Ankle Ankle

[BrooklynTA]

New member,

58 year old former dancer with avascular necrosis and a collapsed talus in my left ankle.
PT is keeping me walking, but I’m looking to undergo surgery in May.I need to choose between a fusion, and a talar replacement with a TAR on top.
My research, including 4 visits with 3 surgeons tells me I am in a fairly unique situation.
I am hoping there is someone out there with experience or knowledge of, the state of current technology around Talar replacement (with a custom artificial talus based on a CAT scan of my good talus).
2nd question: My left talus is 80% dead. Fusion will leave the 20%. But what are the chances that I continue to lose bone after the surgery? I’m afraid the fusion in these circumstances is as risky as the full on replacement.
Would appreciate any perspective. After 4 months of dealing with this, I’m no closer to making a decision.
thanks to all,
BrooklynTA

 

[Jaycey]

@BrooklynTA Welcome to BoneSmart! Sorry that you are having to make this tough decision. Do spend some time in our Ankle forum. I don't think any of our members there have had talar replacement but you can certainly ask the question.

 

[Larryr]

New member,

58 year old former dancer with avascular necrosis and a collapsed talus in my left ankle.
PT is keeping me walking, but I’m looking to undergo surgery in May.I need to choose between a fusion, and a talar replacement with a TAR on top.
My research, including 4 visits with 3 surgeons tells me I am in a fairly unique situation.
I am hoping there is someone out there with experience or knowledge of, the state of current technology around Talar replacement (with a custom artificial talus based on a CAT scan of my good talus).
2nd question: My left talus is 80% dead. Fusion will leave the 20%. But what are the chances that I continue to lose bone after the surgery? I’m afraid the fusion in these circumstances is as risky as the full on replacement.
Would appreciate any perspective. After 4 months of dealing with this, I’m no closer to making a decision.
thanks to all,
BrooklynTA

Hi,
Very interesting decision you are facing. I had a TAR three months ago and am progressing quite well. You can see my story on this forum. I was confused by your use of talar replacement? Did you mean talus just to be accurate? I have not seen anyone having to have their talus replaced in addition to a TAR.
Isn‘t the talus a solid foot bone, so I am unclear what you mean by 80% dead? Is it the adjoining ligaments and tendons that are damaged?
I went through extensive research of fusion vs TAR and after consultations with surgeons from the Florida Orthopedic Institute decided the TAR was the way to go.
TAR provides the advantage of flexibility whereas fusion is one solid non flexible joint. With TAR the plastic insert between the titanium pieces attached to the tibia and talus will maintain bone structure thus avoiding continued bone loss as I learned from the experts.
Anyway I wish you all the best as you decide what to do.

 

[Jamie]

If you have the option of a joint replacement instead of fusion, you might want to consider that as you should maintain more movement that way. You may want to get a couple of opinions before you decide for sure what you'd like to do. As you know, when the blood supply is compromised in any area (like your ankle), the risk is always there for bone to become necrotic from under nourishment. I couldn't tell from your post whether your surgeon had suggested that's a risk or not.

Would you happen to have some x-rays you could post?