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Ankle Getting Ready for the Fresh Ankle!

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LauraC

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Yes! I am being careful. Thank you for your response. One note, my long walks include many rests. Managing the swelling, which is minimal. Lots of ice, elevation and resting multiple days if needed. My PT is giving me that same good advice about going slow.
 

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That's great @LauraC! Ice was my friend for a good long while, and after a busier than usual day for well over a year. If you think there's any chance you pushed the envelope, icing afterwards can never hurt!
 

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@LauraC Great update - you are really making good progress. Yes indeed, that ankle will tell you when it is ready to take full weight bearing. Meanwhile your approach is spot on. Well done!
 
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LauraC

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I just wanted to check in. Sure enough, the last time I checked in, I was doing just great. I never felt that I was rushing it or over doing my walks, being careful to use my walker, don't go too far, ice and rest when I got home, following the recommendations of my PT (2x/week sessions}. About 3 weeks ago, my ankle started hurting in a way that it had not before, so I immediately cut my walks down by about 75% (distance, time and frequency). My medial malleolus hurt a lot, and I just ran that by the Dr. who had me come in right away for an Xray. All looked fine. Pretty much not doing anything but walking as necessary in the house, using a scooter most of the time, staying in bed and using the boot again, which seems to help, but even after this 3 weeks of almost nothing, the pain is still there. At PT today, he was saying to cut back more, and I really don't know what else I can cut.

I have a regularly scheduled appt. on Monday, and have to assume that I am OK, but this pain is so different, it has me a bit worried. Wish me luck on Monday.
 

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You might try eliminating any walking besides activities of daily life @LauraC. Ice and elevate, and maybe you can get it calmed down. I had flare ups of pain and swelling for at least a year if I pushed a little too hard, and I seldom thought I had, but my ankle had other ideas.
 

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@LauraC All the best on Monday. Please update when you can.
 

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Hi everyone...I haven't posted in a long time, but am fascinated to read LauraC recovery process. I too had a left TAR Jan 8 2021 that's just 8 weeks and am doing Thank G-d really well. Much better than I had anticipated, being that I've had 3 precious fusion surgeries of midfoot, taylor-naviculus joint and heel. Those were hard recoveries. The Infinity replacement looks great on xray, scar healed really nicely, 2 weeks ago started PT. Wearing my boot except at night. Graduated from scooter to walker, now bout 75 percent weight bearing. transition wasn't easy but i am upright!! I roll around my kitchen on a rolling office type chair and prepare food and wash dishes and all. But still have lotsa tingling and funky sensations, especially below big toe like LauraC mentioned. Keep posting Laurs-you r a few weeks ahead of me and I love the encouragement!!
 

FCBayern

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That tingling and funky sensations will eventually fade, the nerves that were stretched or cut take the longest to heal. When I had my ulnar nerve relocated the OS suggested 500 milligrams of vitamin C twice a day to promote nerve healing. Don't know if it really helped or not but I took it again after both TKR and THR, figured it couldn't hurt, and all those nerve issues have all healed.
 
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LauraC

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@Chanie
Great to hear your progress, sounds like you are doing great. I hope that I will be moving around more soon, am taking a rest but most of the time my body says to get moving, so it is difficult to stay in bed, especially with our incredible weather right now. I am really having trouble with this disconnect between what my body says and what my ankle says. I am interested in what the Dr. says tomorrow about how to understand my ankle a bit better. Wishing you all the best in your recovery, one step at a time. Keep us posted.
 
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LauraC

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@LauraC All the best on Monday. Please update when you can.
Well, I went to the Dr. about the change in the way my ankle was feeling. She recommended a CT. I got the CT results that same afternoon, and my interpretation of the results were that I am headed for a revision. Impingement, both the device and most probably some scarring impingement are causing this sharp, bone pain in my malleolus. I waited for the Dr. to see if my interpretation was anywhere close to what she thinks. After one week of silence (I believe that this normally very responsive Dr. was conferring with her colleagues), I received a message tonight. They are recommending a revision to replace the talar component with a smaller one. I am really devastated. Although I know this happens, and really went into the surgery with eyes wide open, now that it is here, I am having a stronger emotional reaction than I expected. 19 wks today, and now .... I have a lot of questions, and hope to be getting a video meeting with the Dr. this week. Will keep you posted.
 

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@LauraC Bummer about the revision! But at least they have identified the problem and there is a solution. I hope you can get this done quickly and get back to recovery. Fingers crossed! :fingersx:
 

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Sorry to hear about the revision. Best of luck going forward.
 

FCBayern

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So sorry you are looking at more surgery @LauraC. We will be here for you! If more surgery solves your problem it will be well worth it.
 
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LauraC

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Well, I met with my surgeon, and she had indicated that the revision would require implanting a smaller talar component because of the current 4mm (sounds huge! how come?) overhang which is rubbing on my medial malleolus which is causing the pain. She had also suggested a gutter clean out instead of the revision. We reviewed the CT together, and it does look pretty good other than the impingement. Initially, I did not want to do the scope procedure because I felt that I would have to go for the big revision anyway, but she checked with Wright and they do not have a smaller talar component, it would have to be custom made, making that a long road on top of the long road to recovery. The scoping sound like my best alternative at this time because the recovery would be short, no NWB phase, and basically in parallel to my current replacement rather than starting all over again. My strength and ROM are just coming back and I am walking well, jut not far mostly for fear that the pain indicated damage, not something to "work through". I want to keep up that progress if I can. I am scheduled for the procedure on Tuesday, March 23rd. I am vigorously entertaining the thought that this may solve the problem and that I will not need a revision. Think positive thoughts.
 
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LauraC

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Update: Had the scope procedure on the 23rd. Much more painful than I expected, but I think the pain is diminishing. What they found is excessive fibroid tissue, a difficult and extensive procedure. The fibrotic tissue had moved in between the poly and was all removed. Today, the Dr. went picture by picture and explained the process and what she was seeing and doing at each stage. She really could not visualize an excessive overhang on the talar component, and was able to see about 3mm space with a probe in the gutter. Cartilage was all worn off on the media malleolus, she said it could have happened from the fibroid tissue which was so thick. So, the good news is that it is all cleaned out, and I am cleared to start back to PT as tolerated next week. I agree with the Dr. that this was the best thing to do at this time. The revision is off the table for the time being. Please keep your fingers crossed that I can now proceed where I left off with this recovery!
 

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Glad to hear things went well @LauraC. Make sure you don't press too hard and :ice::ice::ice:
 
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LauraC

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I am reclined and icing as I read this. I have such a history of fibrotic interference, that I have to make every effort to keep the swelling to a minimum (which I have so far), and HOPEFULLY minimize the scar tissue that forms from interfering with my joint, and causing the pain that happened. I will gladly leave some ROM behind for the ability to walk without pain.
THANKS FOR THE SUPPORT!
 

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LauraC,
Glad your surgery is behind you. Our TKR's with fibrosis, after surgery to remove it, have done well by focusing on keeping the knee calm and avoiding swelling and inflammation for the first 3-4 weeks.
All the best in your recovery.
 

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