BoneSmart® Hip / Knee Replacement Forum
Knee Replacement & Hip Replacement
Patient Advocacy & Online Community
  1. Your support makes a difference...BoneSmartie Member

    Industry changes have drastically reduced orthopedic partner contributions, which for 13+ years supported the operation and development of BoneSmart.org.

    Our patient-focused articles and world-class joint replacement community forum have helped millions of people. Your gift today provides the important funds necessary to keep this valuable resource online.


    Donate Now
    Dismiss Notice

ankle My left ankle

Discussion in 'Other joint replacements' started by Celle, Apr 4, 2016.

  1. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

    Member Since:
    Jun 8, 2007
    Age:
    75
    Messages:
    70,624
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Why don't you try one of these? It's called an "iWALK 2.0 Hands Free Crutch". Apparently you can do everything in them, stairs, run, golf! Look at the website!

    knee crutch 1.JPG
     
  2. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I thought of that, too, Josephine but, like the knee scooters, it would involve a bit of kneeling on it and I didn't like the feeling of kneeling on a chair.

    Mobility aids is one of the topics I will raise with the ankle OS when I see him.

    I found an interesting article about simultaneous subtalar fusion and ankle replacement surgery, done in the same operation, here:
    https://www.federicousuelli.com/en/...btalar-fusion-and-total-ankle-arthroplasty-2/
    Doing that would retain ankle mobility of flexion-extension, whereas an ankle fusion does not. I would still lose side to side mobility, but that's already minimal anyway.

    Some trials report an increased incidence of ankle arthritis following triple arthrodesis and, since I already have reduced joint space in the tibio-talar joint, I was wondering if the above operation might be a possibility. Something else to discuss with him.

    However, it all depends on what degree of OA the ankle OS considers warrants surgery.
     
  3. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

    Member Since:
    Jun 8, 2007
    Age:
    75
    Messages:
    70,624
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Oh rats - of course! And there was me thinking "It looks neat but I couldn't use one"!!!! Am I dumb or what!
     
    • Funny Funny x 1
  4. OUCH!

    OUCH! Senior

    Member Since:
    Sep 20, 2015
    Age:
    50
    Messages:
    427
    Gender:
    Female
    Location:
    NJ
    Country:
    United States United States
    Oh @Celle, what a bummer to be having this pain now. I hope the surgeon can get it figured out on the 16th and give you some options to considered. I came to check out this part of the forum because my ankle has been aching. It was shattered in the same accident that caused me to need hip and joint replacement. I'm sure it is compensating as I recover from those surgeries, so I am hopeful that the pain will eventually improve. I just thought I might poke around here and see what might be in my future.

    I hope the specialist has some ideas for you that are less drastic than surgery. These surgeries do not sound fun to recover from.

    As for the NWB afterwards, I couldn't use crutches after my accident. I got around NWB with a walker off and on for nearly a year. After my knee replacement, I stuck with the walker mostly. The pt's wanted me on crutches, but the walker was just much more comfortable. Hopefully it won't come to that for you but if it does, don't give up hope.
     
  5. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    Thank you for you concern, @OUCH!

    I'm really hoping for some answers from the ankle surgeon, because the pain I have started over 10 years ago, when I didn't have any signs of arthritis, but after I sprained the ankle badly. It has got progressively worse, but the pain isn't constant. I can go for days without pain and then it flares up again.

    I can see the signs of arthritis now on the MRI and X-Rays, but I don't think they are the whole story and I don't want to go through a surgery, only to find that I still have the pain.

    Something just doesn't add up to me.
     
  6. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I saw my new OS yesterday - the one who specialises in ankle and foot problems. His name is Salil Pandit. He trained in NZ and Australia.
    He was nice. He examined my foot and ankle carefully, had me walking and trying to stand on tiptoes. He looked at my X-Rays and MRI and discussed them with me.

    He listened carefully to my history and my concerns.

    He agrees that the OA in my hind foot may not be the entire problem, because of my 10-year history of pain when I first get up from sitting after a while. For the first few steps, I have to support myself on furniture - and that started about 6 months after I sprained my ankle, almost 11 years ago. That pain is intermittent as well. I can go for months without it, and then it flares up again. To me, that says possibly tendon inflammation.

    He said that, while fusion of the hind foot bones seems to be indicated, he is reluctant to do it at this stage, before we have ascertained that OA is the whole cause of my problems. As he said, he would not like to submit me to a surgery that does not have an easy recovery, until he is certain that it will fix the entire problem.

    So, the next move is for me to have a CT scan of my ankle and foot, and see what that shows. I am to continue using the orthotic for now.

    I have another appointment with him in 6 weeks' time.
     
  7. Pumpkln

    Pumpkln Forum Advisor

    Member Since:
    Oct 27, 2011
    Age:
    66
    Messages:
    16,007
    Gender:
    Female
    Location:
    United States, West
    Country:
    United States United States
    Glad you have a plan, hoping an answer is found.
     
  8. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I hope so, too, Chris.
    I was most impressed with his thoroughness and the way he explained everything. I hope his surgical technique is as good. He's the only ankle specialist in our half of the North Island - there aren't many of that ilk around.
     
  9. Pumpkln

    Pumpkln Forum Advisor

    Member Since:
    Oct 27, 2011
    Age:
    66
    Messages:
    16,007
    Gender:
    Female
    Location:
    United States, West
    Country:
    United States United States
    As thorough as he was with you, I am sure he pays attention to every detail during surgeries.
     
  10. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I had the CT scan of my ankle and hind foot this morning, at short notice. The X-Ray department phoned me yesterday afternoon, to ask if I could take an appointment this morning. Of course I said "Yes!"

    It has been put through under Accident Compensation, still relating back to the original ankle injury in 2006.
    I'm hopeful that my surgical consultation will be, too.

    The CT scan only took a few minutes. Just my lower leg was inside the machine. It was one of the newer machines, with a smiley face and a counter for how many seconds were left until completion. The machine made a whirring noise, a bit like the Tube trains in London.

    I'll phone my GP's rooms in about 10 days, to see if he has a report. Otherwise, I shall have to wait until my specialist appointment at the end of March.

    Of course, typically as these things go, my ankle was neither swollen nor painful this morning!
     
    • Like Like x 1
  11. Pumpkln

    Pumpkln Forum Advisor

    Member Since:
    Oct 27, 2011
    Age:
    66
    Messages:
    16,007
    Gender:
    Female
    Location:
    United States, West
    Country:
    United States United States
    Good News to have the CT behind you.
     
    Last edited: Feb 20, 2017
  12. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I had an MRI a while ago. This CT scan is to see if it shows anything that the MRI missed.
    I hope it reveals something to explain what is going on with this ankle.
     
    • Like Like x 1
  13. Pumpkln

    Pumpkln Forum Advisor

    Member Since:
    Oct 27, 2011
    Age:
    66
    Messages:
    16,007
    Gender:
    Female
    Location:
    United States, West
    Country:
    United States United States
    I updated the post. :doh:
     
    • Like Like x 1
  14. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I've edited mine, too. :flwrysmile:
     
    • Like Like x 1
  15. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I saw my GP today and he has given me a copy of the report on my CT scan of the left ankle and hind foot.I see the surgeon next Thursday, so we'll see what he says. He was proposing conservative treatment when I last saw him.

    This is what the report says:
    CT L. HINDFOOT 21/02/2017
    INDICATION: Persistent ankle and subtalar pain after inversion injury 2006. Sinus Tarsi pain. Assess changes in the ST, TN, and CC joints.

    Decrease in joint space and medial aspect of the ankle joint is accompanied by talar osteophytes, subchondral cyst formation and minor sclerosis with adjacent cystic changes in the medial malleolus.
    Decrease in joint space is most marked medially.
    Cystic changes also appreciated on the lateral malleolus adjacent to the talus with cystic and sclerotic change.
    What is thought to be synovial calcification in the posterior aspect of the ankle joint where degenerative changes in the adjacent talus are seen.
    More pronounced sclerosis and cystic changes seen in the subtalar joint with osteophytes and sclerosis of the talonavicular joint.
    Decrease in joint space, osteophytes, sclerosis and subchondral cystic changes seen at the first MTP joint with changes also appreciated in the underlying medial sesamoid.
    No evidence of malalignment however is appreciated aside from metallic/deformity of the great toe. No obvious evidence of previous fractures.
    COMMENT: Appearances are most consistent with osteoarthritis.
    Multiplanar and 3-D reconstructions created.
    I think I've understood from the report that I pretty much have OA throughout my foot and ankle. Bother! That won't be easy to fix. I may have to live with it.
    The big toe was fractured many years ago, when a large oxygen cylinder fell on it. The comment about "metallic/deformity" is incomprehensible to me. Perhaps it was meant to be "metatarsal deformity" which could have happened if it was squashed by the O2 cylinder?

    I was aware that I probably had OA in the mid-foot, as my foot swells sometimes and I have pain there, too, but not as much as in the ankle and sinus tarsi region.

     
  16. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    Annoyingly, with the OS appointment coming up next Thursday, my pain isn't too bad at the moment. I have decided that, even if the surgeon recommends surgery, I will try to defer it until after Christmas. With a house to de-clutter, refurbish and sell, half our furniture to get rid of, and a smaller house to move into before Christmas, I can't take time out to recuperate from surgery. I'll have the injection, if he offers that, though.
     
    • Agree Agree x 1
  17. Pumpkln

    Pumpkln Forum Advisor

    Member Since:
    Oct 27, 2011
    Age:
    66
    Messages:
    16,007
    Gender:
    Female
    Location:
    United States, West
    Country:
    United States United States
    I agree, you are going to be busy with your move and all that involves.
     
  18. Celle

    Celle Forum Advisor
    Thread Starter

    Member Since:
    Nov 19, 2011
    Age:
    75
    Messages:
    20,183
    Gender:
    Female
    Country:
    New Zealand New Zealand
    I saw my OS this afternoon and he discussed the CT results with me, while showing me the images on his computer. I do like these surgeons who show you the pictures while they are discussing your problem.

    He says that, while I have OA in my ankle joint, most of my hind foot, and some of my mid foot, none of it is far enough advanced to justify hind foot fusion or ankle joint replacement, unless I have severe pain. The cysts in the bones are easy to see, but they are still small.

    So, since my pain is not as bad as it was a few months ago, we have decided to work on a plan of masterly inactivity for the time being. I can continue to use the orthotic, use an ankle support when necessary, and elevate and ice to control pain and swelling.

    Since that suits my current plans, I am happy to continue as I am for now.
    I can phone him at any time I feel I need further input or help.
     
    • Like Like x 1
  19. Pumpkln

    Pumpkln Forum Advisor

    Member Since:
    Oct 27, 2011
    Age:
    66
    Messages:
    16,007
    Gender:
    Female
    Location:
    United States, West
    Country:
    United States United States
    Sounds like a good result. Glad you will be able to proceed with your move, without needing to do anything with your ankle.
     
    Last edited: Mar 29, 2017
  20. Jamie

    Jamie Administrator

    Member Since:
    Mar 24, 2008
    Age:
    68
    Messages:
    48,725
    Gender:
    Female
    Location:
    Kansas
    Country:
    United States United States
    Way to go, Celle....heal thyself!!!
     

Share This Page

If this forum is helpful to you, please consider a donation!

Support BoneSmart with a Tax Deductible Donation

Loading...
Sponsors
Close X