No ankle cartilage. Help!

[Rebecca]

I am 30 years old. Five years ago I suffered a broken ankle. I had pins, screws and a plate attached and one year later had them all removed in two operations and was told that all went well. I have experienced regular mild pain since and only severe pain after very strenuous activity. I reported this to my doctor and was told that it was to be expected when I pushed my ankle too far. My ankle always recovered after a few days rest. Everything changed this year. I started a job where i stood up most of the time, as apposed to my previous mainly seated job. For the past nine months since I started that job I have had severe pain everyday. I can barely put weight on it in the mornings after sleep and any time after sitting. The rest of the time I hobble about in severe pain. I also have barely any up and down movement in the ankle. After a three month wait I finally got to see an orthapaedic doctor in Melbourne (where I live) who specialises in ankles. He told me I have basically no cartilage left in my ankle and my only option was to have an ankle fusion. After researching this and other options I found that this operation leaves you with extremely limited mobility and leads to further ops in the future as a result of pressure on the other joints. What are my options? Is ankle reconstruction an option for me? Or cartilage regeneration? Or anything non-operative? Please, any advice would be wonderful. I feel that ankle fusion is not an option for a formerly active 30 year old.

[injuryupdate]

Seriously, if you have a missed syndesmosis injury (which often happens in conjunction with fractured fibula), then there is a possibility to get a fusion (screw) between the tibia and fibula to stabilise the joint. This may help - too difficult to explain here and not sure whether it applies to you, but perhaps is an alternative.

I would avoid a fusion like the plague. It will just stuff up your other joints nearby. Wait until ankle replacement is a little better if the pain is that bad.

I know it sounds outrageous and callous, but you would be much better off with an amputated foot than an ankle fusion. Amputees in the Paralympics can run 100m in between 11 and 12 seconds in the men's races (which is a lot faster than me). If they had a race in the Paralympics for those people with an ankle fusion, the winner would limp in at about the 30 second mark. This is non-sensical to me, that surgeons could suggest an option that is functionally so terrible compared to the alternative of amputation. If your ankle pain is bad enough to warrant an amputation, then have it cut off and start training for the Paralympics (because at least you will be able to run again, and fast!). If you suddenly don't think the pain is that bad, then try glucosamine.

[Norm]

Rebecca, I have a similar predicament where I have seen 2 specialists both of whom have recommended fusion, but I am not keen on closing all doors just yet. I would be very keen to compare notes on treatments tried and am also keen to hear from anyone else with any suggestions.

My ankle was operated on several years ago to remove some bone fragments and during the operation it was discovered that the cartilage was worn. Since that operation my ankle has got progressively worse, is starting to lean to the outside and is very painful. I have tried physio, glucosomine all with no improvement.

I would be interested to hear from anyone who has already had an ankle fusion.

[Tom]

Hi, I have had a ankle fusion 2 years ago.

It all started with a dislocted ankle in 1986 I was 17 years old. I had surgery to fix the ankle and after the surgery it seemed ok, but never 100% more like 85 to 90%. I played all kinds of sports after the surgery.

In 2001 I started to have alot of pain in my ankle and went to see a orthopedic surgeon and she suggested physical therapy and advil. I tried both and it did not work. I also tried glucosimine and different kinds of braces. This went on for about 8 months and the whole time I was going to physical therapy. My doctor had mentioned a fusion as a last resort.

It got to a point where every step I took was like walking on a nail. I went back to my doctor and she suggested a different kind of brace and I told her that was it. I wanted to get the ankle fusion because I was in to much pain.

The operation was succesful and I was glad to have it done. The operation was about 3 1/2 hours long and it was day surgery. I have heard that some hospitals will keep you for a couple of days. I was laid up for a couple of months. I have very little motion in my ankle now, but I was glad to get it done. My walking is perfectly normal. I do not were any braces or special shoes.

I know that this is a very difficult decesion to make. I was there. All I can tell you that it worked for me and I am pain free. I have not experienced pain in any of the other joints, but it has only been 2 years.

If you have any questions please ask

[injuryupdate]

Good reply Tom. Post dislocated ankle you might expect pretty severe arthritis which would have meant your ankle could give rise to lots of pain.

It also sounds like you did your research and worked out that you wouldn't have great function afterwards but wanted pain free daily walking etc. which you now have.

Good decision and thanks for the input.

Ironically if you ever wanted to run in the Paralympics you could get an amputation and start bounding away on a new 'joint' that has range of motion, but it obviously would change your life in a way that was completely different convenience-wise and psychologically for example.

Also, if ankle replacements ever become as good as knee and hip replacements, you could still possibly get one done after a fusion (although they would be trying to create a new 'joint' out of a blob of bone rather than out of a worn one).

It is never an easy decision when you have a joint with severe chronic pain and obvious severe abnormality on the scans causing it.

The main point is fusion = decreased pain from the ankle vs. trade off of no function out of this joint (meaning decreased physical activity or pain coming from other joints taking up the slack)

[Rebecca]

Thanks very much for those replies.
I have to let off a little steam first, so please excuse but take heed.
I saw another specialist yesterday. He gave me pretty much the same (bad) news as the first specialist I saw last year but was, how shall I put it? A better doctor. A doctor being someone who is supposed to advise, help and care for their patients. I had such a bad experience with the first specialist I saw last year, it put me off seeing or trusting another doctor. So I haven't until now. Yesterday's specialist spent about half an hour with me examining, advising, listening and explaining my situation and options to me and all in a pleasant professional manner. Wow! If only i'd seen him first! The first person I saw saw me for 7 minutes. In total. He addressed me in a curt manner, looked at my xrays, then at my ankle, told me terrible news I was not at all prepared for and while I sat there in shock restraining tears, he left the room and did not return. I paid my $150 and left, distraught and confused. Then I did alot of research on the web and informed myself. This didn't cheer me up but at least I fully understood my situation.
I am no shrinking violet. I am an intelligent and inquiring person but this still happened to me. Think of all the people who aren't so confident with their communication or language skills. It is not acceptable for some doctors to be negligent in this way. People's health is the cost. Be prepared for this sort of negligence and then move on to a real doctor.
Now that i've gotten that off my chest..
I have a couple of months to decide whether or not to have an ankle fusion. It seems that this is my only option. Like the specialist told me yesterday it probably won't be me but my body that makes the decision. My pain is so severe and my mobility so limited now that part of me just wants the op now but I'm torn. I thought total ankle replacement might be an option for me, it seems to be having alot of
success in America but I was told it isn't advised for osteoarthritis, only for rheumatoid arthritis in the elderly. Which is contrary to what i've been reading about in the states. Aren't we leaders in medicine in Australia? I'm seeing another specialist in June (with the support of the present one) who has actually performed ankle replacements as well as fusions which will be the decider for me I guess. Other treatments such as injections or a brace, which end up doing more bad than good, are only temporary fixes for me. Glucosamine is not helping and above all pain killers don't seem to work on bone on bone pain. As you can see it is all quite a dilemma. Any advice would naturally be great!
In the mean time i'll keep you updated on my progress.

[Rebecca]

Hi Tom,
I was wondering if you wouldn't mind providing me with some more details about your experience with ankle fusion please?
I'm seriously considering having this op and have a couple of months until I see another specialist to seriously consider the implications of this surgery. He has explained which bones are fused and which still have movement but i'm really trying to visualise and I guess try to experience what it will be like. I suppose i'd like to know how natural your normal walking is and also in varied situations, such as going up/down hill etc? What movement you do and don't have? Can you raise your foot like when you stand up on tippy toes? How far can you bend your knees when standing or squating? Do you do any other form of weight-bearing exercise? Anything else you can think of. Too many details is not enough for me! I know the recovery period is around 6-12 months. How was that experience? What sort of physical therapy did you do and for how long? Pain. Do you have any pain at all now? My pain threshold is really high but am not excited about going through a procedure like this and then still having pain. Of course there are no guarantees and I will ask the specialist all these sorts of questions but you're in a position they're not in. You've been through it.
I've had three operations on my ankle already for the original break so I understand that sort of pain and recovery etc. I'm not squeemish either so feel free to be gory if need be!
Any input from you is greatly appreciated Tom.
Thanks,
Rebecca

[John]

Hi rebecca,
I shall have another attempt at replying.
I have had my right ankle fused in august of last year, I have now learnt that I have a possible non union of the fusion and will have to have revision surgery.
I learnt this from a specialist in Melbourne that may be a mate of the one you saw, or indeed the same one!!
I am comeing to terms with the prospect of having to go through the process of doing it all over again. Not such a daunting thought, more the worry of "will it work this time".
I opted to get it fused for pain alleviation and so far, no good. I guess the non union is fully reponsible for this which is a right pain, pardon the pun, I was looking forward to a relatively pain free foot and will have to wait a little longer it seems.
If you wish I can fill you in on the intimate details of the arthrodesis at a later stage.
cheers
John

[james]

Hi Rebecca

I'm an active 50 yr old who was used to climbing moutaineering kayaking and a bit of running. I smashed the lower end of my Tibia in an accident. After it was mended I was left with post traumatic arthritis of the ankle joint. I was offered a fusion but when I did some research it suggested that I wouldn't be able to run and that other joints would eventually suffer. For a while I considered a below knee amputation as the only way to recover full mobility. I got to know a Royal Marine officer with the same problem who had opted for the amputation and gone back in the Marines at full fitness.

However, none of the surgeons would go along with this and eventually one of them introduced me to another army officer, Andy. This man is 36yrs of age and had a fusion 5 years ago following a parachute accident. I met up with him and aked him how active he was. I was amazed! He can not only walk normally but does long route marches with a full pack. He skis, climbs rock and ice and most amazingly he runs (10km in 40mins). He is presently training for a triathalon. He didn't start running until 15mths after his fusion. He uses normal shoes and boots with sorbothane insoles.

Talking to Andy has inspired me and so 7 weeks ago I had a fusion. It was done arthoscopically which is less invasive and has a faster recovery time than open joint surgery.

Andy and I are aware that at some time in the future we may get further joint problems(but it's not always the case). If that happens, below knee amputation is an option but we'll cross that bridge if we come to it.

As for footwear after the fusion I'm going to check out Masai Barefoot Technology shoes. They have a rocker sole and are highly recommended by our local orthotist.

I hope this helps.

Best wishes. James

[Taylor]

Hi Rebecca my name is Tammy and I am searching high and low for info on ankle surgery which may help my partner with his ankles. He broke them both over 20 years ago and is in extreme pain daily. He broke the left one again playing basketball. He is very active and loves his sports, or should I say he would like to be!. It is soooooo disheartening to read the options available. I do know that he swears by a cream call "A little bit of relief" which probably helps more with the arthritis more than his actual ankle problem, but when its a daily thing if it helps its good. He takes tablets daily and our bill for panadol etc is huge!!! (Mainly Nurofen he likes to use). We have 2 young children and the heartbreak is terrible when he can not run and play with them like other dads. As I said we are searching for something but he doesnt even want to have to consider fusion. I dont know if you have read anything regarding frames on the ankle to pull the joint apart thus giving room for new growth of cartiledge, the frame is on for approx 4 months. I only know of these procedure from what I have read on the internet and dont know where this is offered. I wish you all the luck with what ever you decide to do and after reading your letter and others have discovered there are many more in the same predicament. Best of luck with the decisions you have yet to make.

[CudjoeKrew]

My 19 year old daughter will be having experimental ankle surgery this Friday the 29th. The ankle was smashed in a car accident just over a year ago. She has no cartilage and after a year of plates and screws and pain meds is in pain pain pain. Walking is basically a hobble. She was told by numerous OS to that fusion is her only hope. Also that within 5 years or so that she would have arthritus in her foot as a result of the fusion. We checked out all her future possibilities. We applied to Duke for experimental ankle replacement. Note that she is bone on bone and arthritus set in within a month of the accident. The answer from them is that no case study exists for her case and she was rejected because of her young age. We continued on with no health insurance to find a OS willing and agreeing that in two years something more may be available to her. He waved most of his fees, and got a surgical hospital to wave most of it's fees, we pay for the halo-frame, and the cartilage injections will be donated free from the company. Friday he will go into surgery and take the plate and screws that were left in the ankle and prepare the ankle bones and area for injection room. He will pin and screw the halo-frame to her foot and calf and she will undergo several weeks of injections (we love chickens now) the frame should remain on for 2 to 3 months, the later part slowly releasing movement for her ankle and then slow therapy to see how it all went. We are crossing our fingers and ankles on this one. She is cautiously excited. I will keep you posted if you have interest on how this goes. The surgery will be done in Miami, Florida. Good luck to you all as well.

[GEOFFA]

The forum is interesting and should be made available to more people looking into surgery.
I had my left ankle fused on 27 January 2005, I am now walking using a walking stick, a fair bit slower than before but the nail driving into my nerves with every step has gone at last. It had reached the point that every step was agony and pain-killing injections stopped working.
In 1997, the specialist warned me that fusion was a last resort and I reached it.
I am happy to be pain free, am surprised at how much movement I have in the ankle.
I am frustrated that I was unaware of how long recovery would be, and not having clearly explained that getting up too early would delay recovery. As a workaholic, I went back far too soon and wound up with an infection that required further surgery to clean out properly (after I discovered the hard way I am allergic to penicillin)
Was it worth it - YES

[james]

Geoffa, I'd be interested to know more about your experience. I asume you are now out of plaster. I had my fusion in Feb which was done through key hole surgery. Next week it wiil be 12 weeks and i'm hopeing the plaster can come off. Since starting to weight-bear with crutches I've been surprised that I've had a lot of pain in my mid foot and fore foot. It varies a lot depending on what i've been doing. I have a number of theories about it... Swelling inside the plaster may put pressure on joints and nerves.. Other joints are having to move more now that the ankle is fused.... Anyway my consultant doesn't seem worried about it but I sure hope it goes away.

I wondered what your experience was during the first 12 weeks. As I said in a previous entry, I know a man who's had a fused ankle for 5 years. He is now training for a triathlon! It shows what can be done if you've no other problems and you arte determined.

Best wishes

James

[GEOFFA]

Hi James,

Yes I am out of plaster, unfortunately I am a disaster in plaster, I had a reaction to the cast so only had 2 weeks in a walking cast, then wound up slowly weight bearing on crutches with no cast. Yes I had a sore forefoot too at first but now that has gone completely and I have soreness in the Achilles tendon as my body adjusts.
The first 8 weeks were in a back slab and only the two weeks in a walking plaster. When I first took weight on the leg, I thought they had stuffed up because it hurt so much. I rang the physio who said a small amount of pain was normal. NORMAL, I spent three days on Panadine Forte but then it calmed down and now almost 15 weeks later my left foot and ankle are fine the left knee is a little sore but for the first time in 30 years I am walking with almost no limp!
Expect some tenderness in the ankle when the cast comes off and take it slowly but I recommend swimming as soon as you can as it will help rebuild the calf and ankle muscles that will have deteroriated in the cast.
Good luck.

[Cindy]

Rebecca,
I saw your post about your ankle injury and read most of the replies. I had severe trauma to both ankles in a car accident in 1975- I was 24 at the time and am now in my early 50's. Both my ankles were fused and I can do a lot of things and never regretted the surgeries.. One thing I did though was go through over 10 orthopaedic surgeons until I found a Doctor I felt was capable to treat me. If a doctor tells me that "I am either a surgeons nightmare or a surgeons dream" I know I am in the wrong place. Spend all of your efforts in finding the RIGHT DOCTOR. Make sure the surgeon is the BEST one you can find.
I was really bothered by the post from unjuryupdate administrator that told you that you would be better off with an amputation. Why is he deciding that you need to, or want to run in a marathon--he was putting his own criteria for life in his response.

What I Can't Do: can't run or jump--too bad, can't wear high heals anymore but that's ok too. I could however run if a moving train were headed toward me!

What I Can Do: ride a bike long distances, go hiking in the mountains, I ski ( not great but good enough for me--don't rent ski equipment--buy the best boots you can find). Ride a horse.
Last summer I painted the whole outside of my house (1500 sq ft) all by myself. Just finished wallpapering my kitchen and bathroom all by myself.

As far as pain goes - I do have some now and after 4- 5 hours on my feet I am having pain which has gotten worse lately because I let myself get overweight in the last few years. Bad thing to do with bad ankles. But I take naproxyn (over the counter)on a regular basis and it is very effective. I don't take anything else for pain. Sorry to tell you that the surgery is painfull but just tell your doctor to make sure you have lots of pain medication.

Ankle replacement had been mentioned to me and there is no way I would do it based on the high percentage of failures and sometimes last only a few years and not long term at all. And as far as amputation-- there's no way I would do that -- I can do alot of things and I don't need to run a marathon!! Hope this helps. Take care. Cindy

[Cindy]

Rebecca,
I forgot an important thing -- eat right and take vitamin supplements.--if you have access to a nutritionist or go to a health food store and get the information on what you should take. I took mega doses for 3 months before and 6 months after surgery.
All the best to you.
Cindy

[Polly]

Hey Rebecca.. I just came to this site looking for information and trying to find out if anyone has had the surgery that i am going through right now.. I am 19 years old and got into a car accident in January of 2004.. I Broke and Shattered every bone in my ankle and servered one of my Tendons in half.. Well I was doing fine for the first couple of months on Lots of Pain Killers.. and was working as a hostess at a Restaurant {Probably Not The Smartest Thing To of Done}.. Well anyways.. I Went and Researched many doctors in South Florida and all of them told me the same thing.. my only option was to get my ankle fused, until I found one Doctor.. I am doing an experimental surgery where they put a Halo on my ankle and I have 7 pins going through my ankle and calf and they injected me with 5 injections of Rooster Cartilage.. I have had it on for a 1 1/2 months and have had all of my injections.. i already feel more movement and less pain than I had before.. I get the Halo off in 2 1/2 weeks.. So far the Cartilage is adapting to my bones.. and we are only waiting for them to take it off to find out if the Cartilage holds.. Hopefully it will.. but i have heard many people talk about how they got ankle fusions and everything went well.. but because of my age.. I figured I'd let them experiment on me so that if it works.. it could help others also.. So in 3 weeks I will come on and let you and everyone else know how it went.. My fingers are crossed.. Just letting you know that there are other options I dont know exactly your condition but if it can work for me I'm sure it will work for others.. They're only specific Doctors able to do this experimental surgery and I was told many times that I didn't have any other options.. Goodluck.. I will keep you Updated.. - polly

[Cindy]

Hi Polly,
I read your post about the experiment to get cartilage to grow in your ankle and I would be very interested to know what the names of the doctors and the hospital that are working on you. Although I had both ankles fused (Talus bones) many years ago and have done quite well, I am in need of cartilage regeneration between the tibia and the talus bones (this is not the part that was fused) that has worn down and is causing pain now. (I didn't know until a few years ago which bones were actually fused). Please let me know who is doing the experimental work on you and how things work out for you.

All the Best to You,
Cindy

[jason cook]

Gidday, Im Jason cook I have been reading all of the comments on ankle fusion with interest. I am recovering from a fall from a horse where I had a compound dislocation of my ankle.It snapped all ligaments and damaged all the inside of my ankle,soft tissue cartilage etc. My orthapedic surgeon has told me that it is most likely I will need an ankle fusion. I would like to know if there is anything I should be doing now to maybe limit or daley the pain. The accident happened 8th October this year, I have just got out of plaster and go pack to the doctor in 2 weeks when we will then start physio. I am not aloud to put and weight on it until I go back to the doc.Any info or advice would be great.
I live in Gatton Queensland but if I had to travel interstate to see experts in this field I am willing to do so.

Thanks
Jason Cook

[Rebecca]

Wow!
Really impressed with the input from everybody on this subject.
It's been invaluable to my decision making process.
Thanks so much to everyone for your stories and advice.
Glad to see it's helped others too. I agree that this information should be shared more easily but am glad to have the oportunity to talk about it at this site.
I've just seen the last specialist on my list and as they say, three's the charm.
I'm going to go ahead with a fusion. There are no other options open to me at this stage (in Australia) and I have been told it will still be possible for me to try alternative operative solutions in the future if i'm not happy with fusion.
It will be done arthroscopically (key-hole surgery) which means less trauma on the limb and the rest of me too, i'd say!
Still a 12-18 month recovery period though.
Total ankle replacement is not an option for me at this stage but if the durability of the prosthesis improves in the next decade or so I can still give it a whirl then.
I'm very happy with both the specialist and his team. I feel completely confident that i'll achieve the best result I can with him doing the surgery. His operative and post-operative plan for pain management and rehabilitation of the limb is well constructed and reassuring.
In the last couple of months i've been wearing a brace when appropriate and using a cane as my ankle started just collapsing without warning and also the pain has been getting too much.
I look forward to walking without these "crutches". It makes me almost look forward to surgery.
It has been inspiring to read all the stories of people's capabilties after fusion.
The extent of activity is surprising and wonderful.
Even though this problem is relatively rare -i've just found out my lack of cartilage resulted from some bone being sheered of the side of my ankle when the break occurred. This is not what happens in most ankle breaks- it seems there are quite a few people in the world who are trying to find new and improved ways of helping people in our predicament. Whether it be through improved ankle replacements, synthetic, cadaver donor or ROOSTER (amazing!) cartilage regeneration or by stimulating the bodies own powers of cartialge regeneration.
There is a lot of hope for us and for the future.
Best things i've learnt thus far:
-Get as much info from as many sources as possible
-Find a good doctor you can relate to, trust and understand
-Stick to your recovery plan until the very end
-Have the surgery when it's best for you and your support network
-Put healthy things in your body to aid the body's healing process and plan some recovery activites to keep the mind and heart happy also
-If in doubt at any stage always ask for help and don't take no for an answer (especially when in pain)!
Now I just have to stick to my own advice!
I'll be having the surgery in the next month or so and will keep you posted.
Thanks again everyone.
Rebecca

[John]

Hi All,
Its interesting to hear of all the experiences of ankles and damage done to said ankles.
It seems that we follow more or less the same path ie we opt for an ankle replacement prosthesis and then find that our orthopaedic surgeon doesnt reccomend it. I was told I couldn't have one because of my age (50ish) so the only treatment was a fusion to relieve the pain of walking.
It also seems the same for most is the lack of cartilage!
I have had 2 fusions done to the same ankle now, the first was a non fusion and the second operation was revision surgery to have another go at fusing it. Too early to gauge any success so far but the foot feels better than the first fusion.
The fusion (2nd) used a method called the Blair Slide which use a bone graft from the hip. This is I think inserted into the front of the joint to promote stability and bone growth. I was prepared to accept any method as long as it makes it possible to walk with diminished pain again.

Inotice in the early post in a reply to Rebecca, that the Moderator suggests an amputation. I would suggest this as an absolute last resort and would fight tooth and nail even then. I have thought that if this fusion fails as well I may look at amputation until I read what amputees have to put up with, for instance, bleeding and ulcerated stumps, having to clean the area all the time, phantom pain etc. No doubt its a method of walking but I have seen one-legged people on crutches and no sign of a prosthesis. Again I speak with no authority but I am attached to my foot as bad as it is and would hate to see it gone.

I now look at people walking normally in the street and often think that they dont realise just how easy it is to lose that easy mobility. I just we all get some of our back
cheers
JJ

[Cindy]

Hi John,
I read your post and as I had posted previously, I have had both ankles fused ( 3 fusions ) about 25+ years ago. I had a failure to fuse on my right ankle and had it done the second time which was successful -- that was when I was taking mega doses of vitamins ( I went to a nutritionist). I also went through about 10 - 12 different doctors until I found ones that I felt knew what they were doing. (about 4 years searching). I had one surgeon who told me "that I was either a surgeons nightmare or a surgeons dream - and the best that I would ever do is a brace and a cane" and I replied, "the problem is not with me, it's with you. You are not qualified to treat me and you won't admit it". (Another time I'll tell you about another surgeon who raced me down a long hallway in my wheel chair pretending to run me into a brick wall - he thought it was funny - I wasn't laughing). I did have some weird experiences.

On the subject of ankle replacement, I don't think the technology is very good yet -- too many failures (and some amputations)-- I recently spoke to some of the people involved in this procedure and was told that I am too young -- I am 54 and the reason is, that the artificial ankle does not last long, so this particular doctor (Saltzman) recommends it only for people that are much older and won't need it very long. (not encouraging). But what I really want is cartilage not an artificial ankle, not an amputation.

My fusions have done very well for me for over 25 years - I had my surgeries at 2 of the top research hospitals in the US -- UCLA, Los Angeles, California and Barnes Hospital in St. Louis, Missouri. I also had bone grafts (from my hips) not only for the fusion but also because parts of the bones, I was told, were actually dying. Now the cartilage between the tibia and the talus bones has been pretty much been squished to nothing from being quite active all these years and now I have more pain -- but all along I knew I would need something more, eventually.

The good news is that I did find some great research being done on cartilage regeneration at Stanford University in California and in Europe. (I live in California so that's good for me). Here's a few links to the sites:

http://med.stanford.edu/profiles/r_smith/

http://med.stanford.edu/bioengineering/research/regenmed.html

http://www.arthritis.ca/programs%20and%20resources/news%20magazine/1996/transplants/default.asp?s=1

The governor of California (Arnold "The Terminator") appropriated 3 billion dollars to stem cell research even though Bush won't spend federal money. When he (Bush) finally gets out of office and we get a President with a brain, hopefully more money will be spent on stem cell research for many different diseases that can be cured with this type of research.

On the subject of amputation, my brother lost his leg at the age of 22 back in 1971 and has had many problems over the years. He did well for some years but as time went on he had many problems. He couldn't even wear his prosthesis at times. While I was in my search for an orthopaedic surgeon early on, my brother even suggested amputation to me. ---- I too, am attached to my feet.

I am confident that this cartilage regeneration research is going to be successful in the near future and if we get it here in California, I don't think it will take too long for the technology to get to Australia and worldwide.
- hey, didn't they put men on the moon some time back?

Good luck with your latest surgery!!

Cindy

[Cindy]

Hi Rebecca,
I didn't see your note right away as it was sent private and I need to change my options on the site.
On the subject of running and jumping -- the reason I can't do it is I am afraid to - but probably can't even if I tried jumping --just doesn't seems like I want to put too much pressure on them. When I was younger and took aerobics classes I tried a little light jog and was able to do it but then realized it was not a good thing to do. You want your ankle to hold up for walking and living.

I was in Mexico about 10 years ago and went para sailing over the ocean but I made sure that the Mexican guys on the beach caught me when I landed so I didn't land hard and screw myself up. These bones are damaged and very fragile so I try to baby them - I took me a long time to get fixed so I don't go out of my way to mess them up although I have taken some chances. I always wanted to sky dive but that's definitely out too.

As far as the effect on the other bones in my feet - I really don't know because so many of them were injured in my accident, it's hard to say which came first the chicken or the egg. In my accident my right ankle was pretty much crushed by the engine that was pushed up to the front seat. My left ankle was almost completely severed and was almost amputated at that time. ( a doctor found a pulse in my foot with headphones) so they tried to save it. This is unusual, but the fact that I did not have a seat belt on probably saved my life because I ended up in the back seat and of course broke many other bones as well (hip, pelvic, tibia, several ribs, a fractured skull and broken bones in my face) what a mess! The only thing that was long recovery was my ankles. By the way, I do recommend using a seat belt.

Back to your concerns- you will not be completely normal if you have a fusion but you can still have a lot of fun and do a lot of things. I personally do not miss jumping, and running well maybe you will be able to - ask your doctors what they think. Also - just so you'll know, for the most part, for all these years I have walked really good without a limp - most people have no idea that I have had problems. My surgeon at UCLA used to call other doctors in to look at my xrays and then tell me to show them how well I walked - he was proud of his work.

Good Luck
Cindy

[John]

Hi Cindy

Thanks so much for the reply, it really is a comfort to hear of other people going through the same experiences.

I'm sorry to hear that you have had such a horrific car accident and the all the pain & recovery you have had to go through. Did you ever get any compensation?

We are the same age too by the way. I'm guessing that my age may have a little to do with the rate of fusion taking place. The surgeon said that the previous fusion was very fibrous and softish, therefore I had micro-movement between the talus and tibia. In X-rays, it looked like it had been spot welded with distinct dark lines still in the joint meaning that there was minimal growth.

I know I was ignorant when the surgeon explained to me that I had lost the cartilage. My reaction was "well it'll grow back". I'm certainly educated now on the workings and damage that can happen to an ankle. And you had TWO to deal with. So I guess when we have damage to the extent as most of us on this forum have, then fusion is more or less the option we are left with. By all accounts, talking with my surgeon is that we will lead a normal walking life, although I hear whisperings from well- meaning friends that I will have ongoing trouble with knees and hips because of the abnormal gait. Has this been the case with you Cindy?
I got into the habit of throwing my bad ankle sideways when I was walking to alleviate the need to bend at the nuvicular joint. This in turn put undue pressure on the knee and every now and then it would lock out causing a near fall or a bad stumble. I'm hoping that the revision and hopefully lack of pain will allow the gait to relatively normal!

I'm glad to hear you have done research into both your surgery needs and cartilage replacement. I have no doubt that it will come or there may be synthetic cartilage. I'm also glad to hear of your concernd with the Bush Administration. We in Australia were vehemently opposed to the war in Iraq but out prime minister blindley followed wrong advice and went in to a war without end.

I had a smile with the experience of being "hurled at a brick wall". My surgeon is fairly circumspect, so I'm not expecting similar treatment, I hope!!!

I hope we are not frightening those on the forum who are yet to have the surgery done. Dont worry about the pain, todays nursing is so advanced in pain management that it is rare to go through any severe pain. The worst I have had is the nerve damage done in the bone harvested from my hip, apparently the iliac nerver gets damaged and creates numbness down the outside of the leg. My leg is still partially numb after now almost 6 weeks post-op. It is improving tho.

I shall let the forum know of my recovery and fingers crossed, the success of the revision surgery. So far it feels a heap better than the last time although I am yet to weight-bear. Just so sick of wearing the ski-boot and sitting down in the shower. But these are minor niggles.
Again Cindy, thx for the info, you have made the day a bit brighter.
Cheers
John.

[GEOFFA]

Good afternoon,

It is finally wet in Sydney and although the traffic will suck, my dams at work are full!

I thought I might update those who are considering fusion and John you are quite right, the pain is a side issue really and I was lucky, due to the old injury there was enough bone in the ankle to use in the fusion- so I didn't wind up not sleeping on one side only!

Seriously – My fusion was done on 27 January this year, everything except the bone bit went wrong, allergic reaction to the cast, allergic reaction to the penicillin, infection on the wound BUT…. While the tendons shrunk because of the delay in getting to physiotherapy it is wonderful to have no constant pain. My ankle even kept me awake at night.

Now while I avoid down slopes wherever possible, walking is a whole lot less painful than before operation. I finally got back in the pool again yesterday and managed 200 meters again no pain. I used to swim 1 to 2 kilometres until the ankle became too painful now I have to rebuild fitness and loose some weight at last.

I guess what I am saying is that while there may be some drawbacks initially, I am very pleased I had the fusion and my best advice so far has been that it will continue to improve for at least another 6 months from now. So if I am pleased now imagine how much I have to look forward to!

Just make were you ask the right questions about the surgeon because there are a few out there that shouldn’t be doing this type of work. A good one is not cheep but it is money well spent….

Oh and John, not all Australians happen to disagree with Howard but at least we can disagree here without looking over our shoulders all the time…. :-)

Cheers
GeoffA

[John]

Hello Geoff,
Isnt it great to see the rain, although the people on the Nth Coast and Gold Coast would be saying that 20" is enough thank you.
I have been working in regional development where water and lack of has been such an issue.

I have read your posts about the reactions to your treatment. That would have added an extra dimension you didn't need. I like your idea about rehabilitation with swimming. I dislike exercise intently but swimming is halfway pleasant to do.
My physio told me that we will partially lose leg muscles because of the restricted movement, particularly the calf muscle. So I guess exercise is almost a pre-requisite if we are expecting to gain near full mobility!
I dont know if its common to others that have lost mobility to gain weight? I gave up smoking on the day of the accident and the inactivity means I have gained around 15kilos and that, no doubt does not help with walking on a freshly fused ankle. I used to take our dogs walking almost daily and that has not occured in nearly 3 years.


I wont follow the thread with politics and our illustrious PM Geoff, we will agree to disagree. And yes you are right, we take our way of life for granted.

On the 4th July, I go for a CT scan and will have some idea then how successful this surgery has been. I will keep the forum informed for others that may be going through similar issues. I find that it is cathartic to share our experiences.
Look forward to hearing from others.
Cheers,
john.

[Faizel]

Hello Rebecca

I'm a 31yr old SA male who also had to make this decision. I had the ankle fusion done on 27 May 2005 andthere are about 2 weeks left for the cast to be on. Although I have the discomfort of the cast, I have to admit the the pain in the ankle is virtually gone. I do believe that I will have limited movement in the ankle, but I do take strength from Norm's msg.

I would really like to hear from anyone who is playing sport after having this op, particularly cricket. I can't seem to find alot of info on playing sport of having this procedure.

Rebecca, one last thing, your specialist was right, your body will tell you... all you have to do is listen to it...

[Faizel]

Found some kwool info regarding the whole fusion process... check out http://www.blackburnfeet.org.uk/patient_information/operations/ankle%20fusion_pat.htm

Cheers

PS Rebecca

Goodluck with the op

[rep]

Polly,
There are a few more procedures you should be aware of. Having had more ankle injuries than fingers, I have personal and profession experiences. Being as young as you are, deplete all your options before you fuse because there is no going back once you do it. I've had 4 ankle surgeries within the last 7 years and I'm thankful for my health. There are many disable or paralyze people out there that would trade spots with us. Fusion is not the end of the world but deplete all your options. Your current procedure uses Hyaline cartilage injection called Supartz or Synvisc? with an Ilizarov frame (I use to promote this to OS). There is a procedure that uses donor (cadaver) cartilage you should look into and it goes like this; You get on a waiting list and wait for a donor. The wait is typically not long because the ankle is not use often. An osteotomy of the malleous (inside of your ankle) is performed and your ankle is turn 90 degree exposing both surfaces (top of foot and bottom of tibia). This surface is rasp to induce bleeding of the bone and the donor cartilage is transplanted to the ankle. It's stitched on and eventually incorporated as part of your ankle. You are nonweight bearing for 3-4 months to ensure the sure set. I have a friend who I recommended the procedure and is doing execellent after a year (he was bone on bone). This will be my last resort before a fusion. Good Health Polly...Aloha!!

Hey Rebecca.. I just came to this site looking for information and trying to find out if anyone has had the surgery that i am going through right now.. I am 19 years old and got into a car accident in January of 2004.. I Broke and Shattered every bone in my ankle and servered one of my Tendons in half.. Well I was doing fine for the first couple of months on Lots of Pain Killers.. and was working as a hostess at a Restaurant {Probably Not The Smartest Thing To of Done}.. Well anyways.. I Went and Researched many doctors in South Florida and all of them told me the same thing.. my only option was to get my ankle fused, until I found one Doctor.. I am doing an experimental surgery where they put a Halo on my ankle and I have 7 pins going through my ankle and calf and they injected me with 5 injections of Rooster Cartilage.. I have had it on for a 1 1/2 months and have had all of my injections.. i already feel more movement and less pain than I had before.. I get the Halo off in 2 1/2 weeks.. So far the Cartilage is adapting to my bones.. and we are only waiting for them to take it off to find out if the Cartilage holds.. Hopefully it will.. but i have heard many people talk about how they got ankle fusions and everything went well.. but because of my age.. I figured I'd let them experiment on me so that if it works.. it could help others also.. So in 3 weeks I will come on and let you and everyone else know how it went.. My fingers are crossed.. Just letting you know that there are other options I dont know exactly your condition but if it can work for me I'm sure it will work for others.. They're only specific Doctors able to do this experimental surgery and I was told many times that I didn't have any other options.. Goodluck.. I will keep you Updated.. - polly

[vanessa]

Tom, just joined injury site and saw your old message...I am having another fusion next week. Had one 2 years ago and things were good until recently. How are things with you now and how long was your recovery this time???

vanessa

[Rebecca]

Hi everybody,
I had the fusion done on the 4th of August. The fusion was done in the morning and i was released from hospital the next day in the afternoon, as i was doing really well. During the operation, I was given a nerve block (which was injected just under my knee) to help with the pain when i came out of the anaesthetic. I was quite emotional when i came to. Which i'm guessing is becuase all of this has been such a long time coming, although i certainly couldn't work it out at the time (drugged haze an' all). I don't normally have tearies when i'm coming out of a general! So when that finally stopped, the vomitting started. For a good 6 hours. A lovely reaction to the morphine. I was warned about not having any feeling in my lower limb (from the nerve block) but it turned out I could actually "feel my leg". I had pain but I was only getting a small amount of what was really there. The nerve block was really amazing. I didn't start having any real pain until about 9 or 10pm that night (had the op around 11am) and even then I was only on Pandeine Forte which i took every four hours from then on. I'd get to about the third hour and know that i must be due soon, so it was pretty good. When I was in the hospital the first time after my accident I had so much pethadene i was like a black and blue pin cushion. They were even injecting into my tummy! So this was nothing. The next morning, apart form feeling exhausted from op and from being woken every couple of hours, I felt great! The fact that they had finally removed the drip and the oxygen certainly made a difference too. I was also treated really well by everyone i came into contact with in the hospital. The nurses were wonderful! In the past i've been mistreated in hospital, so i really believe that the high level of care i received this time made it possible for me to leave hospital earlier than expected. So i left the hospital with a back slab cast and crutches. When i got home i took Pan Forte for a week and was then able to move onto Nurofen, as the pain was quite tolerable. After 2 weeks of only leaving bed for the bathroom (being waited on hand and ankle - haha!), I went back to have the cast and sutures removed and got the lovely cam walker on and was instructed to continue to not weight-bare and just go through the motions of walking, by imagining every "step" i take on buggered ankle is like i'm stepping on a cherry tomato and not even bruising it. With crutches, of course. Sooooo good to be able to take the storm trooper boot (as in star wars- yes, i'm bored!) off to have a bath and at night to sleep! I was expecting another cast for 6 weeks and we all know how frustrating those things are! I'll see my doctor in 6 weeks with an x-ray and will find out then how it's all coming along. I didn't find out much last week as i only saw a nurse, except that i had fibrosis in there too (as well as lack of cartilage), which is to be expected considering my past ops and length of time this has been going on. I also have five "portals" in my ankle, instead of two and i got the feeling something else wasn't as they expected it to be but my doctor is the person to ask about all that, so i'll wait until then. When the cast was removed i thought the ankle looked great (again comparing to the past) but the nurse was not impressed with the amount of swelling and bruising. She put that down to my past ops and trauma.
So here i am, down to 4-6 Nurofen a day and doing pretty well. Now that i can leave my bed i feel a lot more sane. I 've got some great friends who visit me and take me out and about a bit and of course my mum who i couldn't do with out. I may be able to get around on crutches but as far as carrying anything from A to B. Nightmare. I did have one night alone where i was nudging a bowl of noodles along the floor from the kitchen to lounge with my crutch. That was interesting!
Someone mentioned weight and exercise in previous posts, This has been on my mind also. As my pain increased in the past 18 months I couldn't exercise (heck i could barely walk) and a result gained weight. 20 kilos to be precise. I know my body very well and cannot lose weight without cardio.v. exercise and have been looking into some options. Swimming isn't really an option for me as i'm allergic to chlorine and it would be too early for something like that anyway. So, other upper body exercise? Weights and ab work is fine but not really cardio. I am looking into a "Upper Body ergometer" which is like a bike for your hands. It does apparently produce a low to medium cardio.v. workout over a half hour. I'm going to try and rent one from somewhere to give it a whirl. Lugging around all this extra weight on crutches aint fun! If you can swim, use a floatation device for your legs so you only use your arms until you ankle is stronger. Water aerobics is also good if you tell the instructor about the injury. I'm also thinking about doing a Tae Bo video i've got only using my upper body (i'm getting desperate now!). Good luck to all with upcoming ops and who are recovering. Thank god we have each other! I'll keep you posted with more news after i see my doc.
Happy hoppin!
Rebecca

[SPK]

Congrats Rebecca.

It sounds like it all went well for you and I hope it continues to do so. It certainly doesn't sound like a pleasant thing to have done, but you're happy and I hope you get the results you want.

With regards to the Upper Cardio exercises you talked about, have you considered purchasing one of those large rubber exercise balls that Physios use?

A good mate of mine was off his feet for awhile and couldn't do pretty much anything, so he bought one of those balls. It came with a book that had all stuff to do for your upper body and looked like a pretty decent workout. He lost the weight, but he also started dieting, so I'm not sure how effective it truly was.

I have no idea if you'd be able to do something like that but I guess that's something for you to find out.

The ergometer sounds pretty good too. That's probably worth a shot.

Anyway, good luck with it all and I hope it goes well for you.

[Tom]

Tom, just joined injury site and saw your old message...I am having another fusion next week. Had one 2 years ago and things were good until recently. How are things with you now and how long was your recovery this time???

vanessa
Hi Vanessa,

Sorry for such a delay... I lost the link to the web site.

Things are going very good. I am still pain free. I have occasional soreness, but nothing major. Im still glad that I had it done. I am limited in physical activities such as jogging, basketball, but I do play golf once a week go biking and walking. I may try skiing this winter.

[frankm]

Hi, my name is Frank and I am a 52 yo HIV+ Aussie living in Palm Springs, CA (24years in the US). I have acute arthritis in both feet. I had a partial knee replacement in Feb 04. I have had increasing pain in that ankle since then. I had an Xray and found the ankle has no cartlidge and the other foot has spurs. My podiatrist had me get an MRI to find out the extent of soft tissue damage. He immediately refered me to an osteo surgeon, so I am going to the same guy who did my knee, in an hour. I have received a plethora of info from the postings on this site and thank you all. I currently take 5 different pain killers for pains in different parts of my body. I don't know what I am going to do but I think now that I won't consider the ankle replacement option yet. I exercise 4 times a week to help rebuild my body after wasting syndrome took me down to 118lbs in the mid 1990's, so my legs are in fairly good muscular condition. But, every time I lie down and then get up, I have to wait until my leg calms down and I can then put pressure on my leg. It seems to get better after walking a bit, but my ankle is swollen and I use lidocaine pain patches at the end of the day so I can sleep. I will keep you up on what happens today. Thanks to you all for all your input. I was amazed to find out this site was Australian! It gave me a boost!
Frank

[Unregistered]

I've busted my knee several times. I started using this product called flex-force. It helped to lubricate my knee joint. Try it, see if it works for you guys. Go to www.flexforceworks.com. Hope this help!

Bill

[Unregistered]

I've busted my knee several times. I started using this product called flex-force. It helped to lubricate my knee joint. Try it, see if it works for you guys. Go to www.flexforceworks.com. Hope this help!

Bill

[frankm]

I've busted my knee several times. I started using this product called flex-force. It helped to lubricate my knee joint. Try it, see if it works for you guys. Go to www.flexforceworks.com. Hope this help!

Bill
Well, my appt was changed and so I waited. When I went to my surgeon and he said that surgery was the last option that he wanted to take. He explained as much as I was able to understand. Fusion was not what he wanted to do if he could avoid it and rejected ankle replacement out of hand. He said that I have severe arthritis in both feet and all the cartilage is gone and it ain't gonna grow back! However, he said that there may be something and he is going to look into what options that I may have and sent me on my way. He gave me an injection of something, directly into the ankle and the novacaine worked great and there was not pain for a few hours - oh, what a relief! When the novacaine wore off the pain came back, but I was able to walk easier for a few days, but there was no major improvement for long.
Thanks Bill, I will take a look at flexforce and see what's up.
Frank

[Unregistered]

hi , Just a small question , how long did it take for you to recouperate from the ankle fusion surgery? Ie , how long were u in plaster, and after the plaster was removed, how long before you could walk or go out shopping etc?
Thanks a million,
Jeanette
PS: pls send me a copy of your reply to fernandes@perceptivei.com as I am a sailor and often do not get a chance at web access.
================================================== =

Hi, I have had a ankle fusion 2 years ago.

It all started with a dislocted ankle in 1986 I was 17 years old. I had surgery to fix the ankle and after the surgery it seemed ok, but never 100% more like 85 to 90%. I played all kinds of sports after the surgery.

In 2001 I started to have alot of pain in my ankle and went to see a orthopedic surgeon and she suggested physical therapy and advil. I tried both and it did not work. I also tried glucosimine and different kinds of braces. This went on for about 8 months and the whole time I was going to physical therapy. My doctor had mentioned a fusion as a last resort.

It got to a point where every step I took was like walking on a nail. I went back to my doctor and she suggested a different kind of brace and I told her that was it. I wanted to get the ankle fusion because I was in to much pain.

The operation was succesful and I was glad to have it done. The operation was about 3 1/2 hours long and it was day surgery. I have heard that some hospitals will keep you for a couple of days. I was laid up for a couple of months. I have very little motion in my ankle now, but I was glad to get it done. My walking is perfectly normal. I do not were any braces or special shoes.

I know that this is a very difficult decesion to make. I was there. All I can tell you that it worked for me and I am pain free. I have not experienced pain in any of the other joints, but it has only been 2 years.

If you have any questions please ask[/QUOTE]

[barry]

Hi Everyone
My name is Barry and I have just turned 36.
I am a very active person enjoying football, golf, diving, surfing etc.
About 12 years ago I sustained an ankle injury quite severe and was unable to walk for a couple of months. The hospital said it was just a sprain so being a stubborn male I just lived with. I carried on doing sports until abot 6 months ago when the pain became to much. Since the original accident the ankle hasremained swollen. I went to a specialist and he did X-Rays, MRI scans and Ultrasound to understand the dmamge. The ligaments on the outside and inside of my ankle are completely torn resulting in the leg bones over rotating around the ankle joint. This has caused the cartlidge on the top of the ankle bone and the bottom of the leg bone to be damaged. At the end of September I had an arthroscapy and during the procedure my surgeon drilled holes in the areas of the bones where the cartlidge was missing. The idea being scar tissue will grow back to componsate for the missing cartlidge. He also discovered arthritis in my sub talar joint. I went back to see him today where he dropped the bombshell that the only I may have is ankle fusion. Well I have just got home and am beside myself.
I really don't know what to do next and there seems to be contradicting reports on this site. Once fused how much up and down pivot movement does the ankle have? Can it pivot side to side? How about sports like swimming? Will I be able to extend my foot outside so I can wear fins when diving?
All answers gratefully received. I live in the UK and am considering STAR ankle replacement as an option.
Thanks

[frankm]

Thank you for your reply. In the past couple of weeks I have been having more pain than previously. I tripped getting out of a friend's SUV ( I have a low vehicle) and the pain almost sent me mad. Since then it has been pretty bad and I may rethink my options. I appreciate your help.

Frank

[kim]

Hi Rebecca,
I have enjoyed your informative emails however I am awaiting an update from you about the fusion. I am booked in for next Thurday.
Hope all is well, can't wait to hear from you.
Kim.

[Alinoz]

Hi All, my name is Alan and I'm in a similar situation to most on this site in that I've been recommended for Ankle Fusion. I damaged my ankle and broke my leg playing soccer 8 months ago. The leg had screws and a plate put in and seems ok (apart from the screws being too long and stick out of the other side of my shin). The hospital have ignored my ankle for the last 7 months just telling me to rest it. I have since seen a specialist who thinks I've damaged my Subtalar joint and the only thing he can do is an ankle fusion.

Having read most of your replies I am a little supsicion about the diagnosis because I can walk without pain, run, jump etc. After running for a while my ankle will be sore for 3-4 days but nothing chronic.

So, after looking around for an alternative treatment I came across something called Prolotherapy. I only know what I have read on the web but am due to see a Musco-Skeletal Specialist who uses Prolotherapy in his treatments in 2 weeks. I'd be interested to hear if anyone reading this forum has tried Prolotherapy. It seems more suited to Ligament/Tendon damage to bone damage but I'm prepared to try any non-surgical treatment before fusion. I'm even prepared to play sport in pain rather than lose the ability to play sports at all.

Here is an interesting article I found during my research.

http://www.getprolo.com/ankle_fusion_alternative_prolotherapy.htm

Would love to hear more success stories.

Take Care.
Alan.

[Adrian]

All this talk of amputation sounds so primitive. There seems to be other options available to fusion and amputation. Try researching cartilage replacement

Patients with large and well-localized cartilage and bone loss may benefit from resurfacing of the bad part of the joint. The joint is usually evaluated with an arthroscopic camera and then the region involved is resurfaced. Most commonly "plugs" of cartilage and bone are removed from a part of the knee and placed into these areas.

Occasionally, cartilage cells are removed and sent to a laboratory to be expanded and then reimplanted. For very large cartilage problems on one side of the joint, a cadaveric transplant of cartilage and bone can be used. The surgeon often needs to cut part of the bone to gain proper access to the ankle joint for these procedures. In these cases, screws are used to hold the ankle bones in their proper alignment while healing. Patients are usually admitted to the hospital overnight after these procedures. The recovery period usually involves two to four weeks in a splint and six weeks of crutch use to take weight of the healing ankle.

[Unregistered]

I am 32 years old and had my ankle fused 5 years ago. My experience is this ... after an ankle fusion you will only have the up and down movement provided by the joints in the front of your foot (minimal - enough to press the accelerator in a car). Slow swimming is OK but strokes such as freestyle that require up and down kicking put strain on the ankle. You will not be able to wear traditional fins because they facilitate the up and down movement, however I have just seen a new Australian invented fin that redirects the pressure to other joints. My gait is good, assisted with orthotics, and people generally never pick that my ankle is fused. I am not as active as I used to be and prolonged standing and walking causes pain.

To have the fusion is a big decision and I am now experiencing secondary problems related to the fusion. My advice has been that no ankle replacement will last your lifetime...


Hi Everyone
My name is Barry and I have just turned 36.
I am a very active person enjoying football, golf, diving, surfing etc.
About 12 years ago I sustained an ankle injury quite severe and was unable to walk for a couple of months. The hospital said it was just a sprain so being a stubborn male I just lived with. I carried on doing sports until abot 6 months ago when the pain became to much. Since the original accident the ankle hasremained swollen. I went to a specialist and he did X-Rays, MRI scans and Ultrasound to understand the dmamge. The ligaments on the outside and inside of my ankle are completely torn resulting in the leg bones over rotating around the ankle joint. This has caused the cartlidge on the top of the ankle bone and the bottom of the leg bone to be damaged. At the end of September I had an arthroscapy and during the procedure my surgeon drilled holes in the areas of the bones where the cartlidge was missing. The idea being scar tissue will grow back to componsate for the missing cartlidge. He also discovered arthritis in my sub talar joint. I went back to see him today where he dropped the bombshell that the only I may have is ankle fusion. Well I have just got home and am beside myself.
I really don't know what to do next and there seems to be contradicting reports on this site. Once fused how much up and down pivot movement does the ankle have? Can it pivot side to side? How about sports like swimming? Will I be able to extend my foot outside so I can wear fins when diving?
All answers gratefully received. I live in the UK and am considering STAR ankle replacement as an option.
Thanks

[Unregistered]

Seriously, if you have a missed syndesmosis injury (which often happens in conjunction with fractured fibula), then there is a possibility to get a fusion (screw) between the tibia and fibula to stabilise the joint. This may help - too difficult to explain here and not sure whether it applies to you, but perhaps is an alternative.

I would avoid a fusion like the plague. It will just stuff up your other joints nearby. Wait until ankle replacement is a little better if the pain is that bad.

I know it sounds outrageous and callous, but you would be much better off with an amputated foot than an ankle fusion. Amputees in the Paralympics can run 100m in between 11 and 12 seconds in the men's races (which is a lot faster than me). If they had a race in the Paralympics for those people with an ankle fusion, the winner would limp in at about the 30 second mark. This is non-sensical to me, that surgeons could suggest an option that is functionally so terrible compared to the alternative of amputation. If your ankle pain is bad enough to warrant an amputation, then have it cut off and start training for the Paralympics (because at least you will be able to run again, and fast!). If you suddenly don't think the pain is that bad, then try glucosamine.
Wow this is the most depressing post I have ever seen. Any one that suggests amputation instead of even trying other ways of treatment is not all there. Boo

[Unregistered]

Wow this is the most depressing post I have ever seen. Any one that suggests amputation instead of even trying other ways of treatment is not all there. Boo
I agree, this post made me really down. I have just had a triple arthrodesis. It is not as uncommon and radical as you seem to think.

I suggest people who are not into elite sports and do not live and breathe to compete do not take the advice of this site to heart.

[Unregistered]

Wow this is the most depressing post I have ever seen. Any one that suggests amputation instead of even trying other ways of treatment is not all there. Boo
I am considering an amputation after under going my second ankle surgery. I'm almost eight months out from a distraction. My ankle is fusing itself. I have very limited motion and severe pain. I see an amputation as a possible way to get back on my feet without the crutches I'm forced to use and the pain I live with.

[Forum helps]

I agree, this post made me really down. I have just had a triple arthrodesis. It is not as uncommon and radical as you seem to think.

I suggest people who are not into elite sports and do not live and breathe to compete do not take the advice of this site to heart.

I like that this site at least opens up the debate about treatments. Surgeons never seem to tell the whole story or all the options, just their own preferences. At least I could go back to my surgeon with some information that made him answer and justify his course of action.

[netballer]

Hi rebecca

Glad to hear the operation has gone well and I hope you get back on your feet soon.

I have had the choose to have my ankles fusied, but I have turned it down because I was born with club feet and I have had over 25 operations between the both ankles. I am a mad sports person, but not an elite athlete. I can roll either of my ankles in a blink of an eye and I really don't have alot of ankle because they removed bones to try and straighten my feet.

I badly rolled my right ankle last year playing netball which put me out for the whole season, but this was when my doctor told me about ankle fusion. With the way my ankles are it really won't help me, I do strap my ankles when playing netball and when I am walking long distances. I decide against it and I am managing pain with physio. I was lucky as my doctor really talked me out of it once he had a good look at what was left of my ankles.

I hope it all goes well for everyone who has had this operation done and I hope that you are all pain free soon.

[vance]

Hi Everyone
My name is Barry and I have just turned 36.
I am a very active person enjoying football, golf, diving, surfing etc.
About 12 years ago I sustained an ankle injury quite severe and was unable to walk for a couple of months. The hospital said it was just a sprain so being a stubborn male I just lived with. I carried on doing sports until abot 6 months ago when the pain became to much. Since the original accident the ankle hasremained swollen. I went to a specialist and he did X-Rays, MRI scans and Ultrasound to understand the dmamge. The ligaments on the outside and inside of my ankle are completely torn resulting in the leg bones over rotating around the ankle joint. This has caused the cartlidge on the top of the ankle bone and the bottom of the leg bone to be damaged. At the end of September I had an arthroscapy and during the procedure my surgeon drilled holes in the areas of the bones where the cartlidge was missing. The idea being scar tissue will grow back to componsate for the missing cartlidge. He also discovered arthritis in my sub talar joint. I went back to see him today where he dropped the bombshell that the only I may have is ankle fusion. Well I have just got home and am beside myself.
I really don't know what to do next and there seems to be contradicting reports on this site. Once fused how much up and down pivot movement does the ankle have? Can it pivot side to side? How about sports like swimming? Will I be able to extend my foot outside so I can wear fins when diving?
All answers gratefully received. I live in the UK and am considering STAR ankle replacement as an option.
Thanks


This is my situation almost exactly. I look upon the fusion surgery as the last resort. I wonder if there are other options (besides replacement and amputation)?

[Unregistered]

Hi Barry,

I was just wondering how your ankle is at the moment

and

have you decided on which medical treatment you are going to opt for ?

[Unregistered]

Hey hey
I have just seen a orthopod after seeing all the ankle replacement "good news" on the web. Copound dislocation fracture. I was full of optomism as one site had claimed that tennis and jogging were quite within expected outcomes.
It took him five minutes to evaluate then say you know your ankle is stuffed. My advice is to wait. Wait for what, another 14yrs of pain in every step. I came so close to telling him to just get @#%#@.

Waiting til I no longer wish to leave the lounge.

[Unregistered]

Hi Rebecca

I know exactly how you feel. My name is Rachael Griffin and I'm 35 years old and also based in Melbourne. I'm suffering the same as you. However I also have Cerebral Palsy which effects my legs. I walk with the aid of sticks. I have also been told recently that I need Ankle Fusion and also have no cartiladge. I've written a Diary about what has heppened with me over the last 2 years. Feel free to read it and comment Go to
rachaels-story.blogspot.com, perhaps we can help eachother find the answers we want.
I've been in contact with my Orthopaedic Surgeon regularly, I have known him for years. He has done a lot to help me. I've given him lots of constructive suggestions. I've had consultations with 2 other doctors and they have informed me that I need an ankle fusion, however they've told me that Surgeons don't like doing this procedure because, to a Surgeon it means having to admit defeat.

I have recently communicated with my surgeon about having Anke Replacement. He has informed me that I would not be a good candidate for this because of my disability. For you however, it might be different.

He also told me there are a number of doctors here that do Ankle Replacement. They are Mark Blackley, Will Edwards, Andrew Beischer(I've seen this doctor - he's based at Epworth Hospital, Richmond) & Gerard Bourke. There is also Kim Slater, who is based in Norh Sydney, He is the President or the Australian Foot and Ankle Society. Check him out on www.nsosmc.com.au. I've told my doctor I'm not giving up searching for an answer, and nor should you. I hope this helps.
Regards Rachael

[COB]

Hi Rebecca,
My name is mark and I am 28 and have had a lot of problems with my ankle from birth I live in Newcastle NSW and have seen all the best doctors that have been recommended to me. In my opinion the best is Kim Slater at north Sydney sports medical centre. I have seen him for a while now even though I looks like in time I must get my ankle fused he was able to inject my ankle with stuff and have had the best 3 weeks I have ever had with my ankle I can not recommend him more highly he is very professional and it is a pity that he only does ankles and not a gp as I would go to him for everything it is worth a trip to see him I would talk to him get your x-ray and scans that he will need before you come up to see him .I believe he is the best person for ankles !

[kaypee]

Hi There Rebecca

I am a 34yo female from Perth, Western Australia and I am actually writing with a problem as a result of a fusion…

I received a gun shot wound to the left ankle in 1988 when I was 17. I underwent many, many surgeries; so many that I’ve lost count.

I was treated as just having a broken ankle in the first instance as no-one in Australia had ever dealt with gun shot wounds to the ankle.

The bullet was the kind they used in the Boer War (Dumb Dumb bullets I think they were called) the kind that make a really neat little hole at the front and obliterate everything behind it.

The first surgery I remember was just to clean out a bit of the shrapnel and put a knee high full plaster on.

When I came out of the plaster, I was rolling to the outside of my foot so they did a vascularised bone graft (from the hip) and placed it in the inside of the ankle (!!!) joint. I was still rolling outwards so they took a wedge of bone from the left side of the ankle (blob of bone) to try and get me walking flat.

This worked for a period until the fusions started to fail; I was then given my triple arthrodesis. Actually I’m not quite sure it was just that but here are the details…

Calcaneus fused to the cuboid, Calcaneus fused to the navicular, Calcaneus fused to the talus and the cuboid, navicular and talus all fused together.

That was great I was totally pain free for about 2 years. I then went to visit another orthopaedic surgeon who suggested that I have an Ilizarov External Fixation Device attached – to mend the fusions that had failed and to fuse the Tibia and Fibula to the Calcaneus too.

The re-fusion worked really well for about 9 years when it too started to fail… I had another Ilizarov put on, which saw me through to about May 2005. I started having incredible pain again… This time in the mid to fore-foot area. I went back to my orthopaedic surgeon who suggested that I needed an adaptation to my shoe to fit a stiff (completely inflexible) rocker sole on the shoe… As a result I had a pair of Dr Martens altered and whilst they are fantastic in winter they are absolutely no use to me in the middle of a Perth summer -- I of course wear my usual off-the-shelf sandals instead!!!!!!

I didn’t just settle for the shoe approach so I starting surfing this wonderful resource the internet and found that there was a procedure called a Beuchal Pappas Ankle Replacement procedure performed by someone in Florida. My brother-in-law lives in Canada and was all set to move down with me for the procedure. By accident I was showing my Dad the website and I stumbled across the Australian version of the website. Suddenly I have moved from the East Coast of America to the East Coast of Australia. I rang the first name on the list and found out there was a Doctor in Murdoch (2 minutes away from my house) in Perth, Western Australia who was able to perform this surgery. I made an appointment to see him about 6 weeks later and …

To no avail – he WOULD NOT do the implant as my ankle was not like a normal ankle with a fusion and he COULD NOT guarantee that the implant would hold in place.

I am in sooo much pain; I am taking 100mg morphine by tablet and top up liquid as needed. I use a TENS machine attached to my ankle and lower leg to block the pain every night after I get home from work. I use heat packs and cold packs too. I have two beautiful children an eight year old boy and a four year old girl.

My husband is so supportive and does practically does everything around the house while I sit on my backside… I CAN NOT and DO NOT want to live like this anymore. I have now suffered like this for more years that I was without it.

I have been told that amputation was always going to occur and that my surgeons have just been delaying the inevitable. I’m at the stage now where I think it might be the best option – I can learn to walk again, and I will be suffering from less pain I’m sure – even if I suffer from phantom pains and infections in the stump, fitting and refitting of the stump as the swelling goes down.

If anyone can help with what to do next; a name of someone else who has any ideas on what to do with already fused ankles, please contact me by personal email at k.polak@curtin.edu.au

[Unregistered]

Hi everyone,

I sprained my ankle badly a couple of months ago and felt a grinding session from one ankle to the other and at the top of my foot. I am still suffering from slight swelling and bruising and the talas in my foot is completely restricted. I cannot squat as the foot I injured won't allow me to bend my leg forward, I also cannot run, let alone brisk walk without severe pain and throbing in my ankle and talas area. Even lying on my front hurts the front of my foot and ankle and causes me alot of agony and swimming hurts my foot. I have had two xrays to rule out a break.

I am a little worried after reading your comments on Fusion as it sounds like a difficult choice to make. I know the injury is too soon to judge, but I know my foot and I think there is diffinitely something wrong bone wise.

Can anyone tell me what their pain symptoms were or if anyone had a lot of restriction in their foot before the doctor recommended an operation?

Thanks Michelle

[Unregistered]

Hi I had a triple arthrodisis when I was 10.due to mild CP so that I could put my foot flat on the floor. ((three joints fused in my foot-not the main ankle joint.) I then ran track-palyed tennis etc. I am 45 now. Now that joint is bone on bone from wear and tear. The pain is agonizing. I just finished getting orthovisc shots (cartiledge shots) in my ankle in St Louis. This is my second round. They have helped alot one year ago. I don't know if I would even be a candidate for ankle replacement or cartiledge disks because my ankle is pretty frail. Most doctors have told me that I need to get the joint fused. I don't want to- My Dr. is the only one I have found who is willing to do something other than fuse the ankle. Now Iam looking at the STAR ankle replacement along with every other type. Let me know how you are doing. Dede

[Unregistered]

Has anybody skied or hiked after their ankle fusion? How long after?

[Syd Uni sports clinic]

I haven't done so, but I reckon you could do downhill skiing, as the ankle is pretty fixed in skiing. In fact it would probably be the best sport you could do (unless you injure the knee as well - stay on the green and blue runs!)

[Unregistered]

Hello all.

Looking for thoughts...

I'm 36 and active (running 5 times per week, swimming, hiking, skiing, biking, walking through cities)...or at least i was until 2 months ago. An MRI showed bone chips (from a teenage soccer - football for the nonamericans- accident), a cyst, reduced cartilege....just a very "old" ankle. A doctor - Dr Myerson- at the Foot and Ankle Reconstruction Institute at Mercy Hospital in Baltimore, Maryland, said fusion would be best. He said this after simply reading the MRI I sent to him ( I currently live in Cairo, Egypt)...I haven't chatted with him but will.

I don't have heaps of pain, but there is a dull ache/discomfort from walking farther than 3 km. I don't run anymore but swim (don't practice kicking) and just biked (which felt good). I do want to return to my life of running and pain free walking...exploring cities.

I'm not too sure about fusion....it sounds so drastic and limiting. Or is it? I'm encouraged by an earlier post of the Marine who competes in triathlons.

My question is.....what would you all do? What options should I avoid? Who/where has the most advanced techniques? It's good knowing that prosthetics are so advanced, but I don't think I'm there yet. Any advice?

thanks.
Jamie

[Martin, London.England]

I injured both of my ankles when I was about 19. I am now 37 and in constant pain with my ankles. Can't do any sport without excrutiating pain. I am now on the verge of asking for the fusion. I need both ankles fused. Would I get them both done in one hit or each one seperately? Do you walk with a very noticeable limp after fusion? Are there any up to date alternatives to fusion ?

As much info as possible would be most helpful.

Thanks in advance

[Unregistered]

Hello all, i found this forum by accident
I was starting to think i was the only one with this problem. Seven years ago i fell from a ladder, and ended up with a compound fracture of the left talus. First operation they just put screws in. After continous severe pain, i went and saw three surgeons and seven different registras at the hospital because of going back for check ups, they all told me that i would have to have a ankle fusion to get rid of the pain. I have had all the pain killers and i mean the strong ones and none work, i don't even bother taken them. I have had two more operation since then, first was a sub-talus fusion, second was a ankle fusion.
They also cut my acillies to try and straighten my foot. After this you think i would be right, well nothing could be further from the truth. I am now in worst pain than i have ever been in. My foot is swollen and tender, which will probably be like that for the rest of my life they tell me, i can not even put a shoe on that foot. The only movement is in my toes, i can only walk about a 100m before i have to sit down, walking up and down hills is out. I am now 42 and after being very active, having to give up my job it's amazing how suddenly your life can change. Anyway they want to cut my leg of now, but i have also spoken to a number of people that have had this done and told me to keep my leg as long as possible, so i don't know what to do either. But i will say this, explore all options before you have your ankle fused. If i had my time again i wouldn't have a fusion.
Dave I'm in Townsville

[Unregistered]

Fuse your ankle means.....
-difficulty going up and down the stairs.
-knee, hip, lower back, neck .... pain
-No more running, no sport

If you can live the way it is now. Just live it! or try something less drastic.

My doctor told me I need to fuse my ankle or amputate my foot.
I will not fuse my ankle
People with no foot have a better life style than people with a fuse ankle
Melanie
cloumelanie@hotmail.com




Hi All, my name is Alan and I'm in a similar situation to most on this site in that I've been recommended for Ankle Fusion. I damaged my ankle and broke my leg playing soccer 8 months ago. The leg had screws and a plate put in and seems ok (apart from the screws being too long and stick out of the other side of my shin). The hospital have ignored my ankle for the last 7 months just telling me to rest it. I have since seen a specialist who thinks I've damaged my Subtalar joint and the only thing he can do is an ankle fusion.

Having read most of your replies I am a little supsicion about the diagnosis because I can walk without pain, run, jump etc. After running for a while my ankle will be sore for 3-4 days but nothing chronic.

So, after looking around for an alternative treatment I came across something called Prolotherapy. I only know what I have read on the web but am due to see a Musco-Skeletal Specialist who uses Prolotherapy in his treatments in 2 weeks. I'd be interested to hear if anyone reading this forum has tried Prolotherapy. It seems more suited to Ligament/Tendon damage to bone damage but I'm prepared to try any non-surgical treatment before fusion. I'm even prepared to play sport in pain rather than lose the ability to play sports at all.

Here is an interesting article I found during my research.

http://www.getprolo.com/ankle_fusion_alternative_prolotherapy.htm

Would love to hear more success stories.

Take Care.
Alan.

[Unregistered]

Bonjour,
The person that wrote about amputation, please contact me.
cloumelanie@hotmail.com


Wow this is the most depressing post I have ever seen. Any one that suggests amputation instead of even trying other ways of treatment is not all there. Boo

[Unregistered]

Bonjour,
I think we are in the same situation. I had 4 surgerys and nothing work. Now I am asking to have a amputation.
It would be grate if you can contact me
cloumelanie@hotmail.com


I am considering an amputation after under going my second ankle surgery. I'm almost eight months out from a distraction. My ankle is fusing itself. I have very limited motion and severe pain. I see an amputation as a possible way to get back on my feet without the crutches I'm forced to use and the pain I live with.

[Martin - London,England.]

It is depressing to see someone would prefer amputation. Who has had an ankle fusion with the last 3 years ?

What is is like.

As many details as possible please. I am seeing the specialist next wednesday and
much info would be appreciated.

[Tawena]

Can i join you please ?

I had never heard about ankle fision until Monday when the Dr menetioned it
They are thinking of offering me one in the future
I 1st broke my tib/fib on my right leg close to my ankle falling down 4 stair about 10 years ago I had pins and a plate for a while then had them removed

It healed OK but as we all know its never the same but I have just gone along in life with it
5 weeks ago tomr i had another fall one morning coming in from the garden
I have broken the tib/fib again on the same leg very close to the ankle !!!!!!!!
1st they were going to operate but then changed their minds.I have had an air cast as the plaster cast rubbed me and made me clausterphobic (sp)
I went for my check up on Monday and they are very worried about my ankle its very badly arthritc so the dr mentined a fusion and another op but didnt take it all in
He said once this break is better they want to discuss it wih me

Has anyone else broken their ankle twice ?
Do you think it will make my already bad ankle worse?
Any advice gratefully recieved


Martin i feel bad for you do hope someone can give you some good advice
Have you looked at ankle replcements? I know they only last 10-15 years but things are getting better all the time I am thinking maybe have that done and hope they can advance before I need a new one

Hello to Everyone on this forum and thanks for your posts they are very helpfull

Karen

[Unregistered]

There is hope for those of us who are not quite ready to give up our mobility... I am a 29-year-old obese woman (300 lbs). I broke my leg and ankle at the age of 19. There is officially no cartilege left in the right ankle now and there hasn't been for about five years. My pain got pretty bad in 2002. However, I am much better now. I have not woken up with a frozen ankle in three years. Pain has not kept me awake more than a handful of times over that time.

The best thing I did was to use an ankle foot orthotic - rigid custom-formed plastic. I use it when I am going to be engaging in any prolonged ankle-involved activity. I take it off a lot of the time to help maintain flexibility and leg muscles. It irritates me during the hot months and I hate not being able to wear dainty shoes... but it is worth it.

I do not consistently take any medication. Nor do I take glucosamine - except when I remember every couple of months. I elevate but I don't use ice or heat. The brace does cause a bit of uneveneness and my opposite hip will hurt, but that happens without the brace as well.

I would recommend it to most people in my situation. I think the theory is that it prevents bone chips and allows any chips that are there to be absorbed into the body. They seem to be a major source of pain and inflammation.

My AFO is my third best friend.

Hope this helps.

[Old bugger]

Hi All

I to did alot of damage to my right ankle some 14 years ago in the military. I max out on pain killers from forte to ducene and a few others. Every day is killing me, my body is getting tired from struggling with pain 24/7. No cartlidge and bone damaged of the talus from a climbing/abseiling exercise. I have young children I still want to have fun with, but need to get off these pain killers. Fusion maybe the way to go or a surgeon has suggested removing excess cartlidge and bone from my knee and placing it in my ankle to space the bones apart...what to do. He said it would be a good operation but can't garantee the out come.....If anyone knows of a good ankle surgeon in the Newcastle AU area let me know thanks in advance.

[Unregistered]

Hi there. I hope this answer doesn't get to you too late.

I had a VERY similar experience to yours. Soccer player, very active and all of the sudden while excercising (running) my ankle starts bothering me. ??? I believe it's just some ligament a bit out of place, so I keep running thinking it will get back to normal. Some days it's worst than others until it really really hurts, to the point that it hurts walking and I can't even go up or down hill. So I went to a doctor who ordered an MRI. I have a "focal osteochodral lesion involving the medial talar dome measuring approximately 10 mm in AP dimension and 6 mm in lateral dimension", or in other words, I have a gap of 10x6 mm in the cartilage. Thankfully the doctor didn't recommend ankle fusion but microfractures. Since I'm not a friend of surgeries I inquired about prolotherapy after I received an e-mail with info about a mad doctor arguing for its benefits. I've been receiving shots every 2, 3 or 4 weeks. I've received about 5 treatments and to tell the truth I felt much better until the last one. After 3 treatments I could walk normally an did not feel almost any pain at any time of the day, but I didn't force things either, I work sitting down and have not exercised in over 1 year. Bummer! No, A REAL BUMMER! And about the last treatment, I believe the doctor nailed me with the seringe in the wrong place because I had a lot of pain for 1 straight week after the treatment to the point that I called the doctor for guidance. Afte this last incident I am not sure what I'll be doing next but for sure it won't be ankle fusion. I've been reading about this problem on the Internet and found other options (Microfracture, Autologous Chondrocyte Implantation [building cartilage from a few cells] and cartilage transplant from a cadaver as well).

I hope this helps.
Pepe


Hi All, my name is Alan and I'm in a similar situation to most on this site in that I've been recommended for Ankle Fusion. I damaged my ankle and broke my leg playing soccer 8 months ago. The leg had screws and a plate put in and seems ok (apart from the screws being too long and stick out of the other side of my shin). The hospital have ignored my ankle for the last 7 months just telling me to rest it. I have since seen a specialist who thinks I've damaged my Subtalar joint and the only thing he can do is an ankle fusion.

Having read most of your replies I am a little supsicion about the diagnosis because I can walk without pain, run, jump etc. After running for a while my ankle will be sore for 3-4 days but nothing chronic.

So, after looking around for an alternative treatment I came across something called Prolotherapy. I only know what I have read on the web but am due to see a Musco-Skeletal Specialist who uses Prolotherapy in his treatments in 2 weeks. I'd be interested to hear if anyone reading this forum has tried Prolotherapy. It seems more suited to Ligament/Tendon damage to bone damage but I'm prepared to try any non-surgical treatment before fusion. I'm even prepared to play sport in pain rather than lose the ability to play sports at all.

Here is an interesting article I found during my research.

http://www.getprolo.com/ankle_fusion_alternative_prolotherapy.htm

Would love to hear more success stories.

Take Care.
Alan.

[WyattEarp]

Amazed that so many people have had similar experiences. A little over 10 years ago I was in a car accident. When the ambulance guys got there I pointed to my foot and said, "Make sure that comes with us." I had the multiple surgeries including bone and muscle grafts and then had to just about start over 5 months later because of infection. I got by OK for 3 or 4 years, only experiencing intense pain after putting a lot of stress on the joint but it would go away after a day. Then it got progressively worse. My golfing buddies thought I had a drinking problem because I would stay in the 19th hole until everyone left. The truth was I didn't want them to see the struggle it was for me to get to my car. Instead of lasting one day the pain would stay for 4 or 5 days. No anti inflammatory drugs had any effect and the only way I could sleep was to take heavy narcotic pain medication. Five years ago I had the ankle fused. I found this site today because now my ankle is starting to give me problems again and I am worried that my fusion is coming unglued or something. I want to explore all alternatives before going back to see my surgeon. Prolotherapy sounds interesting and is something I would like to learn more about. There have been times when I have said that I would have been better off if my foot had just been amputated at the time of the accident. Before they put me under I felt sure that was going to be the case anyway. For better or worse, they kept it and I am very attached to it. I'm 52 and have to get up and go once during the night. The idea of having to strap something on to get to the bathroom or of peeing in a bottle every night for the rest of my life doesn't sit well. Anyway, that's where I am now. I'll share a few thoughts about fusion for those who might be considering it. When I had mine done I researched total ankle replacement throughly. I was not a candidate--too young and not enough "good stuff" left to work with. The fusion provided a lot of pain relief--not 100%, but significant. My mobility is limited but I am able to walk almost normally(until now). I can't run at all and have to hang half my foot over steps to go down. Steep hills I have to traverse. But I never had much flexion after the initial injury so the fusion was not a great sacrifice for me. I played tennis every Thursday night for years but never played after the accident. I play golf and ride a bike. As for the surgery, it was a nightmare for me. I hate general anethesia so I was heavily sedated(asleep whole time) and had local and nerve block. The problem was when the nerve block wore off it was 2:00 AM and there was no one availiable that could up the dosage on my morphine pump. I have a high tolerance and it wasn't touching me. Having gone through 10 previous post-ops with this thing I thought I knew about surgical pain. Wrong!! This was excruciating. I lived with it in agony until 7:00 AM. This was completely unnecessay and is one of the things that really ticks me off about medical profession. They undermedicate. These drugs are not addictive when used as intended. I have never had the slightest desire for morphine, demerol, hydrocodone and actually couln't wait to stop taking them. But at times, they are necessary. Anyway, that's my story and I'm sticking to it. I'm hoping this current flare-up is just temporary but if anyone knows anything about prolotherapy or failing ankle fusions, I will appreciate all input. Best of luck to all.

[pussendaboots@aol.com]

i had an ankle fusion done....and after 2 years it finelly fused....i went threw alot with mine and now i wish i would of never of done it....my legs is shorter...and now i walk with a limp....your ankle wont move at all....so swimming sucks...walking around...sucks cause you need a speical shoe.....like a rocker bottom one....i dont know but i wish i never would of had it done...yeah i dont have anymore pain in my ankle.....but now my foot hurts cuz its trying to do all the bending......good luck

[Martin,London.England]

I went to the specialist yesterday. They xrays showed both ankles are not far off from fusing themselves. I am having an arthroscopy done on 03 june on the right ankle to have and look inside and to get rid of some of the bone chips. He thinks this may alleviate some of the pain and give me a bit more time before a fusion is nescessary. From all of the replies on this site the fusion option is still very confusing. Some people are happy some are not. I currently can play golf and kick a football about but i would not be able to walk for a day afterwards. I can do without the football. I don't want to have to do without golf.

I hope the arthroscopy will delay the fusion, but i still feel the fusion will be the only option
in the long run.

[Pamela]

I too am amazed at so many similar experiences when I'd been thinking I was the only one in this situation. I am finding I can do less and less but still struggle to see to my horses somehow. Can't ride though. Got myself a quad bike so I can get round the paddocks to do odd jobs. Have had to give up on gardening which I used to love.
WyattEarp - I too am doing the same as you, going to exreme lengths to avoid friends seeing me struggle to walk. Crazy isn't it?

Martin - may I ask you which centre/hospital you are going to for your ankle problems? I am in the North of England and saw a consultant in my region. I don't think he specialises particularly in ankles and I am not happy with the treatment I got. I would like to go for a second opinion at a larger centre such as London.

[jmorganf]

I am so thankful that I found this forum. I can't believe others are suffering the exact same way as I am. I broke my ankle in 1998 during a freak accident while visiting a festival here in Atlanta. I was stepping off a low platform,and my ankle bone popped out of place. I've have had a surgery to put screws and plates in and a surgery to take them out. Just like all of you I am in excruciating pain on a daily basis. I am presently on cortisone therapy (2 shots a year) which is not helping at all. My doctor suggested an ankle fusion also, but I am too scared of that. He doesn't recommend ankle replacement at this time, he said it doesn't last long. It is so good to share with people who understand what I am going through. My family, as much as I love them, just don't understand my limitations with my ankle, I live in a 2 story house and it is a challenge just to walk up and down my stairs and my co-workers surely do not understand or care about hearing about my ankle problems. For the past 8 years I have had no one to talk to except my doctor who happens to be the Atlanta Hawks Basketball team doctor. It amazes me how those hugh athletes can break their ankles and a few weeks later they are back to playing ball, and here I am a female who was just basically standing up and broke my ankle and lo 8 years later I am still in pain. Go figure. I do 3 things to get relief from this pain 1. Wrap an ace bandage tightly around my ankle and foot. 2. Wear tennis shoes and 3. Pray. Now that I know all of you exist out there, I will be praying for you too. God Bless.

[Martin, London-England.]

Pamela - Luckily i am covered by BUPA so i am with a private consultant. But i do know the best hospital in the UK for ankle injuries is the Royal National Orthpaedic hospital in Stanmore, Middlesex which is just on the surburbs of London.

Website is : http://www.rnoh-stanmore.org.uk/

The consultant is : Mr Dishan Singh

Secretary to Mr Angel & Mr Singh, 020 8909 5842

I hope this helps.

[Pamela]

Thank you Martin. My GP did his training at Stanmore so he should be willing to refer me there. Part of the problem in this country is that you can't get to see who you want without your GP's referal.

[Tawena]

Hello Again

Thanks for the no Martin I have made a note of it and will make an appointment to see Mr Singh
Although I do not have private cover I will go private rather than have an op the NHS are offering if I dont feel its right for me

I am worried that as this is my 2 nd tib/fib break same leg and my ankle is already arthritic will it make it even worse ?

I am more keen on ankle replacement ,fusion scares me although I may come around in time if i get really desperate

YES its wonderfull to come in here and read all the posts it helps so much

I joined a fib/tib break forum but its not really where i want to be at the moment I have been down this road before so know how it will go its the long term effects that are my main concern as my ankles already in a bit of a mess from the last time

Thanks for reading this it helps to write down my thoughts however all over the place they read LOL

Best wishes to you all

Love Karen xx

[Unregistered]

Hi there. My name is Pepe and I am currently receiving Prolotherapy shots in my left ankle. I already answered another message about Prolotherapy in this forum. My experience is that it works for me to some degree. 2 shots ago I was in much pain during a week. I believe the doctor put the needle somewhere where he was not supposed to because my ankle/foot was bad for 1 straight week and after that it hurt going up and down stairs again, which had not happened for a few months. I was very discouraged by this but last Friday (May 5) I went again. The shot itself was excruciating again and during the day of the shot my ankle was very very sore. Yesterday it was sore but I could walk normally and today it's been OK. I try not to estress my ankle so I don't really know how much progress my ankle is making but I can tell you that it's a lot better than it used to when I first started seing doctors about it. I don't know if this will fully recover my ankle but I'm trying anything before an operation and surely before a fusion.

Finding information about Prolotherapy is actually very easy. Just search on Google or any other engine. From many of the sites you can find a link to a site with info about doctors that practice Prolotherapy.

Pepe


Amazed that so many people have had similar experiences. A little over 10 years ago I was in a car accident. When the ambulance guys got there I pointed to my foot and said, "Make sure that comes with us." I had the multiple surgeries including bone and muscle grafts and then had to just about start over 5 months later because of infection. I got by OK for 3 or 4 years, only experiencing intense pain after putting a lot of stress on the joint but it would go away after a day. Then it got progressively worse. My golfing buddies thought I had a drinking problem because I would stay in the 19th hole until everyone left. The truth was I didn't want them to see the struggle it was for me to get to my car. Instead of lasting one day the pain would stay for 4 or 5 days. No anti inflammatory drugs had any effect and the only way I could sleep was to take heavy narcotic pain medication. Five years ago I had the ankle fused. I found this site today because now my ankle is starting to give me problems again and I am worried that my fusion is coming unglued or something. I want to explore all alternatives before going back to see my surgeon. Prolotherapy sounds interesting and is something I would like to learn more about. There have been times when I have said that I would have been better off if my foot had just been amputated at the time of the accident. Before they put me under I felt sure that was going to be the case anyway. For better or worse, they kept it and I am very attached to it. I'm 52 and have to get up and go once during the night. The idea of having to strap something on to get to the bathroom or of peeing in a bottle every night for the rest of my life doesn't sit well. Anyway, that's where I am now. I'll share a few thoughts about fusion for those who might be considering it. When I had mine done I researched total ankle replacement throughly. I was not a candidate--too young and not enough "good stuff" left to work with. The fusion provided a lot of pain relief--not 100%, but significant. My mobility is limited but I am able to walk almost normally(until now). I can't run at all and have to hang half my foot over steps to go down. Steep hills I have to traverse. But I never had much flexion after the initial injury so the fusion was not a great sacrifice for me. I played tennis every Thursday night for years but never played after the accident. I play golf and ride a bike. As for the surgery, it was a nightmare for me. I hate general anethesia so I was heavily sedated(asleep whole time) and had local and nerve block. The problem was when the nerve block wore off it was 2:00 AM and there was no one availiable that could up the dosage on my morphine pump. I have a high tolerance and it wasn't touching me. Having gone through 10 previous post-ops with this thing I thought I knew about surgical pain. Wrong!! This was excruciating. I lived with it in agony until 7:00 AM. This was completely unnecessay and is one of the things that really ticks me off about medical profession. They undermedicate. These drugs are not addictive when used as intended. I have never had the slightest desire for morphine, demerol, hydrocodone and actually couln't wait to stop taking them. But at times, they are necessary. Anyway, that's my story and I'm sticking to it. I'm hoping this current flare-up is just temporary but if anyone knows anything about prolotherapy or failing ankle fusions, I will appreciate all input. Best of luck to all.

[WyattEarp]

jmorganf, I don't think many athletes that have had the severity of ankle damage that those that have found this site have sustained are back to playing ball in a few weeks time. Case in point--Joe Theismann. My ankle injury was similar to his. See the link at espn.com: http://sports.espn.go.com/espn/espn25/story?page=moments/75

[li_low]

Have been following ur fusion with interest as my husband is due to have his on the 29th of this month..wondered how u were doing with it all...last time you were still on crutches I believe..love to hear if you feel it was a success and if you are now pain free???
Cheers Lou.
PS Just realised I spelt your name wrong and it will not let me edit the title for this ...I am sorry.

[perial]

I was in a car accident in 1999 and I broke my ankle [displaced medial malleolus and disruption syndesmotic ligament]....when i got to the hospital i was seen by DR SWIGER, in athens tenn. the guy felt my ankle for a pulse then gave me a card And told me to make an appointment !! i made the app....when i was seen he told me it would be a couple of weeks befor he could operate because of fracture blisters, to make a long story short it ended up being 4 weeks befor i had surgery. I did find a better os to do it but he assured me that the outcome would be bad, its been almost seven years now and i have very limited motion,severe arthritus and spurs,chronic pain to the point it has about ruined my life. I can only be on my feet for about 30 min and I suffer for it . last year I seen a os that specializes in ankles and he recomended the ankle fusion and I said I just wanted it cut off. the ligament damage is so bad,I have no cartlidge and such severe arthritus I cant see how a fusion would or could help or benifit me. he kinda freaked when I asked him to amputate,he refered me to pain management !! I go to my first pm appointment tomorrow maybe I will finally get some pain relief ? if anyone has suggestions please post them im open to just about anything at this point .

[kaypee]

Hi Perial

I have been in EXACTLY the same situation as you.

I had an ankle fusion about 15 years ago that came undo and was redone about 7 years ago. Since then I have experienced increasing cronic pain in the midfoot area. After all the midfoot is being used for something it was NEVER designed for.

I have been seeing a Pain Management Specialist for a year now, and as of last Thursday he had no other ways to help me.

I have tried a TENS unit (I purchased my own) it is great at the end of the day when you can just sit and do nothing. Not really suitable for a working mum with 2 kids.

I have tried an internal TENS (where I had a stimulator inserted in my spine) and if it had worked it would have stopped the pain messages getting from the ankle to the brain. It worked really well when it was turned up real high, but I couldn't get up or move about because of jelly legs.

After that we tried a morphine pump, a catheter was put in the spine and this was supposed to give a measured dose of morphine over a given period of time. I am allergic to morphine that is delivered in this method.

So, we tried a morphine patch, I put in on the Friday night and by Sunday I was experiencing the same allergic reaction as I had with the morphine pump.

I went to report back to the specialist on Thursday last week, and he confessed that there was nothing else he could do for me.

I will go back and see the orthopedic surgeon next week (after about 2 years) to see if there has been any advancement in bones, bionics or ankle / foot replacement surgery.

I know that there is something out there that will help you - try everything you possibly can within your financial / emotional / physical limits.

Please feel free to keep in touch - even send me a personal email every now and again if you wish.

I am located in Australia, I don't know where you are and I hope all these solutions (?) above are available to you.

Kind regards
KayPee

[Rebecca]

Hi everyone,
Wow. I haven't checked the site for a while and it's quite overwhelming to read all your posts and still see more and more people who are having to making the painful (in every way) choice of whether or not to go ahead with an ankle fusion.
As you know, I had the fusion done in August last year, which means i'm a few months away from 'complete' recovery.
For me, fusion was the only option (apart from amputation). Everyone's situation is different and I still believe that fusion is a last resort choice.
This is where i'm at now:
I am happy to say that I have whole days where I forget about my ankle because I have no pain! I do have pain every now and then (maybe once a week on average) but it is so mild in comparison to almost 2 years of can't-do-anything agony I barely notice it.
I can walk non-stop (not as fast as I used to) for approx. 3-4 hours normally. Now and then a little pain might start and my walking is affected but other than that I walk like a normal person.
Running is pretty unco but that was never my thing anyway.
Stairs and steep inclines are interesting. Again, it depends on the day but because of the limited up & down movement I do prefer to take the lift. It's possible just a bit awkward.
Cycling on a stationary bike is fine (and recommended).
I had some exercises that the physio gave me with a wide band to strengthen the ankle which i've stopped doing, so I must be doing ok!
I haven't tried any other weight baring exercies or activity yet.
I'm not emotionally ready to start up dancing again just in case I can't continue doing it. I'd prefer to wait until i've completed my recovery and then give it a whirl.
My surgeon (Mark Blackney, East Melbourne - highly recommended & touted as 'the best' for ankles and I agree, he and his team are fabulous) can't give definates about what i will and won't be able to do in terms of more full on activity. It's totally subjective, so we'll just have to wait and see as I give things a go.
So, for me, overall a good result. I'm living like a normal person again.
My reservations about the future implications of the fusion on my other joints are still the same but Mark seems to think that in my case the likelihood of adverse future effects are low as long as I don't 'overdo it'. So, no high impact activity = less chance of future problems occurring.
OO, I almost forgot. In my case driving a manual car is not preferable anymore. Sad for me because I love driving my 1971 Peugeot, she will have to be sold. I'll have to get myself an automatic which i'll operate with 2 feet, so I can brake with my left foot. I also need a car where the seat is placed a bit higher because it's bloody difficult pressing an accelerator pedal when you have very limited up/down motion in your right ankle.

So, i'm doing pretty well now. I actually have peace of mind. We'll just have to see what the future holds.
Good luck everyone!

Get lots of opinions, ask lots of questions and don't put up with agony.
Rebecca:)

[Unregistered]

To those considering ankle fusion let me just say that it was the best choice I ever made. I am 24, very athletic, and had my left ankle fused 2 years ago with fantastic results. I was in so much pain before the surgery and now it gets "sore," but I am able to do all the activities I could before and more. I run daily, work out at the gym, ice skate, golf....and I only limp slightly. I had my talar navicular fused, so I have no side to side motion at all (which makes it hard when I'm walking on uneven ground) but I have some up and down motion, hence the ability to run/ walk normally. It was a long, scary process but it has been worth it. I just wanted to offer some encouraging words for those of you considering the surgery. My best to all of you, feel free to email if you would like to ask questions/ talk.
~daphne
dctmla25@hotmail.com

[unregistered]

Hello Rebecca,
I think you made a very wise decission. I have had my ankle fused but it was set incorrectly and I have had it redone in May. All is progressiong well, was placed in a Taylors Spatial Frame to have it set correctly this time which will be on for 3 months.
Getting an automatic car is the best thing you can do as prior to my surgery I got an automatic car and I am like you where I used both feet. Keep up the good work.
Judy

[Reed]

Barry and Vance,
I was a very active basketball player before I sprained my ankle and I had the same surgery that you had about 5 months ago - shaved cartilage and drilled holes in hopes to help cartiliage regenerate. (doctor said I had no break - just a severe sprain)... Now, I can't run anymore much less jump 4 inches (I used to have a 35 inch vertical). I hope you guys have faired better and am writing if you have had any follow-up surgeries as it seems I will need to.
Reed

[Lynnne]

Hi Guyz..First of all THUMBS UP. for whoever thought of this website..and moreso...Thumbs up * 2 for everyone that has shared their experiences...Boy it feels so much better to actually know that there are people who can really relate to me...God bless you all...Well My name is Lynn..26 yrs old Living in London..I shattered my left ankle quite severely last July..escapin house fire..jumpin 13 ft below and KAPUT...my life changed..I have had two surgeries on it..and i'm now left with plates on it but i have since developed quite severe ostearthritic ankle...The cartillage is just like a lininig really it's almost not there, now as i write as i have had an excruciating pain today i'm besides myself..My consultant had opted for a fusion and obviously i was like NO..NO...I will look for other options hoping obviously for a replacement or cartillage regrowth...wel well..there isn't proper information or evidence on this issues and i'm left with no choice really but to undergo a fusion as i honestly cannot live in pain no more..I'm going BONKERS.....the painkillers are like a snack as the effect is nil......I'm lookin to get advice on what to do..really...I'm just as confused as everyone else who is faced with the decision of a fusion...I'm looking to even find second opinion in Australia ...so far readin through profiles i've seen recommendation for Mark Blackely in East Melbourne...And Kim Slater....REBECCA & ANYONE esle who has undergone a fusion could you kindly let me know of ur progres..or whaever possible advice you could give would be of much appreciated.Has anyone also known someone who had had their ankle replaced??? or even someone who has had cartillage regrown?? on a bone to bone anthritic ankle coz that is what i really i'm...Any advice would be of great great helpppppppppp....please feel free to contact me. On:
bakitta2000@yahoo.com

Thank you once again N God bless y'all..

[jigneshhpatel]

Hello everybody I read a article on internet , the university of iowa has developed a procedure to regenerate cartiledge, may be it depends upon situation, but it may help to many like me. so here is the web link

http://www.uihealthcare.com/depts/anklearthritis/patientinfo/resurfacing.html

look at that , contact them it might help.

God bless you all.

Jignesh

[Dr Expert]

Well, if you think that your doctor is not trying to get you better, you should see a new one. I don't live in Melbourne so I don't know much about Melbourne doctors so I reccomend that you search for some better doctors that might actually try and make you feel better.

[pauli]

Hi Rebecca - I believe I have a product that will help you; it is helping thousands around the world as we speak. I have been taking a nutritional product I swear by for 15 years this year, because it works. I keep excellent health & never get a cold or flu. It will help you & all your family. It will give your body what it needs to sort itself out. Also grow cartilage within 3 – 6 months – awesome! Contact me & I will give you some more info if you are interested? I have 20 – 30 friends around me taking it all with amazing results. 100% money back, if in 30 days you have taken it 2 twice a day & you say you haven’t had a result – you will. I am so excited at the moment, I am off to Darwin & my friends have just started the product – not even a week & they have had results. They had told me they were healthy, she got a flu just before getting my parcel (first time in years she had a flu) 2 days it was gone. It is well worth a try, hear from you soon. Cheers.

Kind regards
Pauli

[Linda R]

Hi, I am ( or was) an active 46 y/o who suffered a smashed ankle after a head on mva (not my fault) 2 years ago. Both my knees were also broken. I cant believe how quickly my ankle has gone from bad to terrible, so now I have also been told a fusion is my only option. My surgeon is Linda Ferris in Adelaide who I think is very good and I have complete faith in her but I am not looking forward to the sugery as I am sick of the pain after each operation. I've already had 2. I was wondering if you leave it too long before having the operation can your ankle get so bad that then they cant fuse it? I have accepted that fusion seems the only viable option but cant seem to bring myself to schedule the surgery. I feel pretty pissed off at the person who crashed into me to give me such a life changing injury. Any advice would be welcome.

Regards to all, Linda

[unregistered]

Hi Linda
You can leave the ankle fusion for as long as you like, but the pain will only get worse and the ankle can eventually fuse itself but maynot fuse evenly as the surgeon doing the job will shave the bone ends to make them even first before inserting screws to hold the bones into a locked positon. My advise is to get the operation over with so you can then focus on your rehabilitation and working towards a less painful life.
Good luck
judy

[keewee]

Hi, I am 53 and had a fall last March 2005. I was on top of my load on a B-Double when my foot got caught and I went over the side and smashed my right ankle. I have the Tibia and Fibula plated. I broke my ankle joint open as well. All this from 3 metres. I was off work for 6 months then with Workcover wanting to cut my money so as I couldn't live I had to try and return to work. My boss put me through hoops but I went back to driving. I was always in pain, some days better than others. I started back in November,2005 but in July,2006 I have had to stop. The pain kept gettin worse and the arthritis has set in. I hate pain killers but now live on them. I was told from day one I would have to have an ankle fusion within 2 years. I saw a specialist in Brisbane a month ago and he told me to get it done. I am seeing another specliast on Friday here on the Sunshibe Coast as it is closer to home and will be easier for my wife who has been the best support I could have. She found me this site.
I cannot wait to have the fusion so I can walk and be normal again. We were always and outdoor couple and now I cannot walk 100 metres. Pain wakes me up at night.
Thanks for the site and all the imput.

[unregistered]

hi Keewee
My suggestion is to have the fusion as soon as possible. I have had my ankle fused and I can understand how you feel. When your life is so limited with pain it is certainly no fun.
The fusion is a big operation but it is worth it. It is usually a 4 to 5 day stay in hospital and the first couple of days are not much fun. My surgeon had my foot and lower leg in plaster for eight weeks and I suggest you keep the leg up as much as possible as when the blood pools in the foot whilst hanging down it can be quiet painful for the first few weeks after surgery. Once the plaster comes off it is abit scary at the start as you do not have an ankle joint any more and balance at the start may not be that good. Go and get a good physio and hydrotherapy is a god send. Hydrotherapy allows you to do more than on land and is less painful. I found when I went back to work i still had swelling and pain in the foot however hydrotherapy in the evenings after work relieved both the swelling and pain and made sleeping peaceful. my suggestion to help ease the pain prior to surgery would be to do some passive exercises in a hydrotherapy pool as the fitter you are the faster you will recover from surgery. My suggestion would be to have a surgeon who does ankle fusions on a regular basis such as 5 a month. I don't know the names of any foot and ankle specialist in Queensland as I am in Melbourne. I would be happy to give you some names of foot and ankle specialists in Sydney, Canberra or Melbourne should you require it.
I wsh you all the very best.
Judy
jet@uvtc.net.au

[keewee]

You seem lucky as you have some movement still. My ankle is nearly fused already. I only have 5 degrees forward movement and very little sideways. I now have a little feeling in the bottom of my foot. At first after my accident my foot was numb and any uneven surface would throw me.
Pain killers. I have just come off ******** because of the side affects. Took me 4 days to feel good again. Going to try Capadex now. Also take Brufin and Duatrol but they don't help much.
I would like some info on recovery time. I was told I would be back at work in 6 months. For reading about other people here that doesn't seem right.
I was also told I would be able to drive trucks again as I was before with hardy any movement. Suppose I will have to wait and see.

[keewee]

Thanks Dr Expert but there is nothing left to recontruct from what I was told. It is bone on bone and I shortened my right leg 1.6 cm. My foot was facing the wrong way when they cut my boot off and I was told I was lucky they didn't take it off.

[unregistered]

dear Keewee
I suggest you will probaby be back at work before six months. I think 3 months will probably be enough. I went to work way before that but I made a mistake as I was quiet sore and very tired. I don't have movement in my ankle but the lower joints midfoot I have movement and I do hydrotherapy to keep these joints supple. Once your ankle is fused there is alot more work for the midfoot joints to do so these need to be kept strong and also flexible as it will help you walk much easier. I am not sure whether you will be able to drive trucks again as i needed to sell my manual geared car and get an automatic as driving manual was near impossible.
I was told for a full complete recovery it takes about 12 months and i think this is probably correct with the bone and tissue heeling after a fusion and also for your body to adapt to the changes in walking patterns etc.
Considering you are in so much pain and taking quiet alot of pain relief now is the time to get the operation as your body is at a point of needing it and it wouldn't do you mentally or physically any benefit by putting it off. As i said I was in plaster for 8 weeks after the plaster I was put into a cam walker which has a curved sole so as to teach you to rock from heel to toe when you learn to walk again as that is the movement you will be using for the rest of your life, due to no longer having a functional ankle joint.
Being on your feet alot is also not good when recovering so maybe your employer can find you a desk job when you return to work.
Good luck with it and i am sure it will be worth the pain of surgery.
judy

[keewee]

After waiting 3 weeks to see a specialist last Friday he told me he doesn't do ankle fusions so it was a trip to Brisbane.
I saw a Dr Saxby and am booked into hospital on 22nd August. Cannot wait. Am sick of this and not sleeping.:confused:
He doesn't know if I will drive semis again either so will have to wait and see. A change of employment might do me good.

[unregistered]

I am glad you are going for it. The surgery will be unpleasant but after a few weeks the pain will get less and less and I am sure a couple of weeks post surgery you will be in a lot less pain than you are now.
All the very best.
Judy

[MARCO usa-italy]

Hi folks
same problem same pain, can't sleep
I am Italian living in California
31 years old, HYPERACTIVE, huge lack of cartilage from both ends (talus and tibia). Accident in 1994, exposed ankle dislocation, (foot went almost completely off), then recovery, back to sports and almost ok until 2003 ... then BAD ARTHRITIS

had visits with famous doctors both in Italy and California
they don't recommend cartilage transplant for such an extensive lack of cartilage from both ends, cuz it has a low success rate (68%) and insurance don’t pay for it

they suggested 2 LEVELS of surgery:
1) MILD: joint cleaning + (or) microfracures + (or) tissue GRAFT transplant + (or) SYNVISC rooster injection + (or) Ilizarov fixation
2) ULTIMATE: ANKLE FUSION or TOTAL ALLOGRAFT ANKLE TRANSPLANT REPLACEMENT (tibia + talus bone-cartilage ends from a cadaver donor)

Already:
2 yrs ago I had arthroscopic joint cleaning + microfractures + 3 synvisc rooster injections ... cartilage didn't regrow though

NEWS:
DOCTOR1 says I should do right away a FUSION or TOTAL ALLOGRAFT ANKLE REPLACEMENT, since am quite young (31 yrs old) and this would give good ankle movement
http://footandankle.mdmercy.com/conditions/ankle_arthritis/allograft.html

INTERESTING NEW!!
DOCTOR2 says I could try another mild solution:
- joint cleaning with tissue GRAFT TRANSPLANT, this tissue layer from a cadaver donor should help cartilage regrowth (hopefully)

What u guys think about these new graft transplant and cartilage stuff? I really wanna delay extreme solutions to maybe after 10 yrs, I hope research will come up with new solutions in like 5 yrs from now

Do u guys know where’s the best centre for cartilage and foot surgery in the US

I appreciate

MARCO


REFERENCES:
INTERNATIONAL FEDERATIONS OF FOOT AND ANKLE SOCIETIES
http://www.globalfoot.org/minutes_9_16_2005.html

TOTAL ALLOGRAFT ANKLE REPLACEMENT
http://footandankle.mdmercy.com/conditions/ankle_arthritis/allograft.html

[Lynnne]

Hi folks
same problem same pain, can't sleep
I am Italian living in California
31 years old, HYPERACTIVE, huge lack of cartilage from both ends (talus and tibia). Accident in 1994, exposed ankle dislocation, (foot went almost completely off), then recovery, back to sports and almost ok until 2003 ... then BAD ARTHRITIS

had visits with famous doctors both in Italy and California
they don't recommend cartilage transplant for such an extensive lack of cartilage from both ends, cuz it has a low success rate (68%) and insurance don’t pay for it

they suggested 2 LEVELS of surgery:
1) MILD: joint cleaning + (or) microfracures + (or) tissue GRAFT transplant + (or) SYNVISC rooster injection + (or) Ilizarov fixation
2) ULTIMATE: ANKLE FUSION or TOTAL ALLOGRAFT ANKLE TRANSPLANT REPLACEMENT (tibia + talus bone-cartilage ends from a cadaver donor)

Already:
2 yrs ago I had arthroscopic joint cleaning + microfractures + 3 synvisc rooster injections ... cartilage didn't regrow though

NEWS:
DOCTOR1 says I should do right away a FUSION or TOTAL ALLOGRAFT ANKLE REPLACEMENT, since am quite young (31 yrs old) and this would give good ankle movement
http://footandankle.mdmercy.com/conditions/ankle_arthritis/allograft.html

INTERESTING NEW!!
DOCTOR2 says I could try another mild solution:
- joint cleaning with tissue GRAFT TRANSPLANT, this tissue layer from a cadaver donor should help cartilage regrowth (hopefully)

What u guys think about these new graft transplant and cartilage stuff? I really wanna delay extreme solutions to maybe after 10 yrs, I hope research will come up with new solutions in like 5 yrs from now

Do u guys know where’s the best centre for cartilage and foot surgery in the US

I appreciate

MARCO


REFERENCES:
INTERNATIONAL FEDERATIONS OF FOOT AND ANKLE SOCIETIES
http://www.globalfoot.org/minutes_9_16_2005.html

TOTAL ALLOGRAFT ANKLE REPLACEMENT
http://footandankle.mdmercy.com/conditions/ankle_arthritis/allograft.html

:) Thanks for sharing this information...wouldn't it be nice if this is possible ;) ?? I have come to a point where i don't think i can cope with the pain and i have decided to go for a fusion hoping for the best results AND A PAIN FREE LIFEsTYLE ALTHOUGH I KNOW THERE ARE LIMITATIONS...i saw a private consultant here in london and he mentioned someone having had a cartillage regeneration in US..but on a mild ankle injury and he higly doubted if it was really possible with my case..it's very severe and it's progressed so fast and i said to him i have come for a second opinion if this was ur ankle what would you do...he said honestly i would advice fusion..with all this trial you have to be careful u don't end up with bone infections such as osteomyelitis and other complicated issues on the bone that by the time u r fed up of being in pain a fusion is not an option due to weak bones or damaged.I would say if ur pain is manageable and u r still able to work there is no harm in waiting..really if u have the patience...for me i don't think i can hold much longer..:( .i have emailed my xray to the mercy clinic and all my details hopin they will reply me and tell me what my option are..I just thought i would as u never know really ::p ...anyhow goodluk...God bless

[Lynnne]

Hello i emailed my XRAYS to the blackeny clinic to see what procedure they can offer.i just got an email from them and they recommend an ankle arthrodesis done arthrospically so that can be changed in the future should there be an advancement with ANKLES PROCEDURES..will be seeing my consultant end of this month therefore..will keep you posted on whati will have done..in the meantime keep searching..don't give up until you are satisfied on what should be the nest procedure..GOD BLESS YOU AL...Lynne from London...:cool:

[kjwilkin]

Hi Lynne,

Great you heard from Mark Blackney's rooms.

He's a great surgeon, so I'd highly recommend going ahead with him. Sounds better than going for a full ankle fusion.

Let us know how you go and what you decide.

[skittlebike]

All, I can't tell you how great it has been to find this website. I was hit by a car while cycling to work almost three weeks ago. I know I am truly lucky to be alive and count my blessing just to have the ability to type a note to this site. I have broken my tibia and fibula, have 2 plates, 12 screws, and an external fixater. It was an open fracture, and during surgery my OS told me the cartilage just came out in shards of bits and pieces and there isn't much left. I get my stitches out next week and wear the fixator for 3-4 more weeks. No weight bearing for 6 weeks after that. It is still hard to process all of this information and I am struggling with alot of emotions. I am a 37 year old woman with 15 years of military service in the US and have been physically active wth triathlons, marathons, and even an ironman my whole life. Already, I am wheeling my wheel chair up and down the hills on my street to keep the aerobic work up and not lose my mind. Work and my family has been hugely supportive and I know it is still too soon to know how I will recover, but my OS told me I may come to him w/in 6 mos and ask for ankle fusion b/c he thinks I will experience a great deal of pain. To say I am completely thrown for a loop is about right. I don't know what will happen, but I am encouraged by all of your postings and truly appreciate you all sharing your experiences.

[Lynnne]

All, I can't tell you how great it has been to find this website. I was hit by a car while cycling to work almost three weeks ago. I know I am truly lucky to be alive and count my blessing just to have the ability to type a note to this site. I have broken my tibia and fibula, have 2 plates, 12 screws, and an external fixater. It was an open fracture, and during surgery my OS told me the cartilage just came out in shards of bits and pieces and there isn't much left. I get my stitches out next week and wear the fixator for 3-4 more weeks. No weight bearing for 6 weeks after that. It is still hard to process all of this information and I am struggling with alot of emotions. I am a 37 year old woman with 15 years of military service in the US and have been physically active wth triathlons, marathons, and even an ironman my whole life. Already, I am wheeling my wheel chair up and down the hills on my street to keep the aerobic work up and not lose my mind. Work and my family has been hugely supportive and I know it is still too soon to know how I will recover, but my OS told me I may come to him w/in 6 mos and ask for ankle fusion b/c he thinks I will experience a great deal of pain. To say I am completely thrown for a loop is about right. I don't know what will happen, but I am encouraged by all of your postings and truly appreciate you all sharing your experiences.

Welcome dear...i'm sorry to hear about your injury..the thing is most of us have been on that road to recovery...and it's life changing..from the fact that one day u were so able to run errands for urself and the next minute...u r not able to..all i can say is hang in there...be patient and keep ur mind going...as u seem to already be doing the right stuff...God bless :)

[marcoUS]

:) Thanks for sharing this information...wouldn't it be nice if this is possible ;) ?? I have come to a point where i don't think i can cope with the pain and i have decided to go for a fusion hoping for the best results AND A PAIN FREE LIFEsTYLE ALTHOUGH I KNOW THERE ARE LIMITATIONS...i saw a private consultant here in london and he mentioned someone having had a cartillage regeneration in US..but on a mild ankle injury and he higly doubted if it was really possible with my case..it's very severe and it's progressed so fast and i said to him i have come for a second opinion if this was ur ankle what would you do...he said honestly i would advice fusion..with all this trial you have to be careful u don't end up with bone infections such as osteomyelitis and other complicated issues on the bone that by the time u r fed up of being in pain a fusion is not an option due to weak bones or damaged.I would say if ur pain is manageable and u r still able to work there is no harm in waiting..really if u have the patience...for me i don't think i can hold much longer..:( .i have emailed my xray to the mercy clinic and all my details hopin they will reply me and tell me what my option are..I just thought i would as u never know really ::p ...anyhow goodluk...God bless

Lynnne, friends,

I hope that what i've found here:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16221450&dopt=Abstract
is true, and that it will be more successful in the near future also for those who have total lack of cartilage

let's pray

[cackyb]

This is in response to Marco who has no cartilage in the ankle joint. I can only share my experience: injury was similar to yours, but in 1978 due to car accident. My activity level at that time was also very high (I was in my 40s). Eventually went back to full activity, but developed arthritis in the joint due to cartilage deterioration. Had an arthro abrasion in early 80s, and experienced limited relief for a period of time. However, condition continued to worsen, and I learned of the newer allograft procedure totally by accident from a stranger. Contacted the doctor who was mentioned, and after examination and consideration of options on my part, had the allograft procedure in late February of 2004. This involved the tibio-talar slice from cadaver which replaced my completely ruined joint. Now, almost 2 and a half years post surgery, I am essentially pain free and am able to mountain hike (my preference for activity). I have only occasional twinges to remind me of the old unbearable agony. I was 69 when I had the surgery (71 today). My range of motion is limited and I have been advised against any high impact type activity. My personal feeling is that it was a good trade - no pain in exchange for somewhat limited range of motion. I'd make the same decision today.

Surgery was done at UCSD by Dr. Michael Brage who is now affiliated with SCOS, an orthopedic practice located on El Toro Road in Laguna Hills, California.

Hope this helps with your decision.

Cacky Barns
cackybme@yahoo.com

[marcoo]

Thanks cackyb
the search goes on,
check this out
http://www.artificialankles.com/guestbook.html
seems an interesting forum on allograft, lot of patient feedback
also
http://www.artificialankles.com/erinspage.htm

god bless internet and u guys

marco

[marcoo]

how about these links
http://www.artificialankles.com/wwwboard/
http://health.groups.yahoo.com/group/Ankle_Joint_Replacement/
:-)

[marcoo]

hi all

the option2 i was proposed is actually a cartilage restoration method of tissue engineering. It's basically the transplant of an allograft acellular matrix called graftjacket

sounds at least interesting ... still kinda experimental though
wanna know more about it

what u guys think?

m.

[Lynnne]

hey..Marco..so when do u actually get the procedure done:confused: ??? Gud lukHun...:)

[elspethb]

It is depressing to see someone would prefer amputation. Who has had an ankle fusion with the last 3 years ?

What is is like.

As many details as possible please. I am seeing the specialist next wednesday and
much info would be appreciated.

I had a fusion of my left ankle two years ago. I broke my leg playing flag football in college twenty years before and had two operations at the time. Over the years, I lost all the cartledge in the joint and had increasing instability. Then I ended up with a stress fracture doing water aerobics and finally went in to be evaluated. I had a very conservative orthopedic doctor and I managed for about 7 years with occasional stints in a walker boot, cortisone shots and varying amounts of ibuprophen.

When it got so bad I couldn't walk from one end of the grocery store to the other, I threw in the towel and got a fusion. My surgeon is an ankle specialist who studied under one of the artificial ankle inventors up in Michigan-- all he does is feet and ankles, about 50 fusions a year.

The version of the procedure he uses salvages bone from the fibula to use when fusing the joint. He also uses a lot more hardware than most of the procedures I've seen documented on line.

I had very good success with the fusion. I had no complications from the surgery and healed well. I could tell imediately after surgery that the pain was reduced, even with the surgical scars. If I am very tired, I limp, and I have an aversion to walking on unsteady ground but I have greatly increased mobility.

I do low impact aerobic activity and some circuit training, but am unable to run. The biggest complication to my life today is buying pretty shoes. I've had to give that up as a lost cause. The best way to tell if you are a candidate for fusion is if you wear a walker boot for a few weeks and don't want to take it off when they tell you it's time. The mobility you have in the walker is very similar to the mobility you have after the fusion.

[Lynnne]

I had a fusion of my left ankle two years ago. I broke my leg playing flag football in college twenty years before and had two operations at the time. Over the years, I lost all the cartledge in the joint and had increasing instability. Then I ended up with a stress fracture doing water aerobics and finally went in to be evaluated. I had a very conservative orthopedic doctor and I managed for about 7 years with occasional stints in a walker boot, cortisone shots and varying amounts of ibuprophen.

When it got so bad I couldn't walk from one end of the grocery store to the other, I threw in the towel and got a fusion. My surgeon is an ankle specialist who studied under one of the artificial ankle inventors up in Michigan-- all he does is feet and ankles, about 50 fusions a year.

The version of the procedure he uses salvages bone from the fibula to use when fusing the joint. He also uses a lot more hardware than most of the procedures I've seen documented on line.

I had very good success with the fusion. I had no complications from the surgery and healed well. I could tell imediately after surgery that the pain was reduced, even with the surgical scars. If I am very tired, I limp, and I have an aversion to walking on unsteady ground but I have greatly increased mobility.

I do low impact aerobic activity and some circuit training, but am unable to run. The biggest complication to my life today is buying pretty shoes. I've had to give that up as a lost cause. The best way to tell if you are a candidate for fusion is if you wear a walker boot for a few weeks and don't want to take it off when they tell you it's time. The mobility you have in the walker is very similar to the mobility you have after the fusion.

Hiya..I too have reached a point of no return. :( ...and i have decided to go for a fusion...hopefully arthrospically which is meant to be less invasive....and leave some hope for any future advancement.. :confused: so shoewise what are ur sort of comfy shoes???just kindly give us an insight in this area... :) Thanks..God bless

[keewee]

Hi Lynnne,
Good on you. I am in for an ankle fusion on 22nd this month all going well. Like you have had enough. I have so little movement now the doctor says my ankle is nearly fused. I just want to be pain free. As for my ankle I should be but I have now been told I have damaged the fatty cushion under my heel and that is it for life as that cannot be repaired. So I have to find shoes or boots with really soft heels. I also have a lot of nerve damage which affects my toes and soul of my foot and that won't change much either. At least I will be able to walk more than I can do now and get back more of a normal life.
As for shoes will be interested to see what you come up with.
Good luck overthere.
Cheers, Keewee

[Lynnne]

Hi Lynnne,
Good on you. I am in for an ankle fusion on 22nd this month all going well. Like you have had enough. I have so little movement now the doctor says my ankle is nearly fused. I just want to be pain free. As for my ankle I should be but I have now been told I have damaged the fatty cushion under my heel and that is it for life as that cannot be repaired. So I have to find shoes or boots with really soft heels. I also have a lot of nerve damage which affects my toes and soul of my foot and that won't change much either. At least I will be able to walk more than I can do now and get back more of a normal life.
As for shoes will be interested to see what you come up with.
Good luck overthere.
Cheers, Keewee

Hey keewee..good on ya mate...all the best and keep us posted... ;) God bless

[footman]

Good on you -it sounds worth it -i've just come back from an ortho appontment and they offered me a fusion - i have found the experiences and thoughts here very helpful in considering wherether or not go fo the fusion op -After injuring myself on a motorcycle aged 16 now at 50 i find the pain is getting less manageable . For years i have only worn high top light weight walking boots -my favourites have been Ecco -which are soft and have good walking soles but are expensive. For rough ground i use good quality walking boots and use light weight extendable trekking poles which are a must. With a combination of painkillers, good footwear,trek poles and rest i manage evan an occasional day on the hills.

[Lynnne]

:) Hiya...thanks for sharing..since i'm considering a fusion..just wondering what type of shoes you actually get on by..i suppose triners with a comfortable heel really do....as at the moment i find this so..have u byanychance rediscovered a place where they sell speacila shoes...for p'ple who have ahd a fusion or foot and ankle problems in general that you would recommend???tahnks..God bless ;)




I had a fusion of my left ankle two years ago. I broke my leg playing flag football in college twenty years before and had two operations at the time. Over the years, I lost all the cartledge in the joint and had increasing instability. Then I ended up with a stress fracture doing water aerobics and finally went in to be evaluated. I had a very conservative orthopedic doctor and I managed for about 7 years with occasional stints in a walker boot, cortisone shots and varying amounts of ibuprophen.

When it got so bad I couldn't walk from one end of the grocery store to the other, I threw in the towel and got a fusion. My surgeon is an ankle specialist who studied under one of the artificial ankle inventors up in Michigan-- all he does is feet and ankles, about 50 fusions a year.

The version of the procedure he uses salvages bone from the fibula to use when fusing the joint. He also uses a lot more hardware than most of the procedures I've seen documented on line.

I had very good success with the fusion. I had no complications from the surgery and healed well. I could tell imediately after surgery that the pain was reduced, even with the surgical scars. If I am very tired, I limp, and I have an aversion to walking on unsteady ground but I have greatly increased mobility.

I do low impact aerobic activity and some circuit training, but am unable to run. The biggest complication to my life today is buying pretty shoes. I've had to give that up as a lost cause. The best way to tell if you are a candidate for fusion is if you wear a walker boot for a few weeks and don't want to take it off when they tell you it's time. The mobility you have in the walker is very similar to the mobility you have after the fusion.

[Lynnne]

hI MARCO...I DELETED UR PERSONAL EMAIL ADD.BY MISTAKE I NEED TO GIVE U DETAILS RE..ALLOGRAFT...MAIL ME PERSONALLY..RE..DR.William bugbeee



Hi folks
same problem same pain, can't sleep
I am Italian living in California
31 years old, HYPERACTIVE, huge lack of cartilage from both ends (talus and tibia). Accident in 1994, exposed ankle dislocation, (foot went almost completely off), then recovery, back to sports and almost ok until 2003 ... then BAD ARTHRITIS

had visits with famous doctors both in Italy and California
they don't recommend cartilage transplant for such an extensive lack of cartilage from both ends, cuz it has a low success rate (68%) and insurance don’t pay for it

they suggested 2 LEVELS of surgery:
1) MILD: joint cleaning + (or) microfracures + (or) tissue GRAFT transplant + (or) SYNVISC rooster injection + (or) Ilizarov fixation
2) ULTIMATE: ANKLE FUSION or TOTAL ALLOGRAFT ANKLE TRANSPLANT REPLACEMENT (tibia + talus bone-cartilage ends from a cadaver donor)

Already:
2 yrs ago I had arthroscopic joint cleaning + microfractures + 3 synvisc rooster injections ... cartilage didn't regrow though

NEWS:
DOCTOR1 says I should do right away a FUSION or TOTAL ALLOGRAFT ANKLE REPLACEMENT, since am quite young (31 yrs old) and this would give good ankle movement
http://footandankle.mdmercy.com/conditions/ankle_arthritis/allograft.html

INTERESTING NEW!!
DOCTOR2 says I could try another mild solution:
- joint cleaning with tissue GRAFT TRANSPLANT, this tissue layer from a cadaver donor should help cartilage regrowth (hopefully)

What u guys think about these new graft transplant and cartilage stuff? I really wanna delay extreme solutions to maybe after 10 yrs, I hope research will come up with new solutions in like 5 yrs from now

Do u guys know where’s the best centre for cartilage and foot surgery in the US

I appreciate

MARCO


REFERENCES:
INTERNATIONAL FEDERATIONS OF FOOT AND ANKLE SOCIETIES
http://www.globalfoot.org/minutes_9_16_2005.html

TOTAL ALLOGRAFT ANKLE REPLACEMENT
http://footandankle.mdmercy.com/conditions/ankle_arthritis/allograft.html

[hroesch78]

Hi Rebecca and Friends,
It is astounding how may of us have serious ankle injuries, and going into surgery after an accident is such a trust issue with our doctors.

In Febuary of 2004, I fell out of a harness while working on a boat. The fall was a controlled fall (feet first) for about 4 1/2 meters (15 feet...I am an American!) Going into the hospital, my doctor came in a 2 a.m. and while I was high on Percocet and really scared, he told me that my ankle was so damaged and I would never walk correctly or be able to run ever again. Although this was partially the truth, his bedside manner was shocking! He even sent me home with a fat leg because they had to wait until the swelling went down. My poor family was freaking out!

So I persued a different doctor (thank god) and he is the doctor I really needed in this time if scared uncertainty. He immediately put me into hospital again and we went into surgery. He talked and treated me like a member of his family, but I also treated him as a person too. I made a point of asking about his life and family every follow up before discussing my condition. This not only broke up his day, but he ended up spending more of his time with me discussing options, instead of rushing off to the next patient. This is very important when "working with" your doctor.

He put on an External Fixation Device (which is a long bar with a curved end) and four pins going through the skin and into the bone. I wore it for 6 weeks, then had it removed. I was in a cast for a few more then it was taken off. There was some infection in the holes, and now I have some pretty good scars.

Later, I had the three internal pins removed, had it scoped, and a shot of cortizone inserted. I have been managing pain with cortizone injections once every 4 months. This isn't the best for your body, but spreading out the shots minimized the effects of cartilage deterioration and it was heaven when it kicked in a week later!

Now that I am on my own (and have reluctantly settled with the cold hearted american insurance companies), I am fending for myself to look for a way to get rid of this pain, stop the limping, and throw away these burdensome braces I have to wear everyday.

Fusion is out of the question for now, and met with a doctor in Augsburg, Germany who tells me of the S.T.A.R Ankle Transplant (Scandinavian Total Ankle Replacement). I did a search on Google AU and found some pretty good information. However, this procedure isn't approved in the U.S. by the FDA (for reasons I don't know why) and am searching to do this surgery next June or so in Germany.

Since I can't work on boats anymore, I am persuing a pilot career in aviation, but cannot pass the medical by taking pain medication or anti-inflamatories.

If anyone has had a S.T.A.R. ankle transplant, I would love to pick your brain...and buy you a coffee. I am 28 and was very active. I really miss being mobile without razor blades in my ankle.

Keep your spirits up! This site is a great start!
Hadrian

[keewee]

Hi hroesch78
Just read your note. Why carn't you have an ankle fusion? I fell from 3 metres and destroyed my right ankle and had an external fix for a week to get the swelling down then a further to surgeries to plate the tibia and fibula. I destroyed my ankle joint as well so it was bone on bone and was living on pain killers. Got back to work driving B-Doubles for about 8 months but had to give it away. Had an ankle fusion last week and so far it feels great. Had a bit of a bone graft to fill in some gaps and now have a back slab on my leg till the stitches come out this Friday. Doctor wouldn't look at an ankle replacement for me yet as I was to young at 53 because they don't last long yet ?
Germany must be way ahead with theirs.
Goodluck with yours. Just think positive. It gets really hard sometimes and you just don't see an end. This site helped me out heaps.
Cheers, mate

[hroesch78]

Thank you for the reply Keewee.

With all of the information regarding fusion, I understand that although it removes the pain, it eventually wears out the joints surrounding the ankle. If you try to jog, even on a treadmill, I also understand that you often do it with a limp and it isn't good for your foot.

I am making a decision to attempt a STAR ankle replacement and if it doesn't work, then they can always take it out and fuse it. It seems like I would forgo a perfectly good attempt at mobility, and immediately move to plan B. Also, they said that the teflon disk in the middle has a life of at least 20 years if not longer. The replacements existing are plastic replacements for elderly with very limited mobility anyway, and to put it in anyone remotely active, it will break.

Also, I found that the FDA (the U.S. Food and Drug administration) has approved another 125 STAR ankle replacements (currently doing them in Jacksonville, Florida) and are on their way to becoming the next step before a fusion. Not to say a fusion wouldn't be great for me, but it just seems like a step I am willing to take at 28.

Good luck with your fusion keewee. I look forward to hearing about your recovery. Please keep us informed. This is great knowledge for all!

Hadrian

[unregistered]

Hi Keewee,
you are now over the worse of your ankle fusion pain. Just remember to keep your leg elevated for the first few weeks as the swelling will build up when the leg and foot hang down, which will cause pain and throbbing. It sounds like you are already in less pain than prior to the surgery.
Good luck mate and hang in there.
Judy

[Smiley]

Hi
I have read Rebeccas story and others and I feel I should share mine.In August 2000 I fell on a construction site onto a Concrete floor into scaffolding and my ankle was ripped right around way past 90degrees..I put my hand around my head to save my self from a head injury in that split second and ended up with a smashed wrist and also broken leg. All in all I broke my bones on my right side and I was dominant Right handed.
I was taken to Hospital and my ankle was that swollen I had to move around for 10 days to the loo etc while I felt and heard the bones crunching and crackling and me trying to stay sane.
I had surgery and it took 14 hrs to rewire and screw it back together. They said I would be back at work in 3 months.Oh and I havent even mentioned my back injury.
After 5 months I had a screw removed and immediately rebroke my Fibia or? I get it mixed up (the narrow bone) on the outer lower legs. I broke it a further dozen times before it finally fuzed.In the meantime I could not even put weight on my ankle.I had massive amounts of physio and I started on too much Panadiene forte and 2000mg Brufen a day,This did nothing and was endangering my health.I researched pain management and found slow release morphine.I have been on that for over 5 years now and it was the only thing that stopped me going insane with the pain.
My biggest complaint and eats at me all the time is I was always a strong healthy male.I was 33 .I had 2 daughters just heading into their teens and my wife who had to support me. The problem I encountered was the Surgery .When they stretched it all back together they seemingly did it so tight that it restricted blood flow to the cartiledge and result ed in it dying and wearing away.I had Xrays over and over to watch what was happening and slowly and surely It wore away till Bone met bone.
I was told to fuze my ankle however I had spoken to people who had and it causes much stress on other bones in the foot.Long term it is not a choice for someone my age.I know that in 30 years time if I fuzed it I would be paying for it in agony.
I have writtten and researched stemcell research and cartiledge implants as well as contacting some of the best Surgeons in the world.
Its amazing that they often will email you back if you give them enough information and they have made some suggestions.
I believe I will wait.As time goes by this century it wont be too long until full replacement of joints and cartiledge regrowth will be a real option.In Geneva they declared this decade the decade to overcome and resolve repair of all joints and the ankle being the highest load bearing is the last one for them to conquer.
I have reduced my medication and lost weight as I was always a very solid build,Not fat but stocky.
I await the day when this surgery is available to people like us.I will never forget when he told me my right ankle alone was shattered into 9 major pieces and it was a nightmare to remove the small pieces in Surgery or so I was told.
I guess I cant blame the Doctors back then with the lousey system we have in Queensland.However I will never consider fuzing my ankle as most specialists say that any future repairs to the joint when it does become available will not be available to the fuzed ankle .Perhaps in time after they master the first stage they may master a fuzed ankle but I for one am not going to add to my woes by damaging my foot,causing back problems and the risk of breaking the joint because of no movement.
I understand some of you fuzing your joints and believing it to be the best but I cannot do this.I am optomistic that in time surgery will be available to repair my ankle and allow me back my life.The lifespan of any current ankle replacement is 5 years plus and is mainly for seniors or the elderly.I am not in that category.
I have another 25 years of work left in me before I have to retire and I believe that somewhere not to far down the track we will see the surgery that most of us only dream of.Remember that medicine advances so incredibly fast.In 5 years who knows what they will be able to do.
I await that time and live in hope .
Just thought I would tell my story
Stephen

[keewee]

Hi Judy,
I didn't believe the difference I felt coming out of surgery. Pain is right down. Back to the specialist tomorrow,Friday, to have the stitches out and a full cast. I have ben keeping my foot elevated, even here while on the computer.
Thanks for the note and support.
Cheers, Keewee

[hroesch78]

Dear Smiley,

I could just hear the "Crunch" when I read your story. Man, falls are really a tough gig.

Good luck with waiting for medicine to improve. I am with you with waiting but I am coming to the point where the pain is taking over my sanity. Thanks for the information about Geneva. I look forward to reading about it and good luck with your recovery.

Hadrian

[Lynnne]

Hiya...i think you are very couraheous in in your decision....i for instance wanted to wait but the pain has become unbearable...i'm only 26yrs...old...i'm in constant pain most days and walking is a nightmare but i always persevere...but i have decided to fuse my ankle in novemeber...as the future i will just have to wait and see....God bless u n good luck...:;)


Hi
I have read Rebeccas story and others and I feel I should share mine.In August 2000 I fell on a construction site onto a Concrete floor into scaffolding and my ankle was ripped right around way past 90degrees..I put my hand around my head to save my self from a head injury in that split second and ended up with a smashed wrist and also broken leg. All in all I broke my bones on my right side and I was dominant Right handed.
I was taken to Hospital and my ankle was that swollen I had to move around for 10 days to the loo etc while I felt and heard the bones crunching and crackling and me trying to stay sane.
I had surgery and it took 14 hrs to rewire and screw it back together. They said I would be back at work in 3 months.Oh and I havent even mentioned my back injury.
After 5 months I had a screw removed and immediately rebroke my Fibia or? I get it mixed up (the narrow bone) on the outer lower legs. I broke it a further dozen times before it finally fuzed.In the meantime I could not even put weight on my ankle.I had massive amounts of physio and I started on too much Panadiene forte and 2000mg Brufen a day,This did nothing and was endangering my health.I researched pain management and found slow release morphine.I have been on that for over 5 years now and it was the only thing that stopped me going insane with the pain.
My biggest complaint and eats at me all the time is I was always a strong healthy male.I was 33 .I had 2 daughters just heading into their teens and my wife who had to support me. The problem I encountered was the Surgery .When they stretched it all back together they seemingly did it so tight that it restricted blood flow to the cartiledge and result ed in it dying and wearing away.I had Xrays over and over to watch what was happening and slowly and surely It wore away till Bone met bone.
I was told to fuze my ankle however I had spoken to people who had and it causes much stress on other bones in the foot.Long term it is not a choice for someone my age.I know that in 30 years time if I fuzed it I would be paying for it in agony.
I have writtten and researched stemcell research and cartiledge implants as well as contacting some of the best Surgeons in the world.
Its amazing that they often will email you back if you give them enough information and they have made some suggestions.
I believe I will wait.As time goes by this century it wont be too long until full replacement of joints and cartiledge regrowth will be a real option.In Geneva they declared this decade the decade to overcome and resolve repair of all joints and the ankle being the highest load bearing is the last one for them to conquer.
I have reduced my medication and lost weight as I was always a very solid build,Not fat but stocky.
I await the day when this surgery is available to people like us.I will never forget when he told me my right ankle alone was shattered into 9 major pieces and it was a nightmare to remove the small pieces in Surgery or so I was told.
I guess I cant blame the Doctors back then with the lousey system we have in Queensland.However I will never consider fuzing my ankle as most specialists say that any future repairs to the joint when it does become available will not be available to the fuzed ankle .Perhaps in time after they master the first stage they may master a fuzed ankle but I for one am not going to add to my woes by damaging my foot,causing back problems and the risk of breaking the joint because of no movement.
I understand some of you fuzing your joints and believing it to be the best but I cannot do this.I am optomistic that in time surgery will be available to repair my ankle and allow me back my life.The lifespan of any current ankle replacement is 5 years plus and is mainly for seniors or the elderly.I am not in that category.
I have another 25 years of work left in me before I have to retire and I believe that somewhere not to far down the track we will see the surgery that most of us only dream of.Remember that medicine advances so incredibly fast.In 5 years who knows what they will be able to do.
I await that time and live in hope .
Just thought I would tell my story
Stephen

[Lynnne]

Goodluck mate..seems already like things are surely looking up. :cool: .God bless and all the best...;)

[peppiniello]

Smiley,
I agree with you, we shouldn't fuse our ankle and wait for new developement in
- joint replacement
- stemcells research

Are you guys aware of ANKLE ALLOGRAFT?
people who underwent it are so happy with the results.
Of course it can fail, but as some doctors say, allograft doesn't burn any bridges, since one can always go ahead and fuse the allografted ankle or have another allograft

also I was asking myself, if I can't stand the pain anymore and decide for an allograft, and, as Smiley says, in 5 years stemcells cartilage reconstruction is ready:
will I be able to reconstruct the allografted joint that has gone back to arthritis?

am I wrong?

also,

Smiley, what's this Geneva thing ? can u give me more details?

thanks

[trehoo4az]

I am 34 years old and over 19 years ago i was involved in a serious accident. The first thing the doctor wanted to do was fuse my ankle. I was aminor at the time and my parents said no. Instead screws and pins were put into my ankle in a one time surgery procedure. Today i have the worst pain ever in my ankle. Thats not nearly as bad as my hip pain though. Over the last 19 years my arches on my feet have been uneven causing my posture to be off. About 14 years ago i was pregnant with twins and my weight was 204lbs i thought my ankle hurt then. That was nothing compared to now. I often wonder what my ankle would be like if i would of just had it fused?

[hiest2163]

My Ankle was crushed in 1980 in an industrial accident. I lived with a great deal of pain for 12 years, bone on bone, no cartlidge. In 1992 I had a surgeon who convinced me that a fusion would take the pain away, he was right. I never felt better, my energy shot up and while I had lost some movement and could not run I could be active like I never could when I was hurting. I lost a great amount of weight and my attitude improved, it is difficult to understand how living with pain over an extended period of time can lead to a gradual change in your attitude.

Now it has been 14 years and another joint went bad, probably from taking up the work of the main ankle. I have been in pain for over a year, tried pain meds and took a couple of shots of cortisone but the pain never left for long. About two weks ago had the joint fused and now am in recovery, pain free and hope that the results are similar to the last one. I had no reservations about the fusion because of my experience with the first one. Don't put up with the pain if you have an option.

[Lynnne]

Thanksfor sharing that information..I have decided to go for the fusion myself as i thot i cannot live in pain no more...hopefully all shuld be well..So out of curiosity what other joint went bad???i'm just curious to know???as u mentioned it's probably from the fusion...If you don't mind sharing..God bless ;)

My Ankle was crushed in 1980 in an industrial accident. I lived with a great deal of pain for 12 years, bone on bone, no cartlidge. In 1992 I had a surgeon who convinced me that a fusion would take the pain away, he was right. I never felt better, my energy shot up and while I had lost some movement and could not run I could be active like I never could when I was hurting. I lost a great amount of weight and my attitude improved, it is difficult to understand how living with pain over an extended period of time can lead to a gradual change in your attitude.

Now it has been 14 years and another joint went bad, probably from taking up the work of the main ankle. I have been in pain for over a year, tried pain meds and took a couple of shots of cortisone but the pain never left for long. About two weks ago had the joint fused and now am in recovery, pain free and hope that the results are similar to the last one. I had no reservations about the fusion because of my experience with the first one. Don't put up with the pain if you have an option.

[keewee]

Goodluck mate..seems already like things are surely looking up. :cool: .God bless and all the best...;)

Hi Lynnne,
Glad to hear you are have your ankle fused. I ahve had the stitches out and now have a full cast for 12 weeks. After 6 weeks am allowed to start putting weight on it. My ankle feels great and I am nearly off all pain killers. For me and my wife it is a godsend. I feel great and just want to get out there again. I feel a near normal life is possible. I hope you have a great out come. I couldn't wait another 5 years or so for future advances.
All the best. Keewee:D

[Mischap123]

This forum is a wealth of information. Congats to all who have contributed.
My story is also that of a lack of articular cartilage amongst other problems. I have a varus deformity of both feet. Like a mild form of club foot. I have played basketball for 20+ years and up to a national level as a junior. The combination of genetics and b'ball has left me with chronic instability due to ligament insufficiency(rupture), avulsion fractures, unfused previously undiagnosed foot fracture, leading to talo-tibail osteophytes(spurs), subtalar osteophytes, grade 4 chondral wear(bone on bone) and of course pain. I have just come out of a cast 2 weeks ago after having 5 procedures in 2 ops since April this year. I'm planning for the future as fusion has been the only future option given to me. I'm 29 yrs old.
I want to put it out there is there anyone that has had an ankle replacement?
Even if some of the more mature posters in this forum are considered too young, what hope do I have?
As a Chiropractor with excellent anatomical knowledge, I WILL NOT FUSE. I would try anything else before that. Professionally, I see everyday the effects of compensations and understand that some may see no other choice, but I will not fuse.

[peppiniello]

Mischap123

you may find this page interesting
http://www.artificialankles.com/guestbook.html
plenty of email contacts and feedback from people who underwent replacement

take care

[Mischap123]

Mischap123

you may find this page interesting
http://www.artificialankles.com/guestbook.html
plenty of email contacts and feedback from people who underwent replacement

take care
Thanks alot. A very helpful site. Cheers.

[poosie]

Hi Rebecca

I Had An Ankle Fusion 3 And A Half Years Ago. This Was Not A Decision I Entered Into Lightly As A 32 Year Old Woman. After Years Of Suffering, Much As You Described, And Numerous Operations Later, I Succumbed To The Advise Of Doctors And Pressure To Have The Fusion. I Was Under The Impression This Would Be A 'pain Relieving' Operation. I Regret Having The Procedure As I Am In Just As Much Pain, Perhaps Even More And Continue To Take Antiinflammatory Medication As If It Was A Lolly. I Had An Xray Just Yesterday And I Now Have Arthritis In Other Parts Of My Foot. I Am Going To Make An Appointment To See The Specialist Again, To See If Taking The Screws Out Will Make A Difference - I Am So Sick And Tired Of Living In Pain, Sometimes Severe. I Not Saying You Will Be Like Me If You Have The Fusion, But Do Your Research First. I Wish You All The Best. You Are Welcome To Email Me If You Have Any Questions.

Lynda

[peppiniello]

Thanks alot. A very helpful site. Cheers.

also
http://www.artificialankles.com/erinspage.htm

[hiest2163]

To answer your question, my previous fusion was the main ankle joint itself. As the Surgeon explained there are several other joints in the ankle that provide you with some sort of movement and it is one of these joints that was worn out. After fusing the main joint the pressure then moves to whatever moving parts are still left. In my case of an accident there was probably already some damage and after the main joint was fused it put more stress on the remaining joints. I hope I can go another 14 years before another surgery, pain free now and it feels great even if I am in a cast.

[Lynnne]

Thanks for ur reply..Gud luk..Hun...:)

To answer your question, my previous fusion was the main ankle joint itself. As the Surgeon explained there are several other joints in the ankle that provide you with some sort of movement and it is one of these joints that was worn out. After fusing the main joint the pressure then moves to whatever moving parts HANKSD14 years before another surgery, pain free now and it feels great even if I am in a cast.

[Mich]

The only option I had was a fusion of my subtalar joint. I was in a mva with a drunk driver and when I slammed my right foot on the brake pedal the other driver hit me head on and my ankle snapped back. Although it doesn't matter how you break this joint, or any other ankle joint, the option does only seem like surgery. My surgeon informed me that I would suffer from arthritis (wear and tear) of the joint which would get worse, if I didn't have surgery. I am 23 yrs old, an emergency worker, and I have been reduced to office work and could not take one step without pain. Surgery- with its possibility of not being successful was the next step. I was told that non fusion was a possibilty, and I was told that if it was successful, any impact sports would eventually lead to early arthritis of the rest of my ankle. It is the cold hard reality- it is not fair, but the best thing to do would be to speak to a good surgeon, go through the next step and look after your body. And support one another- I know that you think it couldn't be worse, but it could.......

[Lynnne]

Hang in there Mich.....all of us here are going thru the same thing and harsh reality of our present lives..with or without a fusion ...hopin to go back to normality..God bless...:) There is a good yahoo group on fusion and great suppot from the guyz there..it's good reading material..have a look...;)

The only option I had was a fusion of my subtalar joint. I was in a mva with a drunk driver and when I slammed my right foot on the brake pedal the other driver hit me head on and my ankle snapped back. Although it doesn't matter how you break this joint, or any other ankle joint, the option does only seem like surgery. My surgeon informed me that I would suffer from arthritis (wear and tear) of the joint which would get worse, if I didn't have surgery. I am 23 yrs old, an emergency worker, and I have been reduced to office work and could not take one step without pain. Surgery- with its possibility of not being successful was the next step. I was told that non fusion was a possibilty, and I was told that if it was successful, any impact sports would eventually lead to early arthritis of the rest of my ankle. It is the cold hard reality- it is not fair, but the best thing to do would be to speak to a good surgeon, go through the next step and look after your body. And support one another- I know that you think it couldn't be worse, but it could.......

[keewee]

Hi Mich,
It is your call. I had a work accident and after getting back to work had to stop due to the pain after about 7 months. I was on constant pain killers and some I needed I couldn't take because I was a truck driver. I have now had a fusion and still have my leg in plaster. I feel like a new man. I am off all medication and even though I am bored I cannot wait till I am moving around again.
My wife and I have a lot of living to do and the past 18 months really restricted us.
Mich as hard as it gets just be thankful you are alive and think about how much worse it could have been. I know you are a lot younger than me but you will get through it what ever decision you make. Pain can be a real downer mate but think of the future and what you can do.
Cheers mate, Keewee

[barcmond]

Hi, I am ( or was) an active 46 y/o who suffered a smashed ankle after a head on mva (not my fault) 2 years ago. Both my knees were also broken. I cant believe how quickly my ankle has gone from bad to terrible, so now I have also been told a fusion is my only option. My surgeon is Linda Ferris in Adelaide who I think is very good and I have complete faith in her but I am not looking forward to the sugery as I am sick of the pain after each operation. I've already had 2. I was wondering if you leave it too long before having the operation can your ankle get so bad that then they cant fuse it? I have accepted that fusion seems the only viable option but cant seem to bring myself to schedule the surgery. I feel pretty pissed off at the person who crashed into me to give me such a life changing injury. Any advice would be welcome.

Regards to all, Linda

I understand your problems completely Linda,

I had a MVA 26 years ago and had a heap of compound fractures to my leg together with a smashed knee and smashed ankle. I've had 17 operations over these past 26 years. They have helped correct a lot of problems but the pain I experienced all these years with my ankle has been horrendous. Couldn't walk more that 50 metres without my ankle collapsing. If I was on my own and lucky enough to have remembered to take my mobile phone with me, I would have to ring a friend and ask them to pick me up and take me home because I couldn't walk on it. My surgeon at the time said that I had 2 options. Get it fused, which would relieve all pain or have an ankle replacement. He said to me years ago that if I could be tough enough and put up with the pain, eventually an ankle would be invented that would not wear out. Apparently they only lasted about 5 years.

I was at the stage last year where all I wanted was for my foot to be amputed. I couldn't take it anymore. I went to see a foot & ankle specialist named Dr.Alison Taylor (Knox Private Consulting Rooms) Melbourne. I told her that I was out of my mind with pain and virtually trapped in the house laying on a couch all day because I was unable to walk. She had a look at my xrays and told me she wasn't at all suprised that I couldn't walk on it because of the amount of deterioration. She said I could have it fused to take away the pain or try a new invention that has proved really succesful called the TOTAL STAR ANKLE REPLACEMENT. If I had it fused though, it would mean I would never be able to have an artifical ankle put in so I decided to go with the STAR ANKLE (TITANIUM) and as your doc has probably told you, having it fused, you will loose all movement and it will be stiff.

I had the operation last may (2005).

I am now walking with 100% no pain. It has been amazing! I am 49 years old and this ankle will last me out as long as I take care anD just behave like a normal person. She meant no marathon running, that type of thing. I can't believe the difference it has made in my life.

I suggest you look into it.

By the way, I am the same as you. Accident not my fault. Guy came straight out of a stop sign. He got away without a scratch and I have had operation after operation for the past 26 years.

TOTAL STAR ANKLE REPLACEMENT - DEFINATELY WORTH A SHOT

Regards
Barcmond

[kjwilkin]

Hi Linda,

If you want another opinion before having surgery I'd definitely recommend Mark Blackney in Melbourne. He's meant to be one of the best for ankles.

Mark Blackney operates on a lot of the AFL players. There was a Richmond player that had a career ending injury and Mark was able to fix it.

I had an ankle reconstruction and peroneal reconstruction with Mark in late January. My ankle is feeling the best it has for years. My ankle was extremely unstable before the operation and had a lot of difficult walking.

Good luck !

[ggail]

Please post the results of your daughter's experimental ankle surgery - she was to have had it on April 29, 2005 (I think). My 20 year old son has both talus bones shattered and is in constant pain. He has been offered ankle fusion as his only hope. I want to explore surgeons with a greater vision. Please let me know how your daughter is doing. Thank you so much. Gail


My 19 year old daughter will be having experimental ankle surgery this Friday the 29th. The ankle was smashed in a car accident just over a year ago. She has no cartilage and after a year of plates and screws and pain meds is in pain pain pain. Walking is basically a hobble. She was told by numerous OS to that fusion is her only hope. Also that within 5 years or so that she would have arthritus in her foot as a result of the fusion. We checked out all her future possibilities. We applied to Duke for experimental ankle replacement. Note that she is bone on bone and arthritus set in within a month of the accident. The answer from them is that no case study exists for her case and she was rejected because of her young age. We continued on with no health insurance to find a OS willing and agreeing that in two years something more may be available to her. He waved most of his fees, and got a surgical hospital to wave most of it's fees, we pay for the halo-frame, and the cartilage injections will be donated free from the company. Friday he will go into surgery and take the plate and screws that were left in the ankle and prepare the ankle bones and area for injection room. He will pin and screw the halo-frame to her foot and calf and she will undergo several weeks of injections (we love chickens now) the frame should remain on for 2 to 3 months, the later part slowly releasing movement for her ankle and then slow therapy to see how it all went. We are crossing our fingers and ankles on this one. She is cautiously excited. I will keep you posted if you have interest on how this goes. The surgery will be done in Miami, Florida. Good luck to you all as well.

[ggail]

I'm asking my question once more in case you didn't get my reply. My 20 year old son is in constant pain from the shattering of both talus bones. I wish to find out the results of the experimental ankle surgery on the 19 year old girl that I believe took place on April 29, 2005. Please let me know the results. We are trying to see which direction we should go. Thank you. Gail

[merryl]

Hi everyone,
Wow. I haven't checked the site for a while and it's quite overwhelming to read all your posts and still see more and more people who are having to making the painful (in every way) choice of whether or not to go ahead with an ankle fusion.
As you know, I had the fusion done in August last year, which means i'm a few months away from 'complete' recovery.
For me, fusion was the only option (apart from amputation). Everyone's situation is different and I still believe that fusion is a last resort choice.
This is where i'm at now:
I am happy to say that I have whole days where I forget about my ankle because I have no pain! I do have pain every now and then (maybe once a week on average) but it is so mild in comparison to almost 2 years of can't-do-anything agony I barely notice it.
I can walk non-stop (not as fast as I used to) for approx. 3-4 hours normally. Now and then a little pain might start and my walking is affected but other than that I walk like a normal person.
Running is pretty unco but that was never my thing anyway.
Stairs and steep inclines are interesting. Again, it depends on the day but because of the limited up & down movement I do prefer to take the lift. It's possible just a bit awkward.
Cycling on a stationary bike is fine (and recommended).
I had some exercises that the physio gave me with a wide band to strengthen the ankle which i've stopped doing, so I must be doing ok!
I haven't tried any other weight baring exercies or activity yet.
I'm not emotionally ready to start up dancing again just in case I can't continue doing it. I'd prefer to wait until i've completed my recovery and then give it a whirl.
My surgeon (Mark Blackney, East Melbourne - highly recommended & touted as 'the best' for ankles and I agree, he and his team are fabulous) can't give definates about what i will and won't be able to do in terms of more full on activity. It's totally subjective, so we'll just have to wait and see as I give things a go.
So, for me, overall a good result. I'm living like a normal person again.
My reservations about the future implications of the fusion on my other joints are still the same but Mark seems to think that in my case the likelihood of adverse future effects are low as long as I don't 'overdo it'. So, no high impact activity = less chance of future problems occurring.
OO, I almost forgot. In my case driving a manual car is not preferable anymore. Sad for me because I love driving my 1971 Peugeot, she will have to be sold. I'll have to get myself an automatic which i'll operate with 2 feet, so I can brake with my left foot. I also need a car where the seat is placed a bit higher because it's bloody difficult pressing an accelerator pedal when you have very limited up/down motion in your right ankle.

So, i'm doing pretty well now. I actually have peace of mind. We'll just have to see what the future holds.
Good luck everyone!

Get lots of opinions, ask lots of questions and don't put up with agony.
Rebecca:)

Hi Rebecca
Can you let me know how you are manageing now that your ankle fusion has been done for some time. I have seen a specialist and he believes that a fusion is my only option to relieve the constant pain. The pain is affecting my everyday life but I'm afraid that an ankle fusion will also affect my everyday activities only in a different way
Merryl

[Mischap123]

Hi to all out there with ankle/cartilage probs. I wanted to ask if anyone has had an ankle cartilage transplant in Sydney yet? I know it's new and there is a Dr Kuo in Sydney that can do them. My quest for info on this topic has taken me all over the world and this guy operates in a hospital a few hundred metres from my home!!! I don't believe in it, but could this be fate???

[JohnR]

Hi all, I have been reading this column for a while and has contributed to my decision to have the ankle joint replacement in Feb. rather than a fusion. I had an ultralight aircraft accident over 20 years ago and managed to stay reasonably active (being self employed, I had no choice). 3 years ago I had a half cast made and have worn this at all times except bed since and it originally made a lot of difference and I would recommend it as interim measure as I would have preffered to wait until ankle joints are a bit more reliable but the amount of medication I need to keep going then the medication needed to conteract the damage caused by pain killers apart from the mental impairment!. I' m in my early 50s so it will be interesting how long the joint lasts if I continue working (and on my feet) minimim 12 hours a day. The joint is repairable! Another point, I have always worn good quality hiking boots and I really believe the support they give has helped prolong my activity. So for others considering the replacement, I should be back on my feet end March so will keep posted.
Regards JohnR

[RWP]

I am 30 years old. Five years ago I suffered a broken ankle. I had pins, screws and a plate attached and one year later had them all removed in two operations and was told that all went well. I have experienced regular mild pain since and only severe pain after very strenuous activity. I reported this to my doctor and was told that it was to be expected when I pushed my ankle too far. My ankle always recovered after a few days rest. Everything changed this year. I started a job where i stood up most of the time, as apposed to my previous mainly seated job. For the past nine months since I started that job I have had severe pain everyday. I can barely put weight on it in the mornings after sleep and any time after sitting. The rest of the time I hobble about in severe pain. I also have barely any up and down movement in the ankle. After a three month wait I finally got to see an orthapaedic doctor in Melbourne (where I live) who specialises in ankles. He told me I have basically no cartilage left in my ankle and my only option was to have an ankle fusion. After researching this and other options I found that this operation leaves you with extremely limited mobility and leads to further ops in the future as a result of pressure on the other joints. What are my options? Is ankle reconstruction an option for me? Or cartilage regeneration? Or anything non-operative? Please, any advice would be wonderful. I feel that ankle fusion is not an option for a formerly active 30 year old.

Rebecca...I feel your pain, literally...It's been 4 years now since my injury and I'm also cartilage challenged. My options are simple...either do the fusion or have it replaced. I'm 51 and very active and the pain has slowed me down immensely. My Dr. referred me to a spec. in Houston. There, I was impressed as to what my options actually are. There are quite a few ankle prosthesis out there, most with not-so-good track records. My Dr. wants me to have a Link S.T.A.R. device that is not FDA (US) approved just yet (expected soon, though). It has a good long term record in Europe due to the design and other specific reasons. I saw where a Tornier ankle prosthesis was FDA approved in Dec. '06 and it looks very similar to the STAR. The STAR device requires less recovery time than fusion, by about 4 weeks, allows for mobility, and should it fail down the line...repair or fusion is still possible. Fusion, esp. at your age, is going to give you problems with the other flexing parts of your foot down the road, so I'd put it off as long as possible. Look into your joint prosthesis options. Good luck and keep me posted. Ralph

[RWP]

Hi all, I have been reading this column for a while and has contributed to my decision to have the ankle joint replacement in Feb. rather than a fusion. I had an ultralight aircraft accident over 20 years ago and managed to stay reasonably active (being self employed, I had no choice). 3 years ago I had a half cast made and have worn this at all times except bed since and it originally made a lot of difference and I would recommend it as interim measure as I would have preffered to wait until ankle joints are a bit more reliable but the amount of medication I need to keep going then the medication needed to conteract the damage caused by pain killers apart from the mental impairment!. I' m in my early 50s so it will be interesting how long the joint lasts if I continue working (and on my feet) minimim 12 hours a day. The joint is repairable! Another point, I have always worn good quality hiking boots and I really believe the support they give has helped prolong my activity. So for others considering the replacement, I should be back on my feet end March so will keep posted.
Regards JohnR

Hi JohnR,
Which prosthesis did you choose? I'm told the STAR is the best currently, but recently found the Tornier device which looks (and sounds) almost identical. The STAR device is not US FDA approved just yet, and the Tornier device was approved in 12/2006. I am in almost the exact situation, just turned 51, A/C accident 4 years ago and in end stage osteo-A. I appreciate your thoughts. Ralph

[JohnR]

Hi Ralph, Had to check with surgeon to get the name - it is the 'Agility'' by Depuy. He is aware of the STAR but believes in the success of model he is familar with. He assures me that the plastic block can be replaced if needed. As I work for myself, I need to be on my feet for extended periods (up to 18 hours a day!)so this was my greatest worry that when the ankle joint wore out was amputation the next option! At 51, I am at the younger end of the market. At the end of the day, I have to put my faith in the surgeons ability & experience.
Regards
JohnR

[Roselinda]

I'm grateful to find this forum. Eleven years ago I tripped over a little chocolate Lab puppy (he's now an old dog with a white muzzle) and my ankle dislocated and I broke the three major bones. It's called a "tri-malleleol" or something like that. A year later the 7 screws and plate were removed. I've needed a heel lift and occasional cortisone shots but last year the doctor insisted he could remove the bone spur and "clean it up" and extend a fusion for ten years. Now, less than a year later, and terrible pain since the surgery, he says I need a fusion. I use a cane, wear shoes with fairly high heels (because I can't stand flat) and I wrap with a tight ace bandage and limp badly. When I first start walking can hardly walk! As most of you have experienced, the idea of recovery and three months non-weight bearing and surgery pain is horrifying.

I'm seeing a podiatrist and don't know who else to go to for advice. How does one decide between podiatrist or orthopedic surgeon? The one ankle ortho I went to was impersonal and uncaring so I don't intend to see him again. I live in Tacoma, WA and could go as far as Seattle. Do any on this forum have suggestions for doctors here?

I've been reading of the success of the Buechel-Pappas Total Ankle Prosthesis but the doctor is in Florida. I do not want a doctor on the other side of the country although he did respond to my email immediately and that was impressive!

It is good to read that many have had successful fusions and are without pain.
Happy New Year!

[keewee]

Hi Roselinda, I had an ankle fusion in August as it was the only choice for me. I came out of surgury and when the block had worn off I was pain free for the first time in 18 months. I was only none weight bearing for 6 weeks then with the boot on my cast could start weight bearing. It was great. I am on no meds at all. With the cast off I can get around and drive. After a while I do get pain and swelling in my foot but I have a lot of other damage to my foot and ankle which is part of the trouble. I can now sleep at night and feel my life is back on track.
Cheers, keewee

[Glen]

Hi ,I have just signed up on this site,am amazed on how many people are dealing with these ankle problems and how much pain it causes and other effects,I have had this problem for 2 years and progressing and finally had arthroscopy surgery and again as well as others have heard the words ankle fusion down the road,2 weeks after surgery I walked into get stitches out and felt pretty good,then a week later had severe pain and tenderness over the tibialis posterior tendon and that is still there after 2 months and the surgeon has prescribed 6 weeks of Toradol,I have been on it for 3 weeks and no differince,he says if that does not work ,he will try some kind of injection,not sure what that is at this point,again like most people I read about here is this surgeon tells me he is just trying to by me time,I would appreciate any feedback on any of this and also has anyone tried these Homeopathic people for these problems and had any luck,thanks,Glen,by the way I am 54 year old man and I live in Vancouver BC Canada

[Glen]

I'm grateful to find this forum. Eleven years ago I tripped over a little chocolate Lab puppy (he's now an old dog with a white muzzle) and my ankle dislocated and I broke the three major bones. It's called a "tri-malleleol" or something like that. A year later the 7 screws and plate were removed. I've needed a heel lift and occasional cortisone shots but last year the doctor insisted he could remove the bone spur and "clean it up" and extend a fusion for ten years. Now, less than a year later, and terrible pain since the surgery, he says I need a fusion. I use a cane, wear shoes with fairly high heels (because I can't stand flat) and I wrap with a tight ace bandage and limp badly. When I first start walking can hardly walk! As most of you have experienced, the idea of recovery and three months non-weight bearing and surgery pain is horrifying.

I'm seeing a podiatrist and don't know who else to go to for advice. How does one decide between podiatrist or orthopedic surgeon? The one ankle ortho I went to was impersonal and uncaring so I don't intend to see him again. I live in Tacoma, WA and could go as far as Seattle. Do any on this forum have suggestions for doctors here?

I've been reading of the success of the Buechel-Pappas Total Ankle Prosthesis but the doctor is in Florida. I do not want a doctor on the other side of the country although he did respond to my email immediately and that was impressive!

It is good to read that many have had successful fusions and are without pain.
Happy New Year!Im new to this site also,but I can tell you that a podiatrist from my experience really only deals with elderly people with corns etc,I went to one orthpediac surgeon and he told me to see an rheumatologist,who in turn told me to see a orthpediac surgeon,so you do get the run around,The guy Im seeing in Vancouver is Dr smit who seems decent so far,but Im still a ways away yet,dont give up

[Glen]

Hi Ralph, Had to check with surgeon to get the name - it is the 'Agility'' by Depuy. He is aware of the STAR but believes in the success of model he is familar with. He assures me that the plastic block can be replaced if needed. As I work for myself, I need to be on my feet for extended periods (up to 18 hours a day!)so this was my greatest worry that when the ankle joint wore out was amputation the next option! At 51, I am at the younger end of the market. At the end of the day, I have to put my faith in the surgeons ability & experience.
Regards
JohnRHey John R,I was wondering where you had that half cast made and was it expensive and could you walk fairly decent,Glen

[JohnR]

Hi Glen, The cast is an Orthotic. A very tuff plastic and in my case was a half cast to immobilize the ankle and would eventually help the ankle 'fuse' itself or that is what the surgeon who prescribed it said but I didn't notice any difference from 3 years of basically fulltime use but it did initially make a lot of difference to medication - 8 panadine forte a day (paracetomol 500mg/codine 30mg) down to 2. It was made by Garth Talbot in Frankston VIC and was a few hundred dollars. I need ed to get one for my right foot and by shopping around got one covered by my medical fund. I'm still very active, climb ladders, only annoyance is the throttle pedal - you have to push it with your leg as the ankle won't flex enough for normal use.
good luck
JohnR

[Krista]

First let me start by saying I really wish I found this website before having an ankle fusion and giving you a little background information. I was in a car accident July 19, 2004 I was 17 at the time. I fractured my talas bone and dislocated my fibia among many other things. I had a 5 hour surgery that day (it was supposed to take 2 hours) and was in the hospital for a week. While in the hospital I couldn't flex my foot at all which I thought was very odd given the look on the surgeons face. The surgeon that preformed the surgery wasn't from that hospital so I followed up with a different one who knew very little about my case. She told me that I would have to have an ankle fusion (this was in the month following my accident) but that didn't go over well with my mom when it was explained to her. I saw this surgeon once a week to have x-rays and my cast changed for about 3 months. Around this time my mom found an excellant surgeon who decided to take me on because he thought he would be able to have me walking in no time (eight surgeries and two external fixtators later I still can't walk). Well whatever he had planned for me didn't work. Come to find out I had a blockage above my talas bone which was the reason I couldn't move my foot and I developed servere arthritis in my ankle. The second surgeon then told me I had to have my ankle fused. On April 20, 2006 I had the fusion using an external fixtator. I had the frame on for 3 months (I got it off July 21st). I went back to the doctors in the beginning of August and was told its not fused completely so they put a walking cast on. A few months ago they gave me a bone stimulator to use, which I do faithfully. For the past 5 months I have had servere pain in my whole entire foot, its so bad that I feel like I'm going to throw up. I feel that I would be better off having my foot amputated but my surgeon said absolutly not because something about having to change my prosthesis. My questions are, is it normal to flex my foot or does that mean it's not fused yet. Does the pain mean arthritis or is that normal? How long does a fusion usually take from beginning to end? And given my age (20) do you think I would be better off having my foot amputated?

[Glen]

Hi Glen, The cast is an Orthotic. A very tuff plastic and in my case was a half cast to immobilize the ankle and would eventually help the ankle 'fuse' itself or that is what the surgeon who prescribed it said but I didn't notice any difference from 3 years of basically fulltime use but it did initially make a lot of difference to medication - 8 panadine forte a day (paracetomol 500mg/codine 30mg) down to 2. It was made by Garth Talbot in Frankston VIC and was a few hundred dollars. I need ed to get one for my right foot and by shopping around got one covered by my medical fund. I'm still very active, climb ladders, only annoyance is the throttle pedal - you have to push it with your leg as the ankle won't flex enough for normal use.
good luck
JohnRHi John,was that like an air cast that has orthotic hard plastic sides that goes up both sides of the ankle and velcrows around,thanks Glen

[JohnR]

Hi John,was that like an air cast that has orthotic hard plastic sides that goes up both sides of the ankle and velcrows around,thanks Glen Hi Glen, It's just a simple one piece unit, all hard plastic with a velcro strap high on the calf. the first one also had a strap over the ankle but havn't repaired it after it broke and although it is a little more clumsy putting on, totally discourages trying to walk without a boot on which is the main reason they fail/break. Mine is over 3 years old.
good luck JohnR

[mikimi]

Hi. i live in Israel ,name-Mikimi,44. Had ankle fusion 28/08/06. While in plaster, I broke fibula and fragmented malleoulus. Revision surgery was 7/12/06. Now beginning PWB in Bledsoe walking cast but have an option or plaster walking cast with rubber on bottom. My reason for AF was also post-traumatic osteoarthritis from a previous injurty. In my case , a bad fall and ankle surgery when I was 15 living in atlanta, Ga.
Would appreciate advice/encouragement from others.

[Garthca]

Hi All,
What a lot of information to digest about the options available. It makes me winch just reading this forum and sympathies with all out there with dud ankles. It helps that other people are/ have been in my predicament. I too have had a dislocation in 1983 and many ankle injuries during my life. Last year I found I was starting to get server pain in the left ankle after a light sprain. I went to see a physio and found that the treatment was only making my ankle worse. To the physio’s credit she told me to see a specialist and have a MRI done. I arranged to see one Specialist and was advised I had only ½ my cartilage left and server arthritis and my only option was an ankle fusion no Options. Very depressed for a few weeks and decided I would get a second opinion so I found out who was the best Orthopedic guy for Lower Limb and ankle in Brisbane and made an appointment to see him. After my appointment I was relieve to find that I did have other options one was to clean out he joint and the second was to redistribute the weigh on my leg over to the good Cartilage. I have had arthroscopic surgery to clean up the joint and found that this provided immediate pain relief but after 5 months am finding I am going back to square 1. Now getting shooting pain and hot flushes and have times where I can not walk. So I am debating to have Supramalleolar Osteotomy operation around the end of April. From What I can gather this redistributes your weight over to the side you have the good cartilage. I believe the surgery involves breaking your leg and then shaving the bone and attaching it to the other bone so your weigh bearing is over the good cartilage. If successful I should between 10 to 15 years of normal use pain free. Hopefully between now and then new procedures will be available for ankle replacements. My question is has anyone had this procedure or have any more information about this type of procedure.
Many Thanks, Garth :confused:

[nicky]

HI All,

I had a really bad car accident in March 2005.
I shattered my fibia tibia and had to stay in hospital for 3 weeks.In that time i had to wait 10 days for swelling to go down to have an external fixture fitted

[nicky]

Hi everybody,
Iam so pleased i have found this site.Finally somebody knows what we are going through.
I am a 32 year old female with 3 children and a wonderful husband.
On March the 23 2005 i had a bad car accident and was trapped in the car for a while.
I went to hospital and they told me i had shattered my tibia and fibia and there was nothing they thought they could do so they were going to amputate.
Then this one surgeon suggested that we wait for about 10 days untill sweelling goes and put on an external fixture,which i had done after 3 goes .
I was in hospital for 3 1/2 weeks and keeped the external fixture on for three months,my bones were still shattered so they suggested i have another fixture put on for another 3 months i cant remember the name of this one but in was new out and no one had tried it around the A.C.T region before.
Ihad this one put on for another 3 months.After this came of my ankle was still not healing very well.
I then went in a cast boot for the rest of my time which is still now and it is 2 years later.
2 days ago i went for another scan and my ankle is still broken(HEALING VERY SLOWLY)
I have also been using an exogen machine for around 8 months.
I have been told from day 1 that i could not have pins plates or anything like that because there is no bone to plate anything to that is strong enough or big enough.
My last thing a few days ago was being so long that my surgeon said there is a few bones that have gotten stronger so he said we will do a bone graft and an ankle fusion.
He did say it may not work.
After all the fuson is done i have to go and have my toes fixed and tendons done.
I am wondering if anyone out there can PLEASE HELP ME with any ideas on anythine else they have had done and has worked out ok.
I am not very keen on the idea at all to get an ankle fusion.
Could you please tell me a little bit more about fusions?

THANKYOU FOR LISTENING

REGARDS
NICKYxxxxxxxxxxxxxxxxxxxxxx

[nancy]

My doctor at the Mayo Clinic has told me I have no cartilage in both ackles. They are checking for a desease which would cause it to degenerate . Any comments?

[pawcat]

Hi everybody,
Iam so pleased i have found this site.Finally somebody knows what we are going through.
I am a 32 year old female with 3 children and a wonderful husband.
On March the 23 2005 i had a bad car accident and was trapped in the car for a while.
I went to hospital and they told me i had shattered my tibia and fibia and there was nothing they thought they could do so they were going to amputate.
Then this one surgeon suggested that we wait for about 10 days untill sweelling goes and put on an external fixture,which i had done after 3 goes .
I was in hospital for 3 1/2 weeks and keeped the external fixture on for three months,my bones were still shattered so they suggested i have another fixture put on for another 3 months i cant remember the name of this one but in was new out and no one had tried it around the A.C.T region before.
Ihad this one put on for another 3 months.After this came of my ankle was still not healing very well.
I then went in a cast boot for the rest of my time which is still now and it is 2 years later.
2 days ago i went for another scan and my ankle is still broken(HEALING VERY SLOWLY)
I have also been using an exogen machine for around 8 months.
I have been told from day 1 that i could not have pins plates or anything like that because there is no bone to plate anything to that is strong enough or big enough.
My last thing a few days ago was being so long that my surgeon said there is a few bones that have gotten stronger so he said we will do a bone graft and an ankle fusion.
He did say it may not work.
After all the fuson is done i have to go and have my toes fixed and tendons done.
I am wondering if anyone out there can PLEASE HELP ME with any ideas on anythine else they have had done and has worked out ok.
I am not very keen on the idea at all to get an ankle fusion.
Could you please tell me a little bit more about fusions?

THANKYOU FOR LISTENING

REGARDS
NICKYxxxxxxxxxxxxxxxxxxxxxx
Nikki, my Doc has told me that I shd have Fusion rather than replacement as I am too young (42!!), as they do not know if they can replace a replacement!! He told me that if I had the replacement and it came time to be replaced the only option would be to shorten my leg by 1 1/2 inches then fuse it. Next is another arthrocsope, then we will look at the fusion, but he suggests leaving it as long as I can stand the pain. I'm trying to get info on what I CAN do with a fusion (ie stairs etc). I have not been able to live upstairs in my house for 3 years!!! At your age, going on my Docs advice, fusion would be the option. Cate

[Glen]

I am considering having ankle fusion,I was wondering if anyone who has had this proceedure could tell me if playing golf is a problem or not ,and what might some of the restrictions be,thank for any input,Glen

[JohnR]

Now been a week with my 'new' ankle, slight set back as I need to have the blood clot removed under general anesthetic, I think they forgot to prescibe blood thinners. Anyway it only set backs the plaster by a week and there is not much else to do but keep it elevated.
The plastic block (according to my surgeon) is replaceable when it wears out but I'm hoping that is 5 years or more away. I feel very fortunate when I read other stories like Nikky that my injuries were more consise and the total ankle replacement will solve 1 leg.
Regards to all and hope you are coping with your pain.
JohnR

[Glen]

Hi, I have had a ankle fusion 2 years ago.

It all started with a dislocted ankle in 1986 I was 17 years old. I had surgery to fix the ankle and after the surgery it seemed ok, but never 100% more like 85 to 90%. I played all kinds of sports after the surgery.

In 2001 I started to have alot of pain in my ankle and went to see a orthopedic surgeon and she suggested physical therapy and advil. I tried both and it did not work. I also tried glucosimine and different kinds of braces. This went on for about 8 months and the whole time I was going to physical therapy. My doctor had mentioned a fusion as a last resort.

It got to a point where every step I took was like walking on a nail. I went back to my doctor and she suggested a different kind of brace and I told her that was it. I wanted to get the ankle fusion because I was in to much pain.

The operation was succesful and I was glad to have it done. The operation was about 3 1/2 hours long and it was day surgery. I have heard that some hospitals will keep you for a couple of days. I was laid up for a couple of months. I have very little motion in my ankle now, but I was glad to get it done. My walking is perfectly normal. I do not were any braces or special shoes.

I know that this is a very difficult decesion to make. I was there. All I can tell you that it worked for me and I am pain free. I have not experienced pain in any of the other joints, but it has only been 2 years.

If you have any questions please askHi Tom,I was wondering after ankle fusion would a person be able to play golf,let me know,appreciate ,Glen

[Parksy]

Hi Garth, I had exactly this operation in 1998. ( I shattered my lower leg in a rugby game). I had previously had bone spurs removed (as a result of osteo-arthritis) in two operations but eventually the pain kept coming back. I had a lower leg re-alignment (osteotomy I think they call it) to redistribute the weight over my ankle- the aim being to give me a few more years before talk of fusion etc. Worked quite well actually. You have alot of swelling for a while and the end result means your leg looks a bit wonky but the pain had diminished over a year. It worked well enough for about eight years but I have found the pain is back worse than before and I am booked for a fusion in the next month or so. Your op may give you 10 - 20 years. Basically, you are buying time and hope that technological advances in ankle replacement are huge, by the time you need one.
Cheers
Andrew

[Garthca]

Hi Andrew, Thanks for the info - I agree it is a time buying op and hope there are better alternatives in the future. I am meeting with the surgeon next week to discuss my options for the final time. Will probably have the op around the end of April. I am surprised that the ankle has changed so quickly from the clean out in August. Hope the fusion goes well.
Garth

[Glen]

Hi Glen, It's just a simple one piece unit, all hard plastic with a velcro strap high on the calf. the first one also had a strap over the ankle but havn't repaired it after it broke and although it is a little more clumsy putting on, totally discourages trying to walk without a boot on which is the main reason they fail/break. Mine is over 3 years old.
good luck JohnRHey John R how is it going,just to let you know,I did find that half cast,it works pretty good for me,thankyou,Glen

[Tincup23]

Hey all,

I am in the same boat as you. I was told my only option was an ankle fusion and at this time in my life that isnt for me. Last week I bought a pair of MBT sport shoes and they have change my life. I could walk with very little pain in them. They gave me my quality of life back. After wearing them during the day, I have to wear boots at work and they have made walking in my boots much better as well. I would recomend all of you to try them. They are very expensive but well worth it.
Good luck.

Tim

[beloogey]

Tom--
I don't know if you still are a member, but I'd like o know how your fusion is going. I had a replacement three years ago and now it's collapsing again (cartilage is disintegrating). New doc suggested fusion, so I'm asking everyone I can about it. Please let me know, if you're still out there.

Thanks!
Melissa

[beloogey]

What are MBT spots shoes?

[beloogey]

Hi Rebecca--
As of last year, I would have told you that "yes" they are having a lot of success in the States. But now I wonder. I had a total ankle replacement/allograph (using a cadaver ankle) in November 2003. By all measures, it was a success. I was pain free after about a year and stayed so until last Semptember, when pain returned and my doctor told me that my cartilage was deteriorating again. Now, another doctor recommends I hold out as long as I can and then getting a fusion. I avoided hat idea like the plague, but have been releieved to see on this forum that some people have had success with it. No matter what any surgeon tells you, this ankle replacement stuff is only TEN YEARS OLD! It is not enough to make sweeping statememnts about success rates. I've been written up in medical publications and on the news, but no one from my doctor's office is bragging about what is happening to me now. The original reason I went with this was that my doctor said that I would "wear out" an artificial ankle and this would last longer. Three years is not longer. I'm not sorry I had it, but I am sorry I was expecting so much more. Good luck to you. Anyone who wants to know about my personal experience with TAR please feel free to write.

[beloogey]

There is hope for those of us who are not quite ready to give up our mobility... I am a 29-year-old obese woman (300 lbs). I broke my leg and ankle at the age of 19. There is officially no cartilege left in the right ankle now and there hasn't been for about five years. My pain got pretty bad in 2002. However, I am much better now. I have not woken up with a frozen ankle in three years. Pain has not kept me awake more than a handful of times over that time.

The best thing I did was to use an ankle foot orthotic - rigid custom-formed plastic. I use it when I am going to be engaging in any prolonged ankle-involved activity. I take it off a lot of the time to help maintain flexibility and leg muscles. It irritates me during the hot months and I hate not being able to wear dainty shoes... but it is worth it.

I do not consistently take any medication. Nor do I take glucosamine - except when I remember every couple of months. I elevate but I don't use ice or heat. The brace does cause a bit of uneveneness and my opposite hip will hurt, but that happens without the brace as well.

I would recommend it to most people in my situation. I think the theory is that it prevents bone chips and allows any chips that are there to be absorbed into the body. They seem to be a major source of pain and inflammation.

My AFO is my third best friend.

Hope this helps.
This sounds great for someone like me who can still walk with minimal pain, but whose ankle will likely deteriorate further. I'm looking to keep it in there as long as possible. What type of doctor did you see for this? Please let me know, if you still look this over, or, anyone who has tried something similar, please advise. Thanks!

[beloogey]

Hi everyone,
Wow. I haven't checked the site for a while and it's quite overwhelming to read all your posts and still see more and more people who are having to making the painful (in every way) choice of whether or not to go ahead with an ankle fusion.
As you know, I had the fusion done in August last year, which means i'm a few months away from 'complete' recovery.
For me, fusion was the only option (apart from amputation). Everyone's situation is different and I still believe that fusion is a last resort choice.
This is where i'm at now:
I am happy to say that I have whole days where I forget about my ankle because I have no pain! I do have pain every now and then (maybe once a week on average) but it is so mild in comparison to almost 2 years of can't-do-anything agony I barely notice it.
I can walk non-stop (not as fast as I used to) for approx. 3-4 hours normally. Now and then a little pain might start and my walking is affected but other than that I walk like a normal person.
Running is pretty unco but that was never my thing anyway.
Stairs and steep inclines are interesting. Again, it depends on the day but because of the limited up & down movement I do prefer to take the lift. It's possible just a bit awkward.
Cycling on a stationary bike is fine (and recommended).
I had some exercises that the physio gave me with a wide band to strengthen the ankle which i've stopped doing, so I must be doing ok!
I haven't tried any other weight baring exercies or activity yet.
I'm not emotionally ready to start up dancing again just in case I can't continue doing it. I'd prefer to wait until i've completed my recovery and then give it a whirl.
My surgeon (Mark Blackney, East Melbourne - highly recommended & touted as 'the best' for ankles and I agree, he and his team are fabulous) can't give definates about what i will and won't be able to do in terms of more full on activity. It's totally subjective, so we'll just have to wait and see as I give things a go.
So, for me, overall a good result. I'm living like a normal person again.
My reservations about the future implications of the fusion on my other joints are still the same but Mark seems to think that in my case the likelihood of adverse future effects are low as long as I don't 'overdo it'. So, no high impact activity = less chance of future problems occurring.
OO, I almost forgot. In my case driving a manual car is not preferable anymore. Sad for me because I love driving my 1971 Peugeot, she will have to be sold. I'll have to get myself an automatic which i'll operate with 2 feet, so I can brake with my left foot. I also need a car where the seat is placed a bit higher because it's bloody difficult pressing an accelerator pedal when you have very limited up/down motion in your right ankle.

So, i'm doing pretty well now. I actually have peace of mind. We'll just have to see what the future holds.
Good luck everyone!

Get lots of opinions, ask lots of questions and don't put up with agony.
Rebecca:)
Rebecca--
I know it has been a while since you posted this, but I am very encouraged by your story. My advice--don't try to do it all. Baby your ankle and keep walking as long as you can. When I think of "activities" I would hate to give up, walking is PARAMOUNT. everything else is secondary. Hope you're doing well.
Melissa

[AJB]

Hi James, I have been misdiagnosed 3 times now and am not confident with surgeons, my one surgery so far was suppose to be key-hole surgery and I have a scar 3 inches long on my ankle plus now have cartilage issues which I did not have previously, plus was informing surgeon that I still was in pain at the site of the injury and the surgeon kept informing me that some people take longer to heal, I changed surgeons and found that I have a spur pushing into my tendon, which is causing the pain (also told by new surgeon that the first surgeon cut away cartilage and it sometimes does not grow back, as in my case). So...can you tell me the name of your surgeon?

Regards AJB


Hi Rebecca

I'm an active 50 yr old who was used to climbing moutaineering kayaking and a bit of running. I smashed the lower end of my Tibia in an accident. After it was mended I was left with post traumatic arthritis of the ankle joint. I was offered a fusion but when I did some research it suggested that I wouldn't be able to run and that other joints would eventually suffer. For a while I considered a below knee amputation as the only way to recover full mobility. I got to know a Royal Marine officer with the same problem who had opted for the amputation and gone back in the Marines at full fitness.

However, none of the surgeons would go along with this and eventually one of them introduced me to another army officer, Andy. This man is 36yrs of age and had a fusion 5 years ago following a parachute accident. I met up with him and aked him how active he was. I was amazed! He can not only walk normally but does long route marches with a full pack. He skis, climbs rock and ice and most amazingly he runs (10km in 40mins). He is presently training for a triathalon. He didn't start running until 15mths after his fusion. He uses normal shoes and boots with sorbothane insoles.

Talking to Andy has inspired me and so 7 weeks ago I had a fusion. It was done arthoscopically which is less invasive and has a faster recovery time than open joint surgery.

Andy and I are aware that at some time in the future we may get further joint problems(but it's not always the case). If that happens, below knee amputation is an option but we'll cross that bridge if we come to it.

As for footwear after the fusion I'm going to check out Masai Barefoot Technology shoes. They have a rocker sole and are highly recommended by our local orthotist.

I hope this helps.

Best wishes. James

[jfk123]

i had my cartilage transplant done by martin sullivan after these other doctors wanted to fuse my ankle.i could hardly walk before the transplant and now i am playing touch football again.i would not go to anyone else except him in australia.i would also recommend MBT shoes which he put me onto last year .i have to stand at work and they cushion my feet.

[Glen]

i had my cartilage transplant done by martin sullivan after these other doctors wanted to fuse my ankle.i could hardly walk before the transplant and now i am playing touch football again.i would not go to anyone else except him in australia.i would also recommend MBT shoes which he put me onto last year .i have to stand at work and they cushion my feet.I was wondering if you had arthitis in your ankle and that is why they replaced the cartilage,thats what I have they say osteoarthitis and want to fuse my ankle too,they say there nothing they can do,like to hear from you,as I live in Canada,thanks,Glen

[Alex S]

It sounds like Martin Sullivan is the go. He just performed cartilage replacement on my sister-in-law following a sub talar joint injury. Not sure on the time frame of this type of surgery though; it would be safe to say that the earlier the better due to the degenerative nature of cartilage. I have arthritis in both ankles following a parachute accident 7 years ago and have had it all; physio, accupuncture, glucosamine, anti-inflams, and been advised to go for fusion. The pain is such that it keeps me in a constant bad mood and is having a severe impact in my quality of life. Book me in Dr Sully!! If he can fix me, he can write his own checks.

[KiraB]

I was wondering if you had arthitis in your ankle and that is why they replaced the cartilage,thats what I have they say osteoarthitis and want to fuse my ankle too,they say there nothing they can do,like to hear from you,as I live in Canada,thanks,Glen

Hey there is a really good ankle surgeon currently at the University of Calgary, from Switzerland called Victor Valderrabano. If you really don't want a fusion he would be a great person to talk to.

I had a cartilage replacement, but my arthritis was too advanced and the chances of it working we slim...and sadly it didn't. So go and see someone who is less conservative and they may give you other options like cartilage replacement. I didn't want a fusion as I am only 26, and am having an ankle replacement in two weeks, but the results on the internet are a little misleading as they usually from the US who use the Agility implant, which is rather outdated, but the only one currently with FDA approval.

Good Luck

[Glen]

Hey there is a really good ankle surgeon currently at the University of Calgary, from Switzerland called Victor Valderrabano. If you really don't want a fusion he would be a great person to talk to.

I had a cartilage replacement, but my arthritis was too advanced and the chances of it working we slim...and sadly it didn't. So go and see someone who is less conservative and they may give you other options like cartilage replacement. I didn't want a fusion as I am only 26, and am having an ankle replacement in two weeks, but the results on the internet are a little misleading as they usually from the US who use the Agility implant, which is rather outdated, but the only one currently with FDA approval.

Good LuckI have done alot of research on ankle replacment and the life span is not long,especially at your age,I know alot of people that had them for five years and they break,I got a special made ankle cast from a prostictic guy which has had me back to work for 4 months and I golf with it,I do not know your extent but if you can try ,its worth it until ankle replacement advances,Glen

[KiraB]

I have done alot of research on ankle replacment and the life span is not long,especially at your age,I know alot of people that had them for five years and they break,I got a special made ankle cast from a prostictic guy which has had me back to work for 4 months and I golf with it,I do not know your extent but if you can try ,its worth it until ankle replacement advances,Glen

Thanks for the advice. I hope the brace keeps working out for you, but I think I'm a bit past it - probably mentally more than physically. I have very little ROM especially dorsi-flexion, probably about the same amount as someone with a fusion, and it is putting a lot of pressure on my other joints and I really can't walk much or anything.

I went to Europe and talked to two of the top ankle replacement specialists there with the STAR and the Hintegra replacements (mainly since my surgeon said it was unlikely anyone would give a replacement to a 26 year old). They both said I was a candidate and needed to do something fusion or replacement and that I was past the point where any more conservative measures would work.

The results with a very experienced surgeon with either of these implants are pretty good. I am going to go with the Hintegra as the modifications seem to make a lot of sense and it is just new (around 7 years) so they can't give an idea of how long it will last, but seriously if it lasts 7 years that would be 7 years of a normal life (or close to) hopefully. If it only lasts 3 I'll be happy. Also the Hintegra removes such a small amount of bone that future replacements are much easier. So I figure hopefully I'll get 10 years with 2 implants, and then well I hope I can still get another one or they have made some big improvements. If it stuffs up I get a fusion...so I figure what have I got to loose trying to get movement.

I just can't wait longer my quality of life is kinda bad, and I just need to do something so I can get on with life for a bit (I used to be a competitive sportsperson, so not being able to walk even is killing me).

Anyway thanks for the concern and I hope that everything works out for you, will let you know how my new ankle goes

[DARKLYLIT]

Hey there,
My name is Drew from beautiful British Columbia, CANADA. I'm 40 years old. I fell off a roof 3 years ago and DESTROYED my right ankle. Had surgery, steel-plate and screws. Lost 40% of cartilage during my non-weight bearing healing time.Now have no cartilage left. Osteoarthritis has gotten worse and worse since just before last Christmas(2006). Just saw an orthopod and he figures FUSION is the only option as I am "too young" to be considered for an ankle replacement. I'm wondering about the possibility of cartilage transplant surgery and how successful it has proven to be for you. Any and ALL info you could offer would be greatly appreciated.
Thanks.

[syousef]

I'm 32, was born with severe flatfoot, and had my left ankle buckle the first time I went ice skating (about 1990, I was 15). I was on crutches for a week, but was told nothing was broken. I'd get occassional pain but just lived with it.

4-5 years ago it flared up for a week or 2, I got X-rays and was told I had mild arthritis. Then a couple of months back it flared up again. This time it was so bad I was visiting a relative in hospital that had just had a heart attack and had to keep slowing the group down trying to find the place because each step was agony.

Just to complicate matters I have been putting off getting this looked into because I'm about to be married (Sept 1st) and am going to NZ for the whole of Oct. I've saved all my annual leave for the last 2 1/2 years and until my second opinion (see below) was planning to cut the honeymoon short. Also I'm the well one of the pair. My fiancee's had a wide variety of medical issues (one of which I've posted about elsewhere on the board - her shoulder dislocated the other day for the first time in 2 years - after 4 surgeries we thought we'd had it licked but not to be). My ankle was not exactly what I wanted to be thinking about right as we're about to be married.

Anyway I've seen 2 specialists, both mentioned on this board as being good. My MRI shows quite a mess in there, and one described it as interesting while the other literally winced looking at the MRI. Problems include a spur, a large cyst in the navicular (I think this is the main problem), degeration and long term changes, changes due to swelling.

Both agree that I need to lose weight (easier said than done as we all know, even harder to keep it off when you're prone to being overweight). Both agree that I'll eventually need a fusion (not the main ankle but the midfoot. I keep forgetting to ask whether they want to do a talo-navicular fusion or involve more bones).

Doctor number 1 says: Do an arthroscopy and try to get a couple more years out of the ankle. Put me on to glucosamine.

Doctor number 2: Arthroscopy is a waste of time. Your scans are really bad and you need a fusion, probably by the end of the year. You won't lose much more movement because the joint is already stiff. According to this doctor I will end up in a wheelchair if I do nothing. When I said I could walk for about half an hour on a good day he said once you're down to 20 minutes it's time for surgery.

Doctor number 2 is the more senior doctor and seems to have contributed to a couple of research papers.

Both are good surgeons from what I can tell, but both have done things I don't like.

Doctor number 1: Once I had agreed to an arthroscopy he palmed me off onto a secretary who's now fielding medical questions when I email (what the!??? I don't think she's even going back to him, but answering instead based on what she knows about the condition, which I think is just wrong!! I could ask her to discuss with the doctor but I shouldn't need to should I?)

Doctor number 2: Was giving me diet tips that worked for one person but I dont think will work universally. (From experience I have to both modify my diet AND excercise whereas his advice was don't eat blah after a certain point in the day). He wants me to go on my honeymoon then come back and talk about a fusion at the end of the year, but he also wants to see what a weight loss will do. Well success rate when it comes to long term weight loss is lower than anything he's offering me, and if my ankle is so buggered a fusion is necessary why the distraction. I've lost weight before and it required both extreme diet and 2hrs/day which is nearly impossible to commit to while working full time.

It's easy when you have doctors in agreement but I'm finding it hard to agree to any kind of surgery with such differing opinions. Despite the expense I'd go for a 3rd but I'm afraid that'd just add to my confusion.

I realize I'm reading about fusions of the main ankle joint above (not what I'm told needs to be done), but almost none of the above sounds encouraging, particularly if you're under 50. To be honest the entire fusion process sounds like something out of the dark ages. It just doesn't sound like a technically good solution. Most days I'm in pain but I'm still managing it without pain killers 95% of the time. I even have the occasional good day if I don't push it. Whether the glucosamine is helping or whether my flare up settled I'm not sure but I'm tempted to just keep going like this with no intervention for as long as I can put up with the pain.

[kjwilkin]

I'm 32, was born with severe flatfoot, and had my left ankle buckle the first time I went ice skating (about 1990, I was 15). I was on crutches for a week, but was told nothing was broken. I'd get occassional pain but just lived with it.

4-5 years ago it flared up for a week or 2, I got X-rays and was told I had mild arthritis. Then a couple of months back it flared up again. This time it was so bad I was visiting a relative in hospital that had just had a heart attack and had to keep slowing the group down trying to find the place because each step was agony.

Just to complicate matters I have been putting off getting this looked into because I'm about to be married (Sept 1st) and am going to NZ for the whole of Oct. I've saved all my annual leave for the last 2 1/2 years and until my second opinion (see below) was planning to cut the honeymoon short. Also I'm the well one of the pair. My fiancee's had a wide variety of medical issues (one of which I've posted about elsewhere on the board - her shoulder dislocated the other day for the first time in 2 years - after 4 surgeries we thought we'd had it licked but not to be). My ankle was not exactly what I wanted to be thinking about right as we're about to be married.

Anyway I've seen 2 specialists, both mentioned on this board as being good. My MRI shows quite a mess in there, and one described it as interesting while the other literally winced looking at the MRI. Problems include a spur, a large cyst in the navicular (I think this is the main problem), degeration and long term changes, changes due to swelling.

Both agree that I need to lose weight (easier said than done as we all know, even harder to keep it off when you're prone to being overweight). Both agree that I'll eventually need a fusion (not the main ankle but the midfoot. I keep forgetting to ask whether they want to do a talo-navicular fusion or involve more bones).

Doctor number 1 says: Do an arthroscopy and try to get a couple more years out of the ankle. Put me on to glucosamine.

Doctor number 2: Arthroscopy is a waste of time. Your scans are really bad and you need a fusion, probably by the end of the year. You won't lose much more movement because the joint is already stiff. According to this doctor I will end up in a wheelchair if I do nothing. When I said I could walk for about half an hour on a good day he said once you're down to 20 minutes it's time for surgery.

Doctor number 2 is the more senior doctor and seems to have contributed to a couple of research papers.

Both are good surgeons from what I can tell, but both have done things I don't like.

Doctor number 1: Once I had agreed to an arthroscopy he palmed me off onto a secretary who's now fielding medical questions when I email (what the!??? I don't think she's even going back to him, but answering instead based on what she knows about the condition, which I think is just wrong!! I could ask her to discuss with the doctor but I shouldn't need to should I?)

Doctor number 2: Was giving me diet tips that worked for one person but I dont think will work universally. (From experience I have to both modify my diet AND excercise whereas his advice was don't eat blah after a certain point in the day). He wants me to go on my honeymoon then come back and talk about a fusion at the end of the year, but he also wants to see what a weight loss will do. Well success rate when it comes to long term weight loss is lower than anything he's offering me, and if my ankle is so buggered a fusion is necessary why the distraction. I've lost weight before and it required both extreme diet and 2hrs/day which is nearly impossible to commit to while working full time.

It's easy when you have doctors in agreement but I'm finding it hard to agree to any kind of surgery with such differing opinions. Despite the expense I'd go for a 3rd but I'm afraid that'd just add to my confusion.

I realize I'm reading about fusions of the main ankle joint above (not what I'm told needs to be done), but almost none of the above sounds encouraging, particularly if you're under 50. To be honest the entire fusion process sounds like something out of the dark ages. It just doesn't sound like a technically good solution. Most days I'm in pain but I'm still managing it without pain killers 95% of the time. I even have the occasional good day if I don't push it. Whether the glucosamine is helping or whether my flare up settled I'm not sure but I'm tempted to just keep going like this with no intervention for as long as I can put up with the pain.

Hi there,

I can understand how frustrating it can be. Last year I had my second ankle reconstruction after my ankle being incredibly unstable.

It gets very confusing when you get differing opinions. I would strongly advise you go and see a good sports physician who will be able to refer you to a good ankle specialist. Whereabouts are you based ? My ankle surgeon, Mark Blackney in Melbourne is fantastic and would highly recommend him.

I have loose ligaments and am currently seeing a knee surgeon and shoulder surgeon for joint instability. My sports physician is a great case manager of my rehab and regularly liaises with my orthopaedic surgeons. Whenever I see my orthopaedic surgeons I bounce ideas off him and helps me to delve through all the information. It has been a god send.

Good luck !!

[DARKLYLIT]

Hello Fellow Canadian,

I've been researching like mad for the past week or so. Wondered if you've looked into the HINTEGRA ankle replacement at all and if you know of a surgeon in Alberta or elsewhere who uses it or who may have had one implanted? I've was given some info about a Dr.William Bugbee, who does what's called a "Ostechondral Allograft", which is a fancy way of saying Ankle Transplant, but NOT an artificial ankle, a REAL donor ankle, REAL bone with REAL CARTILAGE, potentially lasting longer than an artificial ankle. Apparently it's still in the experimental stages, but it's supposed to be 75% successful(3 out of 4). It's worth Googling.

[DARKLYLIT]

I have done alot of research on ankle replacment and the life span is not long,especially at your age,I know alot of people that had them for five years and they break,I got a special made ankle cast from a prostictic guy which has had me back to work for 4 months and I golf with it,I do not know your extent but if you can try ,its worth it until ankle replacement advances,Glen

Hello Fellow Canadian,
I've got a "custom" orthotic ankle brace as well and it does alleviate some of the pain as it acts as an "almost" ankle fusion, though removeable. It helps, but trying to stand on my bad ankle when I wake up every morning reminds me that it's only an expensive band-aid.
I've been researching like mad for the past week or so. Wondered if you've looked into the HINTEGRA ankle replacement at all and if you know of a surgeon in Alberta or elsewhere who uses it or who may have had one implanted?There is a doctor in Vancouver who uses the HINTEGRA. I'd like to get to see him before too long, though it is proving pretty difficult as he isn't accepting new patients for the forseeable future.

On a different note, I was given some info about a Dr.William Bugbee, who does what's called a "Ostechondral Allograft", which is a fancy way of saying Ankle Transplant, but NOT an artificial ankle, a REAL DONOR ankle, REAL bone with REAL cartilage, potentially lasting longer than an artificial ankle. Apparently it's still in the experimental stages, but it's supposed to be 75% successful(3 out of 4). It's worth Googling.

[Mischap123]

Hi Darlkylit,
I too have researche d chondrocyte trnsplants and spoken with my surgeon about it. He says that these procedures are only successful with focal(small) injuries and not global(large) ones. Buy as much time as you can via orthotics, braces, arthroscopes until such time that they have an adequate option for the younger patient. Good luck

[DARKLYLIT]

Hey there,
I'm researching ALL my options and if a "living ankle transplant" is a viable one, I'll definitely consider it. I actually called Dr Wiliam Bugbee's(who seems to have been the one who "invented" the procedure)office in California and his nurse told me that the Allograft procedure is also "just buying time", just as an artificial ankle would and even a fusion, but the fusion being what seems to be the "inevitable" end-point to it all, but I'm wanting to put that off as long as possible. With or without some form of surgery, particularly without, I guess it just depends on how long one wants to endure ever-increasing degrees of pain. It does "wear" on a life, though I must admit.

[TonyOK]

Hi, I underwent an ankle fusion 7 weeks ago, 14th May 2007.
The reason for the operation was due to a series of injuries over some years my cartilage deterioated to the point where there was none left (Motorbikes and Rugby in my life). Where I live there were not many options, I had had severe to extreme pain for about 4 years with one failed operation during that time. So seven weeks out I am back driving my car and am probably already 80 percent mobile, there is no real pain now, a bit of an ache occasionally and given that I have ignored doctors orders and mobilised sooner then he suggested and have 3 massive screws in my foot I am doing alright.

I feel very positive about the operation and am confident that the outcome will be a significant improvement in quality of life for me (already is in fact). The one key point according to my surgeon is that I was ready for it whereas a year ago I was not, this can have as much to do with its success or failure.

[Roperismsom]

Say hello to your friends! (http://maori-men-health-research.stanley-super-store.com) Nice wo (http://buying-carisoprodol.stanley-super-store.com) rk buy the way!

[Carol]

I just discovered this site and it is wonderful! I am sitting here right now recovering from my 3rd surgery on my ankle. But I've noticed a couple of new things I'm doing that I didn't read about in here. I thought I'd share, if anyone might benefit.

The surgery I just completed was to repair problems with the syndesmosis ligament. Apparently the traditional treatment can involve a metal pin to stabilize two bones together. But my doctor tried a new treatment for me that he just heard about from a doctor at the Mayo Clinic. Instead of the metal pins, he has stabilized the region with some form of high performance enduring polymer. Sorry, I don't know the name of it, but I can get it when I see the doc on Monday. At any rate, it's less rigid and should allow better flexibility. We'll see, I only had the surgery a week ago, and am sitting here in bed with my ankle up, lol.

I've noticed that everybody refers to crutches in their recovery. I don't use crutches. I use a knee walker to get around. It's like a one-knee scooter that you can push around with your good leg (obviously only works for a single ankle injury). It's like a tall skateboard with a handle and a brake. It is sooooooooo much easier to get around on that -- it fits easily through bathroom doors and is actually quite zippy. And your hands can be freed to carry stuff at the same time. I used this to recover from my other two surgeries too, and as I could begin to drive, I still used this and tossed it in the back seat. So easy, compared to a wheelchair or crutches. Google "knee walker" and you'll see it. I saw one for sale for $350 online, but there is one at a local store here for $250. Oh, and if you have a choice between one with one long cushion or two short cushions, go for the one long cushion. The edge on the short cushions can be uncomfortable for extended periods.

My doc has advised me that I too am "buying time" and will perhaps need an ankle replacement in 10 years or so due to cartilage loss and inevitable osteoarthritis. This syndesmosis surgery is an effort at buying time. I am really REALLY hoping that there will be more medical breakthroughs in the next decade, perhaps involving stem cell research.

I wish you all well!

[Carol]

I just realized that I didn't put a subject on my last thread :( So I'm capturing the knee walker recommendation in the title now.

One more thought about recovery. For me on the first surgery from the massive injury, the most horrible part of it was that while my foot was in terrible pain, I had awful diarrhea and nausea as a result of taking Levaquin. Yes, I want to take a powerful antibiotic and I'm willing to suck it up in order to not have infection. But nobody advised me to proactively address the "down stream" effects of taking such a powerful antibiotic.

Think about it: broken foot, wheelchair/crutches/whatever, and diarrhea do NOT go together!

This time, I have been eating yogurt twice daily throughout the antibiotic treatment and it's been going quite well. So to speak. lol. I also have some chewable Acidophilus, but the yogurt seems to be working.

[sbcoach]

In reading all the posts about the ankle replacement, I figured that I would respond. I had three previous surgeries trying to fix a lesion on my talus. Those surgeries were not successful and was referred to Dr. Bugbee in California. I just returned from California last week after having Dr. Bugbee perform the allograft surgery. I also had to have some ligament reconstruction done along with the allograft. I am in a cast and will be non-weight bearing for the next three months. I like some others suffered from pain, stiffness and swelling. It gets to a person emotionally after awhile and being told to lose some weight is the real kicker when you can hardly walk. I am hoping that this allograft takes and will last for a few years, but I definitely feel like I am beginning to run out of options. I was a very sports active person and would like to be able to return to some of the things that I used to do, but it doesn't sound real promising.
Crutches?????? Yes, this has been a two year battle, so I do know what they are like. I also have a scooter type aid. I purchased a turning leg caddy. It allows the person to turn, so it is rather handy, but expensive.
I really can't say much about the outcome yet, as it has only been a couple of weeks, but like others are saying. I am buying time until something else comes along. I am 37 and would like to stay away from fusion, but if that would allow me to be more active, I might be looking at that. I am not sure if they do a total ankle joint replacement with cadaver, but I sure can ask, when I go back for my next checkup. Dr. Bugbee does seem very up on the newest ways to try to help those of us who want to be helped.

[KiraB]

Hi,

Please keep us posted how the alleograph goes! Also please please could you ask if it is possible to do a replacement after alleograft and how difficult/successful are they! And also if you can do an alleograph after a replacement?

I just had a ankle replacement, and it is going wonderfully, but I'm 26, it isn't going to last forever so want to try and keep up to date on whats happening in all the different areas.

It is fantastic you got the allegoraft I hope it takes!!!

All the best

Kira

[sbcoach]

I am almost positive that you can have a replacement done after allograft, as that is what I will be looking at in the future. Allografting is taking part of your damaged bone out and put cadaver bone in its place. I am not sure if they do an entire ankle replacement by allograft. I will have to ask about your second question, but I would think the only option after having a replacement would maybe be an entire ankle replacement with allograft, if they even do that. I have not heard of anyone having their entire ankle replaced by using a cadaver ankle. It is amazing what they can do and who knows what will happen in the next five years. I was told that the ankle is one of the most complicated joints to work on.
I don't get to go back to Dr. Bugbee until December. I will be working with a local Doctor for the first few months, as the cost of flying from Montana to California gets a little expensive. I should just find a job and move to CA, since I plan on having Dr. Bugbee work on my ankle for the future. Like, you I am younger, so it is frustrating to be in constant wonder what will have to happen next when things wear out.
I will keep you posted and see if I can get some answers to your question before December.
Laurie

[KiraB]

No worry about trying to get answers quickly... hopefully years to go, so really december would be more than great (and if you forget don't worry)

I had my replacement in switzerland, and I live in hk. It has been fine doing it long distance, I see my OS here he gets xrays writes a repot of my progress and emails it all to switzerland, who then reply with feedback. They are very reachable by email, I email them and ask them questions my OS can't answer, and my physio also emails their in house physio to check things. It is working well. And like you I plan on seeing my Surgeon for a long time, assuming he keeps being at the cutting edge. SO i recommend seeing how things go post op befroe deciding you have to move closer to the surgeon! I have to see them at a year, then probably not untill 3 or 5 years, so it isn't too bad.

Good luck
Kira

[Carol]

Hi, SBCOACH --

How long did you have to stay in California while recovering before you could travel back home? I've often wondered about that, if I ever want to see a specialist in Germany, etc. I am still recovering from my ligament reconstruction, but am hopeful that it will be 10 years before I need an ankle replacement. During that time, MAYBE somewhere in the world somebody would have made significant progress with stem cells (certainly not in the U.S.!) And maybe the allograph/cadaver ankle replacement will have matured by then, so I'm watching your thread with interest :)

Anyway, I'd think twice before relocating to California. It's seriously expensive there, and I just moved FROM there to Texas to conserve $$$. Altho... I miss it terribly, it's a beautiful place to live.

[keewee]

Just an update on my ankle fusion. I had the ankle fusion in August 2006 and all was great. But as I started to get my mobility back and get out again the pain has come back. I tried driving trucks again and that didn't work so am now in an office doing dispatch work. I had to start on pain killer again and anti inflammatorys. The wet and cold weather really made it worse and is getting back to how it was before the fusion. So back to the specialist who couldn't believe it. The only thing he could suggest was having all the metal removed and hope for a better x-ray as the current x-ray was showing everything to be fine. I put that off as I didn't want a fifth operation. At the weekend my ankle went click and I am now having trouble walking due to the pain. I am going back to the specialist next month to book in and try and find out what the hell is going on. :confused:

[sbcoach]

Well, I got the first cast off and about fell off the table when I saw the incision for the ligament reconstruction. Wow, that was longer than I thought it would be. The incision for the partial allograft was not that big and looks to be healing nicely. I also found out from my physician that Dr. Bugbee is not real optimistic about my ankle doing well. I have terrible arthritis in the joint and they are trying to get it as stable as possible. I definitely will be looking at surgeries in the future. The information that I got from my doctor here is that after an ankle replacement, using the metal, the only real option is a fusion since the bones were cut out to put the replacement in. That is why I went to Dr. Bugbee, he does an ankle replacement by doing a total ankle allograft, which is using cadaver bones to replace the taken out bones and that is what I will be looking at. If that does not work, then fusion.
As far as my stay in the hospital, it was not long. I went into surgery Wednesday night and was out of the hospital Friday afternoon. I stayed in the hotel Friday night and flew home Saturday. The cast and crutches were not a real problem, since I have been with them off and on for two years because of this injury.
I am hoping for some real medical advances also, as I would like to get back to competing in all the league sports that I used to, but that is really not looking like an option either. I thought maybe someone might come up with a way to grow cartilage and start doing some resurfacing with it to get rid of the arthritis, but I think that is something that is just starting.
I guess we just keep our fingers crossed that some miracle treatment comes along in the next few years.

[Carol]

Hi sbcoach! Wow, I can't believe you could fly 5 days after surgery! My doc advised me to wait til the stitches were out because the elevation in the plane would cause swelling which could burst the stitches. I have to travel for work, and had to wait two weeks before I could fly and even then the pressure at 30,000 was a bit painful. At any rate, I'm so happy you could get home so soon!

I guess we'll both be watching the allograft and stem cell progress in the coming years. You are younger than I -- I really really hope you can get to being active sometime soon!!!

[KiraB]

Heya,

I had cartilage replacement before my TAR, obviously it didn't work, but I had very advanced arthritis by that stage so we knew it was nlikely to work, but decided to take the chance.

On the replacement front, I saw two of hte top ankle replacement specialists in the world (created the STAR and the Hintegra implants) due to being only 26 everyone else said I was too young. But all agreed that if either of these two would give me a replacement I could do it. They both said yes, and both said that it was very likley that I could have more replacments after the first one fails and that if nothing goes dramatically wrong (which they both felt unlikely in my case as it is a very straightforward replacmenet) that i could have multiple further replacements. They felt this would buy me time to hopefully take advantage of any further improvements as the structural integrety of the joint would b much more intact than if I fused it, and also less damaging to other joints.

I really hope the alleograph does pull through for you!!

And I flew for 17 hours, 10 days after my surgery. I spoke to the head air hostess on the plane and explained my situation and they let me sleep on the crew seats at the back of the plane, and gave me a small mountain of pillows so my foot was elevated, it wasn't too bad, I just had to go to my seat if the seatbelt sign came up. I slept pretty much the whole way.

Kira

[Carol]

I have some pretty hefty scarring too, sbcoach: one 6" scar on the outside and one 3-4" scar on the inside (and the minor ones for the scope). Fortunately (haha) I already had significant scarring on my feet from 3rd degree burns when I was 2 years old. I am so used to scarred feet that they look natural to me. In fact, when I used to have the kids in bed with me reading at night, I'd comment to them how awful it must be to have boring bald feet. Hehe.

By the way, your doctor can dramatically reduce the visible scar by taking frequently tiny stitches. If he's not doing that, then you should talk with him if you have any followup procedures and ensure he takes care to minimize the scarring.

Kira, it sounds like you are in the best hands possible! Stay with it and I wish you luck!

[gonridin@sympatico.ca]

:(

Wow I have been on a list for an ankle replacement for over 2 years. Not bad all things considered. I am terrified.....Like the healing process, infection etc. And here I am worried and they tell me that ankle replacement is so new, and it won't last but fusion is out of the question. I still want to move. I ride horses and I love it and I try to hike, haven't done that for a few years. Can't sit in a kayak anymore. Wrecked my ankle 30 yrs, have no cartilage between the joints. I just got a phone call and it looks like they can do this for me this Fall. Does anyone know anything about the Hintegra ankle replacement and has anyone had one????? How long is the recuperation period??? I am 54 yrs old and would like to still be able to walk for the next 40 yrs or so....LOL
Any info would be greatly appreciated.
Connie :(

[KiraB]

Hiya,

I had a Hintegra ankle replacement nearly 11 weeks ago, It has been fantastic, I love it. I was weight bearing by day 4 and fully weightbearing by 2 weeks (no crutches). I got my walking boot off at 6 weeks. Didn't need aids to walk then either. I have no pain, except from my achiles which was very short and needs time and exercises to lengthen. I couldn't get my leg to 90 degrees before op, and now have 10 degrees dorsi-flexion, and still increasing (more than I have had in 3 years!). I am still a bit slower than most people, but no limp etc, awesome. I still get quite a bit of swelling, but use a compression sock etc.

I also got a slight infection post op, only after getting stictches out, and oral antibiotics couldn't shake it so I had IV antibiotics. I wouldn't worry about infection, if you get any they will sort it out imediately.

Where are you?? who is doing the surgery??

Good luck, you won't regret it!

Kira

[mombasa33@gmail.com]

I have not read all the answer's but I just found out the type of replacement I am getting and this is it. It is being done by a Dr Angela Scharfenberger out of University Hospital Edmonton, Alta. She is highly recommended. Her # is 780-434-3668. Mine is being done in 2 to 3 months. Her backup at this time is not that bad, but possibly getting to see her is the problem.

Larry

[KiraB]

Good luck Larry, Hope it goes as well as mine has

[sbcoach]

Kira,
It sounds like your outcome is great!!!! I am very happy for you. I am six weeks out from the partial allograft and ligament construction and still on crutches. I will be for at least four more weeks. I had asked about the metal replacement, but my doctor said no. So, you can have continued replacements with metal replacements after the first initial one is done? The only other option that my doctor is giving me is total allograft where they replace the talus and part of the tib/fib region with cadaver bone. I should maybe look into the replacement. I am getting real tired of the crutches and all the stuff that goes with it. I am not sure why I have to be on the crutches for so long.
Who is your doctor and where is he/she located that did your surgery? I might be looking into that. I still have pain in the joint. The only place that I don't have arthritis is where the little piece of bone was replaced. I am going to be looking for options in the future.
I hope your recovery continues going fantastic. I am beginning to think that those of us with this problem need all the luck in the world.

[KiraB]

Heya,

Yeah my recovery has been great, I just did a 1.4km sea swimming race on sunday (I has to walk 1.4km to get to the race start, with about 400m on sand, it was slow but I got there, hardest part of the race haha). Was so cool to do a race again, I can't believe I am doing it only 2.5 months post op! awesome

I would give your leg a bit more time, unless it gets significantly worse, you should give it 6 months to a year to see how things go. You could look at getting one of those rolleraids instead of crutches? You can rent them from the hospitals often. It is so frustrating on crutches, but you have had serious surgery, as soon as it is healed hopefully you will reap the benefits =)

I don't know what your doctor has told you about full allografts, but from the little I have read I gather that due to the time the tests they have to do,take about 3 days, some of the cartilage becomes compromised, which is one of the main reason why they only have success rates of around 60%. Obviously they have to do the tests though. I am hoping that they can reduce the time it takes and that should improve the results. (I am sure it is nothing like as simple as this though in reality!) I am thinking that at some point in my life I will probably get a 'real' ankle back. Until the results are better though I am going to have metal replacements.

Also the allograft only lasts up to about 6 years, what does your doctor suggest when it fails? can they do another? I haven't looked into this yet. I also am unsure as to how they fail, do you get arthritis again? or does the bone get rejected for some reason? (I just have no idea how they decide it has failed). If you could fill me in on the answers I would really appreciate it! It does sound great to have an allograft...who is your surgeon? Bugbee?

You can get more than one replacement, multiple infact, depending on how it failed, and if you have had complications. As mine was very easy they seem to think it will be no problem. How good the surgeon is does seem to determine how much they believe revisions are possible. I have heard from people in Canada who were told they were too young at 40 for a replacement, who said well this chick got it at 26 from Hintermann, and they surgeons essentially said well he is an amazing surgeon and he has the ability to do many things that would be impossible for us...yes he probably could offer that to someone that age, but we can't. Which of course really annoyed the guy, as they still refused him a replacement. I had my replacement in switzerland, by Beat Hintermann. So my advice is get the best surgeon you can to talk to about replacement if you do decide to explore that option later on.

[lmu_pokerplayer]

any new options available? i am 21 years old and have no cartligde in my akle due to skateboard injury had one surgery to repair tendions and clean it up but did nothing. in terrible pain and cant do anything. they dont want to do replacement due to my age and i dont want fusion because i want to be able to run and such and not willing to sacrifice that much. tried everything else and besides pain killers nothing works(numerous scopes, medication, aleve) trying to find a doctor to try the cartlige transplant. Went to UCLA medical school but they were hesitent. just wondering if anyone has had any sucess or anything. THANKS Lucas

[KiraB]

Hey Lucas,
If you have very isolated cartilage damage a cartilage replacement can work, but once the damage is too spread out it won't work, and you go through two more operations for nothing. If you can talk to another surgeon about possibly replacement, the only other option is getting a living replacement from a cadaver, Bugbee is the go to guy for that apparently.

[karenb285]

I had a total ankle replacement done in April of 2005 in Boston, MA and haven't had great results. I have had four surgeries since and still cannot walk without pain. I knew it was experimental when I had it done so I don't regret it, but now I have been told the ankle is shifting and probably should be removed. I am not making any decisions at the moment.

I suppose you need to research how many replacements your doctor has done. I was only the 12th in the state of Massachusetts so I knew I was taking a chance.

[Bliss]

Hey. My name is Bliss and I'm 21. I shattered my tallus bone about year ago. I have 5 screws holding it together and no cartilage. I m going into surgery again tomorrow to get a screw removed that actally moved up ino my joint and causes a great deal of discomfort. I am hoping for the best once they remove the screw but without any cartilage who knows how I am going to feel. I am a former athete and it is killing me not to be able to run all over the place like I have in the past. Please let me know how this procedure works for you because I wouldn't hesitate to do anything to make cartilage come back into my ankle!! Thanks!

[Tincup23]

I was told to get a fusion in 01/07 after 3 sugeries on my ankle. I did not do it and the pain has gone down alot. I take alot of vitamins and no pain meds. I take Bio Flex and just started drinking Elations. I also went to a running store where they watched me walk and suggest certain shoes for me. The shoes helped alot. I run a little but really forgot how so I limp pretty good.

I am in law enforcement so a fusion would destroy my career. I talked to two other cops from different departments who have no cartlidge in their ankle and were told to fuse it. They both told me Not to do it. It took one 2.5 years before he could run and do everything he wanted and he is now on his departments Swat team. The other officer told me it took him 3 years.

I still have pain with every step but I can deal with it where before I did not want to get out of bed.

I just got back to full duty and go back to patrol in two weeks.

Good luck to all,



Tim

[mrfusion]

Hi,

I haven't read all the threads on this forum, but I hope my story can help. I'm living in the UK and I had an ankle fusion operation 2 weeks ago. I'm 24 years old and as many of the nurses, doctors and surgeons keep telling me, I'm pretty young to have had this operation. I shattered my ankle ten years ago in a sporting accident and ever since suffered from arthritis, it took me a year to decide to have the fusion operation after having tried painkillers that were useless and the ankle replacement not being an option because of my age. I was extremely apprehensive about the operation after being told by the surgeons of potential risks (i.e. non-union of the bones or at worse amputation!). Fortunatly, the risks for me were lowered by having the arthrescopic arthrodesis (fusion through keyhole surgery). Apparently this is a far better option than open surgery and pain after surgery, healing time etc are all improved. I had the operation done on the NHS two weeks ago. I am amazed, the after surgery pain was not too bad, a bit painful but I was well looked after - I spent a total of four days in hospital. Have been completely non weight bearing for two weeks. I have now stopped taking pain killers and am COMPLETELY pain free. I had my plaster changed today, were I once again met the surgeon. He took my foot and moved it around and I was amazed that it didn't really hurt and there was still quite substantial movement. (NB: I had my upper ankle joint fused - the up and down movement, NOT my sub-talus which I understand gives left and right tilt of the foot). Anyway, I have been partial weight bearing today and I can't believe how good my foot feels!! I just can't believe I put this operation off for so many years. If you are suffering with arthritis and have limited movement then it really is worth doing. If you have any questions then please send me an email.

[KiraB]

mrfusion,

great to hear that yor recovery is going so well!! It is great to see people happy with both replacements and fusion at our rather young ages! Keep us posted on your recovery!
kira =)

[Dan ankle]

Mrfusion,
Glad all went ok for you, & hope it continues.
I have also been told I need a fusion, after 4 ops to remove a bone spur at the front of tibia that just keeps growing back after football injury. They now say I have arthritis etc..
I am also in uk and I'm looking for the best surgeon on NHS to do the op or recommend any other treatment like cartilage replacement.
Please tell me; What was the name of your surgeon & which hospital, I believe you can get referred anywhere on nhs.
I,ve thought about going private as I,m not happy with the nhs surgeons I've seen.
Cheers Dan.

[Pommie Rich]

I have also been told I need a fusion, after 4 ops to remove a bone spur at the front of tibia that just keeps growing back after football injury. They now say I have arthritis etc..
I am also in uk and I'm looking for the best surgeon on NHS to do the op or recommend any other treatment like cartilage replacement.
Please tell me; What was the name of your surgeon & which hospital, I believe you can get referred anywhere on nhs.
I,ve thought about going private as I,m not happy with the nhs surgeons I've seen.
Cheers Dan.

Dan,

Unfortunately I can't really offer any advice, just sympathy. I solved the specific problem of rubbish NHS surgeons by emigrating. My advice would be to go private, if you can afford it. Best of luck.

I'm hoping someone can point me in the right direction for some more research for my particular problem.

I've had two operations (ankle arthoscopies) for exactly the same thing as Dan (bony spurs), with more or less the same outcome (cartilage damage which effectively means arthritis).

I have a limited range of movement in my ankle joint, and if I do too much on it - too much walking, cycling, etc, it stiffens up and gets really sore. I can't really run any more. I can keep the worst of the swelling and pain away by using anti-inflammatories - enough to keep 'normally' active as long as I don't want to do any sport, or run, or hike anywhere.

After my last (failed) op, the surgeon said the next step would be a fusion. I'm not keen on that at all.

So, I'm wondering if there is anything I can try that's less extreme - possibly some sort of repair operation? The impression I get is that only a small surface area of my ankle cartilage is affected. I'm wondering whether replacing or repairing this might help.

Can anyone give me any further info on this? Has anyone got any info on Mosaicplasty/chondral grafting?

Or can anyonr point me towards anything else that might help?

[skier]

I live in the French alps and am a skier with no articular cartilage in ankle joint following a motorbike accident etc.. I normally ski most days and train the young'uns. Skiing is a large part of my life. My surgeon plans to fuse my ankle joint [talus/tibia]

QUESTION: Has anybody any knowledge relating to skiing with no articular cartilage in the ankle or with a fused ankle joint [talus/tibia]?

Any news would be gratefully received

Bon chance to everybody out there

Ski Bum

[luvintravel]

I am heading where you have been. I currently dont have insurance but I am always looking of a solution..

:)


I understand your problems completely Linda,

I had a MVA 26 years ago and had a heap of compound fractures to my leg together with a smashed knee and smashed ankle. I've had 17 operations over these past 26 years. They have helped correct a lot of problems but the pain I experienced all these years with my ankle has been horrendous. Couldn't walk more that 50 metres without my ankle collapsing. If I was on my own and lucky enough to have remembered to take my mobile phone with me, I would have to ring a friend and ask them to pick me up and take me home because I couldn't walk on it. My surgeon at the time said that I had 2 options. Get it fused, which would relieve all pain or have an ankle replacement. He said to me years ago that if I could be tough enough and put up with the pain, eventually an ankle would be invented that would not wear out. Apparently they only lasted about 5 years.

I was at the stage last year where all I wanted was for my foot to be amputed. I couldn't take it anymore. I went to see a foot & ankle specialist named Dr.Alison Taylor (Knox Private Consulting Rooms) Melbourne. I told her that I was out of my mind with pain and virtually trapped in the house laying on a couch all day because I was unable to walk. She had a look at my xrays and told me she wasn't at all suprised that I couldn't walk on it because of the amount of deterioration. She said I could have it fused to take away the pain or try a new invention that has proved really succesful called the TOTAL STAR ANKLE REPLACEMENT. If I had it fused though, it would mean I would never be able to have an artifical ankle put in so I decided to go with the STAR ANKLE (TITANIUM) and as your doc has probably told you, having it fused, you will loose all movement and it will be stiff.

I had the operation last may (2005).

I am now walking with 100% no pain. It has been amazing! I am 49 years old and this ankle will last me out as long as I take care anD just behave like a normal person. She meant no marathon running, that type of thing. I can't believe the difference it has made in my life.

I suggest you look into it.

By the way, I am the same as you. Accident not my fault. Guy came straight out of a stop sign. He got away without a scratch and I have had operation after operation for the past 26 years.

TOTAL STAR ANKLE REPLACEMENT - DEFINATELY WORTH A SHOT

Regards
Barcmond

[Youngin]

Hey Everyone,
I'm 21 and I've had severe arthritis since i was young. I've had a double knee and hip replacements and now my right ankle is flaring majorly. I'm seeing my surgeon next week about a possible fusion or replacement. But im so new to all this ankle stuff that id love to hear from some of you that have a little insight on it all. Fusion just seems so limited considering how amazing my new hips and knees are! I have been able to do all sorts of sports until now, that i sprained my ankle and the bone is weakened from the arthritis.
Anyoo, all information would be hugley appreciated!

[Mischap123]

Dan and Pommie Rich,
I also had a bony spur (osteophyte) removed from my distal tibia/proximal talus in 2006. It was supposed to be an arthroscope but the osteophtye was as large as the tip of my little finger (which aint so little as I'm 192cm, 100kg and use my hands for a living) so got a scar 5cm long.
Some practical advise is to wear a shoe with a heel or you can put heel lifts in your shoes. What this does is put your foot into plantarflexion and your foot functions away from the painful spot. If the osteophyte is on one side of the ankle joint, then orthotics can be made to place you away from the spot also.

Dan,

Unfortunately I can't really offer any advice, just sympathy. I solved the specific problem of rubbish NHS surgeons by emigrating. My advice would be to go private, if you can afford it. Best of luck.

I'm hoping someone can point me in the right direction for some more research for my particular problem.

I've had two operations (ankle arthoscopies) for exactly the same thing as Dan (bony spurs), with more or less the same outcome (cartilage damage which effectively means arthritis).

I have a limited range of movement in my ankle joint, and if I do too much on it - too much walking, cycling, etc, it stiffens up and gets really sore. I can't really run any more. I can keep the worst of the swelling and pain away by using anti-inflammatories - enough to keep 'normally' active as long as I don't want to do any sport, or run, or hike anywhere.

After my last (failed) op, the surgeon said the next step would be a fusion. I'm not keen on that at all.

So, I'm wondering if there is anything I can try that's less extreme - possibly some sort of repair operation? The impression I get is that only a small surface area of my ankle cartilage is affected. I'm wondering whether replacing or repairing this might help.

Can anyone give me any further info on this? Has anyone got any info on Mosaicplasty/chondral grafting?

Or can anyonr point me towards anything else that might help?

[bazhulk]

Hi i have no ancle joint as sutch,it was destroyed in a fall,ive spent 9 months waiting for my tibia to heal,which its not.As for my ancle,eaven my surgeon doesnt know if a fusion is possible,i may loose the lower leg.All i can say is to try to keep your chin up and the medication down,im 32 with 3 kids i will have to get through this for my sanity and my family.i love sports and i just see this as my head verses my leg,i dont like to lose.Goodluck all.Barry,Scotland.

[erindk81]

My name is Erin. I'm 27.

Mark Blackney (Park Clinic in Melbourne) did a double graft in my ankle in May and June. I come of crutches and out the camwalker on Friday.

I was told 7 years ago that my cartilage was starting to thin and that I would get arthritis. I don't think the doctor at the time knew (and certainly I didn't) realise it would happen so quickly. In December I experienced what I now know to be a 'flare' and unlike previous flare ups the pain didn't go away. The unusual thing about my case is that I have never broken or badly sprained my ankle - it has always been 'weak' and needed bracing and strapping but never a real injury.

In the end the damage was amoung the worst Mark had seen. I ended up with a lesion 1cm deep and 1.2cm wide. When he went in to do the first surgery (the one where the clean it up and take the sample) he found a second area that was beginning to thin. So he ended up doing a double graft - apparently the first in the world.

What I am interested to know if anyone knows what the medium to long term outlook is for cartilage graft surgery. Does this fix it or am I likely to need more surgery at some point?

[lindseyparker]

My friend Mark has a lost ankle cartilage. He is undergoing a treatment for it. The orthopaedic has suggested an "orthotic" for him. Orthotic is a specially made insert that goes in his shoes. It has helped him a lot. It was expensive, but worth it.

[KiraB]

Hi Erin,

I'm not sure how yours is the first in the world of a double graft, maybe of a particular type of graft, I'm no expert in these things. I did however also have a MACI cartilage replacement (they took some out, grew some more and then planted it back in my ankle 6 weeks later). It was also a double graft. I have yet to hear about anyone having a success out of this operation in the ankle (lots of success in the knee) but one can imagine that those who had successful operations are unliky to be on the message boards :)

Mine was a failure, but apparently doomed from the outset after I saw one of the top ankle surgeons in the world in switzerland. Apparently my ankle was too far gone for this operation to be a success.

So assuming yours was bad, but not as bad as mine, there is hope for you. (You said your was bad - but apparently I had particular indicators which suggested this would not work - so while yours may have been bad, it could be for completely different reasons!) I would say definately be optimistic, the graft in the knee has great success so I would assume it has some level of success in the ankle. If it works for you I'm sure it will be great, so be positive and see how things turn out!

When mine failed it was quite dramatic, there was no way you could think it had worked, so if it feels ok then assume it has worked and it is just the usual recovery process and not a total failure.

I would say that it is likely you will need more ankle surgery in the future given your young age (I am 28 myself) but who knows that might not be until you are 70!

So be positive, do everything they say regarding your recovery, and have your fingers crossed!

Best of luck:)

[Airfly]

Hi,

I wonder how is it going with Rebecca? She was the one who started this great forum where we have chance to share our knowledge, happiness and even sad storys. Anyone been in contact with Rebecca or know anything about what happend after her surgery? Very curious.

Best regards // Albin

[erindk81]

Thanks KiraB... I am having my 3 month MRI tomorrow and a follow up with my surgeon but I would like to say that I am feeling more positive about the success... there is no pain over the big graft site but lots of pain towards the back of the ankle and a VERY painful click over the smaller graft... fingers crossed but to say I am stressing about it is an understatement. Put it this way, I can't even do the low impact stuff (like riding an exercise bike) that I was told I could do without paying for it the next day - that any my foot varies in colour from a slight blush to crimson and hot over the course of a week... the frustrating thing is that I have another 10kgs to lose (I lost 17 after my diagnosis) and I can't do the exercise required to really get at it... all I can say, is thank goodness for reformer pilates!!

What did you do after your grafts failed?

[erindk81]

I guess it's my turn to update... and I wish I was bringing better news. Since I had my graft in June last year my ankle has continued to deteriorate (quickly) and I now have a lot more lesions and a cyst. So... I am heading back in for more surgery next week... a debridement, possible microfracturing and removal of the graft... most of all, they are going to have a REALLY good look at the who surface. I have been warned that this may not work (as if I don't know that) and that if it doesn't then I will need a fusion. Anyway, let's hope it works, though I can't say I am as positive as I was going into the surgeries last year.

I have asked about replacements and while I realise that Kira has had some very positive results, my surgeons are aware of the work being done in Europe but don't recommend it.

I understand the debate over fusion v amputation but my view is that you have to try a fusion first, you can't undo an amputation... but my surgeon tells me that a fusion can be reversed.

So there it is... I hope you are all well.

[Bennett]

Hi everyone.

I wanted to post here letting others know of a discussion going on at Knee Guru. You can follow my notes as Irentat but many others are seeing success. Bottom line, I was at joint replacement in my ankle and mostly through HGH injections into the joint, I have been able to rebuild the cartilage. I walk normal now and sometime in the future I will be back to running. This is pretty good compared to 18 months ago I could barely walk.

Take a look.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=46074.0