyst is extremely sensitive to all sorts of things and flares up easily. The Ortho specialists keep trying to make a cast of my foot and make insoles, which I can wear for less than an hour before the limp returns and the pain gets too bad (and I need a cane to take a few steps). Curiously, a strong tube support for the ankle and Birkenstocks allow me to walk about 6,000 steps daily without pain and without a cane. Go figure why that is!
Hence, there are a lot of variables, and a lot of possibilities. If you get to this stage, you just have to keep trying to find what works for you. Jean

[Blinkybee]

Ok, it is now 6 weeks post op and I have had some emails asking about my progress.
I saw Dr Kuo last week and he is very happy with the progress. There isn't much to update except I had a change of cast. I loved having a good stratch after the old one was taken off. The new cast is alot tighter as most of the swelling has gone down and my calf muscle is begining to break down so my leg is getting smaller. Dr Kuo confirmed 6 months non weight bearing 6 weeks down 20 to go. Good news though no pain!!!!! (except the occassional leg cramp). I havent been pain free for close to 5 years YAYAY.