Ankle Replacement

Hi jeff...I recently had the oats procedure to my ankle. I'm 8 weeks post-op. I was just wondering how you are doing and if you were still having pain. I've done a lot of research with the oats and surgical procedures involving the talus. I know this isn't the last surgery for me as i've been told this surgery should buy me time. It looks as though ankle replacement in 10 years time for me. Let me know how you're doing. Take care~amy~

Yup im still in pain at 9 months. I felt for a while when I went to the cane like I was just holding it for the hell of it. As soon as I started full weight , and p.T. With weights it went right back to pain. Im in an afo brace that locks it in place like a fusion and it still hurts. . Got that in jan. I see the doc the 23rd , however I went to the university of pennsylvania for a consultation and another opinion. My surgeon suggested fusion. I saw a guy who is supposed to be the best in the country. Enyi okereki. He offered me 2 options but refused me a replacement based on age, and lack of motion. The lack of motion I dont understand, thats why I want it, right??? He offered a talus replacement,( cadavar). Or a predure where they split the ankle and place pins across it keeping it open for 3 months. They resurface it somehow. But he added the pins come through your skin on both sides. It is a long heal, 3 months before it even touches the ground.!!!!!! And it is very painfull. But he has high success with the 2nd, one. I dont know what im gonna do. He wont touch me till june. I have to give the last job a yr. To see for sure. , I hope yours goes better, ya know. I will let ya know what they say next week. Jeff

Hi jeff...

The doctor you are seeing at u of penn...Is that enyi okereki? I see Dr. Steven raikin at rothman institute. I'm not walking yet...Still another 6 weeks to go...So I can't tell you if the sharp stabbing pain I had for a year-and-a-half before this surgery has gone away. I do have pretty good rom...I've taken it out of my cam walker 3x a day for flexion/extension for the past 6 weeks. Coming out of surgery he basically told me the best part of my ankle was where he put the "plug" on my talus. I had an osteochondral defect which is what i'm sure you had if you had the oats done. Did you have cadavar cartilage or from your knee? I found that right now my knee bothers me more then my ankle. I guess once pt starts it'll help...Well I hope. Before this surgery...I saw Dr. Michael castro as my surgeon through cooper bone & joint. He now is with pennsylvania hospital. I basically went to Dr. Raikin because Dr. Castro wasn't sure what to do with me because of my age at 31 and his thought was ankle fusion which I was against being that I am in nursing school. But...Coming out of surgery...Dr. Raikin said the rest of my ankle looks as though a steam roller went through it and he basically bought me time...5-7-10 years as he puts it until i'll need ankle replacement. He said by that time technology will be more advanced. But...From what I understand...There is a surgeon in seattle and one in pittsburgh that fuse the ankle in a way that down the line can then be reversed for ankle replacement. If the ankle is fused in such a way that is totally permanant...They remove the medial and lateral malleolus...Which...You would need present for an ankle replacement. These drs leave the malleolus so that future ankle replacement is possible. I've also learned that through talking with a friend who is also a patient of Dr. Raikin that recently had his ankle fused...He said at a young age if ankle replacement is attempted and there is failure that amputation would be the end result. I am basically staying on top of this...My husband says I seem to be obsessed with finding answers...But I guess with any health issue that effects your everyday living...The best possible solution needs to be found. Between me talking to others with this same experience and many different surgeons along with researching online...I feel i've done all I can do. No...This is not cancer...But to me it's serious as with my profession depends on long hours on my feet...Which need to be stable. I'm sorry that you are still dealing with pain. I know how frustrating it can be. Before this surgery I dealt with depression as I know that can be an illness in itself. I'm hoping this worked...But we'll see. Hang in there...I know there is a best possible solution out there for you. If you haven't seen Dr. Raikin...He is amazing...Very knowledgeable and basically tells you what is going on with a straightforward approach...Which is what I like. Keep in touch...Let me know how your next appt goes...Take care~amy~

Yes, it came from my knee. It was sore for weeks butt feels great now. I had it done because my talus had a pocket in it and colapsed. All my cartliage is gone. I was told by numerous surgeons that fusion isnot reversable because all the muscle dies off. Everything starts wasting away around it. That was emphasized by enyi okereke. There is no way I will get it fused. Let ya know how my appt. Goes.

Do you have any idea of who the doctor in pittsburgh is that says they can do a reversable fusion. Or even the hospial name. Man I hope its correct. I basically have till june to make up my mind on this. The cage and resurface job on the talus, or fusion. My doc told me yesterday okereke, raikin, hecht , will all do the same thing. T.Y . Jeff

This is one of the sites I came across before with the reverse. I can look for the other one tomorrow. It was an article about a surgeon out of pittsburgh who did this surgery. I'm not sure if it is the same surgeon though. I'll let you know. My e-mail is tw obabyprincess@yahoo.Com
feel free to e-mail me anytime. Let me know how you're making out. I'd like to keep in touch since I know I have the same kind of issue.

Http://www.Allaboutarthritis.C om/allaboutarthritis/layouttemplates/html/ en/contentdisplay/document/condition/arthr itis/clinicalarticle/ankle_fusion_surgery. Htm

thanks...Take care~aim~

Jeff...I'm not sure if that site will go through...E-mail me and when I get your address i'll e-mail you the article...Ttyl

Hello all, I'm 22years old in search of an orthopedic surgeon that is willing to help me w/information in replacing my lt ankle. My talus was fractured last Septmeber due to a horrific car accident (drunk driver) a vehi hit me head on (made a u-turn on fwy) and the engine feel on my feet. My rt foot has healed well, while my lt foot has absolutley no movement. I've made appts. w/numerous amount of ortho. surgeons in the southern california area. But, I was told that I was too young to get the full ankle replacement...b/c my whole talus was crushed. If anyone has any information regarding any ortho. surgeon that is willing to perform this procedure for me...I would be really grateful. contact me !!!!! Thanks

hi there...

I'm sorry to hear of your accident. i'm really not sure of what can be done for a crushed talus. I think for ankle replacements many drs are against young people having them. They seem to push for ankle fusion. But not all doctors.

Hopefully you'll be able to find what surgeons may be in your area who would be likely to do an ankle replacement for you. If you post on there someone may reply with a suggestion. I wish you well...take care~Amy~

I'm in N.Carolina - the surgeon at Duke Hospital is doing some ankle replacements. It wasn't his preference - but I'd rather try to replace it than fuse it.
I was also in a car accident and my talus was split in half. After healing we realized that there were pieces missing that was causing friction between my leg & talus every time i took a step - the arthritis was so bad after a year that I finally found a doctor to do the surgery. He did a inbone replacement . I have been in a cast now for 3 months and probably have another month before I'll be able to start rehab. again. I'll post again to let you know how it's going. I think there's a doctor in D.C. that is also doing this surgery.

To all posting, My name is Dennis in 94 (I was 41 at the time) I was crushed by a tractor trailer from the chest down, everything healed pretty good except my right foot which was pulverized and rotated 180 deg. I was wearing metatarsals boots at the time so they saved my toes. Anyway my foot was fused but my ankle was saved. I have about 3° of dorsal flex and zero lateral movement. The big reason back then and now for not doing a replacement was because of the life of the replacements are only 10-15 years or so. Once that is over it is very difficult to put a new one in so they want you to hold off as long as you can. Also being that young they know you’re going to beat the crap out of it trying to do stuff. Another thing is if you foot joints still have the movement they (some docs and insurance) will want you to get your ankle fused because the foot still has enough give to compensate.
I have been through 4 different docs to date on this. Currently (last 10 years) I am seeing Dr. Martin O’Malley out of Hospital of Special surgery in Manhattan NY,NY. With in the last year the only replacement ankle was the Agility, in 2007 two more came to the USA with FDA approval one is the STAR and the other is the Salto Talaris. It has been 14 year of walking on this piece of poop, On March 26 of this year I will be fitted with the Salto Talaris. This one will be a long recovery process and I am kind of pumped up as well as having second thoughts..
To all of you good luck think positive.

I'm 24 and I'm thinkin about get an ankle replacement. I've been doing a little research my the topic. What happen was I jumped off a roof my company was working on to keep form getting burned. When i came to i had 9 fractures in my right Tibia 3 in the middle and 6 at the bottom some fragments were to small to salvage. Came out of a 5 hr surgery with 13 screws and a plate. I wore an external fixature for 3 months, a soft cast for an additional 3 months and 6 weeks of P/T. At first I was doing very well I was able to run with minor pain and play some sports. After 2 yrs the scar tissue has settled and I can barly walk without a limp. I know how you all feel when it takes about 20 mins to warm up your ankle after sitting for awhile. Just asking for some advice.
Should I try to get the ankle replacement (or) try and get some of the scar tissue removed. Cause I can't deal with this anymore

Dan, as I stated you are too young. If it is just scar tissue then yes get it removed. I went through several of those made a difference. What did you doc say about the ankle cartilage? Is it good? Gone? That is going to determine what they will do.
With scar tissue make sure you massage it while the wound is healing to help prevent it from developing.
dennis

I'm going to talk to my doctor about it. Everyone I know is saying the same thing, they get mad at me because they're seeing me suffer and not doing anything about it. The docter told me me that I severely scared cartilage but it will get alittle better along with my secondary bone. "My ankle is like a car", he said. "I only got so many miles before I have to get it fused", and I'm not getting that done.

My brother broke both his ankles in a horse riding accident about ten years a go. He was operated on because his right foot was twisted & crushed under the horse. He was months recovering & could eventually walk with a limp. Now though, he has almost become a cripple as over the last few years arthritis & deteriation to the joint/cartilage has become so bad he suffers a lot of pain. He did have the ankle pinned at one stage but it was taken out because of the pain. His orthopedic surgeon recommended he wear compressive braces that allow movement with some support to see if he can strengthen the muscles to avoid them wasting away. It's been pretty successful in that he can take gentle exercise now & when he wears them to bed at night his ankles aren't swollen or painful in the morning. The ones recommended were thermomedic therapy garments which he said also warm the joints to help circulation for better joint function. As my brother is still young he is hoping to keep his options open for the future so is putting off further surgery as long as possible. He has some dorsal flex & lateral movement & has been offered ankle fusion but is waiting to see if less invasive techniques can buy him more time. He was a pretty active sort so he can get a bit down at times but is pleased with the progress he is making at the moment though. I''l let you know how he goes...

I am interested in the surgeon at Duke Could you please post his name?

I'm on Ankle_Joint_Replacement group through Yahoo. If you join and go into File under "Inbone info" I saw Dr. DeOrio from Duke listed there. Check it out...I didn't actually read anything from there. But I happened to be on the site tonite and got a message from this forum that someone had posted. Good luck to you.~Amy~

Amy I'm sorry I was unable to find the information you posted about Ankle Joint Replacement. My son was involved in a motorcross accident Dec 06. He had a right fibular fraction, right pilon(distal tibial articular surface fracture, left fibular fracture,left pilon (distal tibia articular surface) fracture, as well as mandibular fractures. He had 2 surgeries and was non weight-bearing for 4 months. Pt for 4 months At first he was walking pretty normal. Within the last few months he is turning his right ankle more and more, (almost 90 degree when walking) You seem very informed and obsesses with finding answers. I am willing to go anywhere to find a good doctor for my son. He is 18 years old and I know he is going to have to deal with this problem for many years. Any information you can share would be appreciated. Thanks

I'm sorry to hear about your son's accident. This must bring on some frustation as a parent in worrying about his future. Was there suggestion of ankle replacement? Have they given you suggestions as to what can be done? Honestly, I'm more informed when it comes to the OATS only because I had it. As for TAR, not so much. I know I need to be informed as I've been told by my surgeon that I need a TAR down the line. Is your son in any pain? If he's turning his foot outward, and he wasn't before...I would have him do more PT or see a personal trainer. He will have more problems with his knee and hip if he's walking abnormally. I'll find out a way that you can access the file in the ankle replacement group site.