OT: Ankle Fusion Surgery

[LightningJack]

Out of options here, seems like the only thing left to do besides the fusion is Lopp it off! Anyone got experience with this or know someone that went through it? I've been told 4-6 months off of work till I can resume something similar to normal activity. Any comments appreciated, Snarky or otherwise

 

[1949 tackle]

Make sure you are going to UNMC. The muscular-skeleton/orthopedic surgery group over there are far better than any other group in Omaha, or anyone within a 200 mile radius around it.

 

[dinglefritz]

Out of options here, seems like the only thing left to do besides the fusion is Lopp it off! Anyone got experience with this or know someone that went through it? I've been told 4-6 months off of work till I can resume something similar to normal activity. Any comments appreciated, Snarky or otherwise

Sorry to hear that. I haven't had it done but a friend had it done for a nasty fracture. You won't be able to resume "normal" activity with a fused ankle but it beats the hell out of constant pain once it's healed. My friend had quite a bit of discomfort for a long time post-op but you do what you have to do.

 

[shine003]

Make sure you are going to UNMC. The muscular-skeleton/orthopedic surgery group over there are far better than any other group in Omaha, or anyone within a 200 mile radius around it.

I don't believe UNMC has a foot and ankle surgeon on faculty at this time. I could be wrong about that and they may have another surgeon that will do them, but he should go with whom he is comfortable with. I normally would agree that UNMC is an excellent orthopaedic group, but this might be a small niche they currently don't have someone to fill.

Getting a fusion isn't a decision to be made lightly, but if your ankle is stiff and painful then getting it fused can reliably get rid of the pain (it will still be stiff obviously). 3-6 months sounds about right to get a solid fusion and back to a functional mobility level (assuming it fuses without complication). Find a surgeon you're comfortable with and go for it if you really can't take it any more. Just be warned that fusing the ankle will increase the stress in adjacent joints (mostly in the mid and hindfoot), potentially creating arthritis in a new joints that may need to be fused at a later date.

 

[dinglefritz]

I don't believe UNMC has a foot and ankle surgeon on faculty at this time. I could be wrong about that and they may have another surgeon that will do them, but he should go with whom he is comfortable with. I normally would agree that UNMC is an excellent orthopaedic group, but this might be a small niche they currently don't have someone to fill.

Getting a fusion isn't a decision to be made lightly, but if your ankle is stiff and painful then getting it fused can reliably get rid of the pain (it will still be stiff obviously). 3-6 months sounds about right to get a solid fusion and back to a functional mobility level (assuming it fuses without complication). Find a surgeon you're comfortable with and go for it if you really can't take it any more. Just be warned that fusing the ankle will increase the stress in adjacent joints (mostly in the mid and hindfoot), potentially creating arthritis in a new joints that may need to be fused at a later date.

What's your take on ankle replacements?

 

[planored]

I don't envy you, foot surgery is about as painful as it gets. Had surgery to repair peronues brevis tendon with double osteotomy on big toe and heal. Sob that was not fun and foot is still fairly numb. Good luck

 

[shine003]

What's your take on ankle replacements?

Should only be concerned for a very specific patient population. The stresses in the ankle are just too high for good implant survival in the vast majority of patients. That said, if someone is thin, healthy, low demand and only have arthritis in the ankle joint, it can be considered and have good results. There may be some advocates performing a larger number of these that feel comfortable expanding the indications but I don't think most people should be candidates. The technology just isn't there yet and who knows when it will get to the point when it can become more mainstream like a hip, knee or shoulder.

 

[dinglefritz]

Should only be concerned for a very specific patient population. The stresses in the ankle are just too high for good implant survival in the vast majority of patients. That said, if someone is thin, healthy, low demand and only have arthritis in the ankle joint, it can be considered and have good results. There may be some advocates performing a larger number of these that feel comfortable expanding the indications but I don't think most people should be candidates. The technology just isn't there yet and who knows when it will get to the point when it can become more mainstream like a hip, knee or shoulder.

I talked casually to somebody a few months ago that had one done and at least so far was happy with the result. We'll see. Much different type of motion.

 

[LightningJack]

I don't believe UNMC has a foot and ankle surgeon on faculty at this time. I could be wrong about that and they may have another surgeon that will do them, but he should go with whom he is comfortable with. I normally would agree that UNMC is an excellent orthopaedic group, but this might be a small niche they currently don't have someone to fill.

Getting a fusion isn't a decision to be made lightly, but if your ankle is stiff and painful then getting it fused can reliably get rid of the pain (it will still be stiff obviously). 3-6 months sounds about right to get a solid fusion and back to a functional mobility level (assuming it fuses without complication). Find a surgeon you're comfortable with and go for it if you really can't take it any more. Just be warned that fusing the ankle will increase the stress in adjacent joints (mostly in the mid and hindfoot), potentially creating arthritis in a new joints that may need to be fused at a later date.

I like the surgeon I found after I went and got a third opinion on this recently with a CT scan. I'm going with GIKK group out at Lakeside. Always had good luck at Ne Ortho, (This will be my 11th surgery) but last surgeon wouldn't give me time of day. I've known for a few years I'm missing a bone, lots and lots of arthritis, heels spurs. Had two rounds of physical therapy, 9 shots of cortisone, been in a walking boot 4X, been going to a pain clinic about 1 1/2 years and recently tore my plantar fascia mowing my lawn. They all tell me about the same thing, that or get a desk job. I've read where some people can stress other joints, parts of foot. I will be able to maintain up and down function though. Just no lateral movement which I don't have now anyways.

Appreciate the info.

 

[LightningJack]

I talked casually to somebody a few months ago that had one done and at least so far was happy with the result. We'll see. Much different type of motion.

This is what I'm hearing, figure it can't be worse that the club foot I have now. Hopefully minus the pain.

 

[LightningJack]

Should only be concerned for a very specific patient population. The stresses in the ankle are just too high for good implant survival in the vast majority of patients. That said, if someone is thin, healthy, low demand and only have arthritis in the ankle joint, it can be considered and have good results. There may be some advocates performing a larger number of these that feel comfortable expanding the indications but I don't think most people should be candidates. The technology just isn't there yet and who knows when it will get to the point when it can become more mainstream like a hip, knee or shoulder.

This is what i was told, mainly older this people getting these done. Still having failure rate like 20% 5 years out I guess. I'm mid forties, solid fusion is my best bet apparently.

 

[skintight]

i feel that the 2 most important variables are your BMI and your intended or expected level of physical activity in regard to joint replacement. considering fusion, when the pain is affecting you psychologically and fundamentally changing you as a person then i think it is time. amputation is the bail out after everything else has failed.

 

[BadgerGrove]

My mom had ankle fusion surgery. She's in her 70 s and took a while to fuse. Everything is good now. No pain. I don't think you can run with a fused ankle but you can walk fine. Over time it may lead to more arthritis in other parts of the foot.

Replacement devices are still in their infancy. Not enough surgeries yet to perfect the device and procedure. If you are young, the replacement may be a better option.

 

[SPbObRT]

orthowest in bugaha,nebraska. they seem to have their shit together and have a great staff of doc's. if they cannot do it i'm sure they would lead you in the right direction.

 

[dinglefritz]

Replacement devices are still in their infancy. Not enough surgeries yet to perfect the device and procedure. If you are young, the replacement may be a better option.

IF it were me and I had the option between an irreversible fusion OR an experimental arthroplasty of some type with unknown result, I would take the experimental option every time and worry about the what if later. Just me. Give me a shot at somewhat normal joint function every time. I had a relatively new and controversial hip resurfacing 10 years ago, that I learned right after I had it done Mayo's had discontinued due to failure rates. 10 years later I am pain free and have had no complications while leading a very physical lifestyle. I am also very thing which helps. New and unproven is not necessarily always a bad thing. You just have to be ready to accept the consequences if you do have complications. I do know that at the point I had that hip done, I was ready for anything just to stop the pain. Death didn't seem like all that bad of an option at the time.

 

[LightningJack]

IF it were me and I had the option between an irreversible fusion OR an experimental arthroplasty of some type with unknown result, I would take the experimental option every time and worry about the what if later. Just me. Give me a shot at somewhat normal joint function every time. I had a relatively new and controversial hip resurfacing 10 years ago, that I learned right after I had it done Mayo's had discontinued due to failure rates. 10 years later I am pain free and have had no complications while leading a very physical lifestyle. I am also very thing which helps. New and unproven is not necessarily always a bad thing. You just have to be ready to accept the consequences if you do have complications. I do know that at the point I had that hip done, I was ready for anything just to stop the pain. Death didn't seem like all that bad of an option at the time.

I see where you're coming from, sounds like you were in bad shape too. My ability to work has been really compromised, would need FMLA here shortly if I don't do something. I asked all 3 surgeons about replacement & my physical therapist. All a no go for me, I'm still younger and I'm to heavy for a replacement. Practically guaranteed failure & can't switch from a replacement to a fusion later on. This is a pre-existing condition and not knowing what healthcare may bring in the future I'm going for the fusion. If i was thinner and knew I would have the money later in life I might go for it.