Ankle Traveling for TAR surgery and recovering

[Georgiahiker]

Hi. I finally had my Total Ankle Replacement at OrthoCarolina by Dr. Davis on November 8, I got to the point a few days before surgery where I couldn't walk at all. It took 3 years and 2 other surgeries to get here. The surgery went well using Stryker/Wright Medical Inbone II and lengthening my achilles. I spent the night at the hospital and was released the next morning to go home to Atlanta. That was not a fun car ride since my nerve block was wearing off. I am now recovering solo with 2 dogs and a knee scooter at 9 days. I had some help for the first few days.

I experienced quite a bit of pain for 2-3 day which the pain killers helped with. Now it's a bearable pain that changes generally worse at the end of the day as I heal. My biggest challenge is taking care of an 11 year old dog (easy) and a 5 month old Aussiedoodle (hard). I have resigned myself to a dirty house and a crazy puppy for a few months. Rover.com is a plus for walks.

I am totally non weight bearing. My first follow up is with my orthopedic surgeon in Atlanta who agreed to take early follow ups which was the key to letting me travel to a high procedure volume provider which is pretty important for TAR.

Hopefully I will be able to bear weight in a few weeks. I'm not sure what my limitations will be.

If you have any questions, let me know and any advice is always appreciated. I would like to be on a trail in 3 months.

 

[Layla]

Welcome to recovery. It's good to read your surgery went well. I can't imagine recovering alone while non weight bearing with two dogs! I don't know much about ankle replacement, but wanted to welcome you to recovery, wish you lots of comfort and an uneventful recovery. Thanks for sharing your update with us. Please stop back often, we'd love to follow your progress and support you along the way.
Best Wishes!
@Georgiahiker

 

[Jaycey]

I would like to be on a trail in 3 months.

Welcome to the other side of TAR! You certainly have some challenges with this recovery. Unfortunately that ankle will decide when you are ready to hike again. Three months sounds very aggressive to me.

My colleague @FCBayern had ankle replacement and is now living life again. I've tagged him to see if he has any input for you.

 

[Georgiahiker]

@Jaycey Well maybe the trail will be a flat one! I will follow doctor's orders during my recovery. 5 more days to my first follow-up! I will continue to update and would be happy to answer any questions.

 

[Georgiahiker]

20 day post op update: Last Wednesday I went to my local Orthopedic Surgeon who is handling my short term aftercare. The original splint was removed and they took a series of x-rays. Everything looked good and I was put in a cast for 2 weeks more after which all sutures and staples will be removed and I will go into a boot and hopefully be able to do some weight bearing. I am not experiencing much pain at all. My foot and ankle area is still swollen and a little tingly/numb which I was told is normal.

On the personal side, I am going crazy trying to take care of my 6 month old Aussiedoodle puppy. She likes to dig and there is nothing that I can do about it as I am not weight bearing and my backyard is about a half acre. I am resigned to having a dirty house for a while. The days need to go by a little faster please! I am getting some help on weekends and have some one hour dog walks set up with Rover which should help.

I should have more to update on my TAR results once weight bearing and PT begins.

 

[FCBayern]

If you have any questions, let me know and any advice is always appreciated. I would like to be on a trail in 3 months.

I would definitely plan for a flat trail at 3 months, but more difficult trails will be enjoyable again after recovery. I would say I was at least 9 months into recovery before I was willing to try difficult terrain. I also found trekking poles for extra stability a big help until I increased my strength and confidence in the new joint.

 

[ken2108]

As of Friday Dec 9th, I'm 8 years post op for R TAR. Doing very well with it but lately I can't stand for very long on my foot. I'm right-handed so I tend to put my weight on my right side that causes pain in the heal bone. I have had x-rays the joint looks like the day it was put in. Overall, I'm very pleased with my results.

 

[Georgiahiker]

Recovery update: At the one month mark, my cast is off, sutures and staples out, and I'm in a tall air cast. X-rays look good. I am permitted to walk with the only limitation being pain. I am able to go up and down stairs and walk around the house. I use my knee scooter for longer distances like at Costco yesterday. My foot is swollen which the doc says is normal but the pain is minimal. My heel is a little sensitive Where they drilled through the bottom of my foot to ream out my tibia for the implant. All in all, I guess I'm doing pretty well. I can start PT in 2 weeks.

I was a little surprised that I am allowed to walk as much as I can stand (I can stand a lot). Does this seem reasonable?

I'll keep you updated. I am happy that I made the decision to go with a highly experienced, high volume surgeon and surgery center for TAR. Traveling was a little inconvenient but worth it as far as I can tell at this point. The upfront research and surgeon selection is very important for TAR.

 

[Georgiahiker]

As of Friday Dec 9th, I'm 8 years post op for R TAR. Doing very well with it but lately I can't stand for very long on my foot. I'm right-handed so I tend to put my weight on my right side that causes pain in the heal bone. I have had x-rays the joint looks like the day it was put in. Overall, I'm very pleased with my results.

If my pain is gone and I can look forward to getting active again, I'm good. I would keep an eye on that heel and look into more analysis if it becomes more bothersome.

 

[Jaycey]

The upfront research and surgeon selection is very important for TAR.

Research and surgeon selection is very important for any joint replacement. Glad you are doing well!

 

[Georgiahiker]

Hi. Recovery update: as of today, January 4, I am 8 weeks post op with my Inbone II implant. I am having no pain or nerve issues. Incisions are all healed up and look good though my ankle still turns purple in the shower. I started PT at 6 weeks. I am able to walk 2 miles with the dogs on flat trails albeit at a leisurely pace, about 2 mph. I experience some swelling but no pain.

What I discovered is that I am not used to walking normally after 3+ years of ankle issues. It is putting some pressure on muscles that I haven't used in a while in my legs and back. I think part of it is that my TAR leg is now a little longer than it was all smashed down with no cartilage. It will take a while to get used to. I am a little uncomfortable going down stairs normally. That hurts a little. I think that is a ROM issue which will improve over time.

I see the surgeon in Charlotte for the first time since my surgery on November 8 on January 9. My interim care has been handled by my local orthopedic surgeon in Atlanta.

All in all, I am pretty happy with my recovery and am glad that I had the TAR. Feel free to get in touch if you have any questions.

 

[Hip4life]

@Georgiahiker This is a great update. It sounds like you are doing well. When you can say that you are happy in your recovery and glad you had it done. then you are in a truly good place. I'm sure there will be a few aches and pains as your recovery goes forward. I know I had those just with sprained ankles. LOL. Best wishes in the coming months. Stay healthy and don't hesitate to drop by for a visit.

 

[FCBayern]

Hi. Recovery update: as of today, January 4, I am 8 weeks post op with my Inbone II implant. I am having no pain or nerve issues. Incisions are all healed up and look good though my ankle still turns purple in the shower. I started PT at 6 weeks. I am able to walk 2 miles with the dogs on flat trails albeit at a leisurely pace, about 2 mph. I experience some swelling but no pain.

That's outstanding @Georgiahiker! Just keep it slow and listen to your ankle about what it's happy doing and what it's not. Swelling with any activity will probably last for quite a while, at least that was my experience. I often wore a compression sock at night to ensure I started the day without swelling.

 

[Georgiahiker]

Thanks FCBayern. I am now at 10 weeks post op from my TAR. PT is starting to ramp up and I am walking with the dogs daily 2-5 miles some flat, some hills. I am also doing some spinning and rowing on the Concept 2. Most of my pains are related to using muscles that have been neglected for, in some cases, years. I will try to keep this slow and steady. I use compression socks and ice periodically though my swell is pretty much under control and I can wear all of my shoes and boots.

I am very happy that I finally had the TAR as my debilitating pain is gone and I am much more stable.

 

[NaturLovr]

Georgiahiker, so glad to see you are recovering so well. I have also had a long road with my left foot injury. Incurred a running injury in Winter 2015. Had surgery in Winter 2019 w/ removal of 2 small supranavicular bones which had torn away from soft tissue. These loose bones were up against the posterior tibial tendon before surgical removal. Since the surgery, I have lost the use of my posterior tibial tendon. This was confirmed when Physical Therapy recently worked for 1.5 mos to get some movement out of the tendon. Now, I have a lot of arthritis in my left foot & ankle, cannot stand on tiptoe, cannot balance on left foot & have generalized foot pain when hike too long or up on my feet too long. Last Ortho Foot Surgeon consult in Santa Fe told me I would be needing a triple arthrodesis (basically an ankle fusion) in 4 yrs or so. I did a lot of research on ankle replacement surgery. Nearest really good foot surgeon that deals with complicated foot cases & does ankle replacement is in L.A. at Cedars Sinai. I have an appt the 2nd week of Feb 2023. Given that I have posterior tibial tendon dysfunction plus generalized foot & ankle arthritis, I'm unsure if I am even a candidate for an ankle replacement. The inability to correctly use my left foot has been very challenging, as we moved to the southwest to enjoy the outdoors & to hike. I will post an update as to the outcome of my appointment at Cedars Sinai sometime in February.

 

[djklaugh]

@NaturLovr Welcome to BoneSmart and thank you for sharing your situation. Would you please start your own thread so that we can offer you more support and help. And what were the exact dates of your surgeries ... we will create a signature for you.

To start your own thread go to the main "other joints" forum and click on the orange "post thread" button at the top right. That will start a thread for you.

 

[Georgiahiker]

@NaturLovr I'm sorry about your ankle issues. Your symptoms are similar to mine but your case seems a bit more complicated. I would advise a lot of research to find centers of excellence for TAR. Lots of people travel to find expertise on TAR and complex ankle issues as TAR is not nearly as common a procedure as knees and hips. Try Facebook groups too. I think that it would be hard to wait 4 years for a potential solution with the pain.

 

[NaturLovr]

@Georgiahiker Yes, I am a retired RN & totally understand that not many Orthopedic Foot Surgeons are skilled at TAR & you have to be very careful who you choose to perform complex surgery on your feet. Through research, I found an MD at Cedars Sinai in LA (I am located much closer to LA then to Duke in NC) that does a lot of ankle replacements & tendon transfers...lots of complicated cases. Sounds like your injury was indeed different than mine. My injury has been a slow slide into increasing flat foot deformity & ankle arthritis resulting from Posterior Tibial Tendon Dysfunction. This was confirmed by the foot surgeon I recently saw at Cedars Sinai. After my injury, I was never told that I should not wait to have surgery. It appears that waiting caused damage to my Posterior Tibial Tendon. When my surgery was done in 2019 (4 yrs after my injury), further surgery should have been done at that time to stabilize the soft tissue in my foot...I was never told that the increasing issues in my foot were due to Posterior Tibial Tendon Dysfunction, which is a progressive disorder that leads to a lot of arthritis in the foot and ankle. What I have learned is that it is prudent to choose a good Orthopedic Foot Surgeon to operate on your feet instead of a Podiatrist. An Orthopedic Foot Surgeon has many more years of training & can address more difficult issues that may come up during the surgery. I have started a new thread under "Posterior Tibial Tendon Dysfunction" on this forum. Best of luck in your recovery, Georgiahiker.

 

[Georgiahiker]

Thank you @NaturLovr. Best to you also. It seems that a lot of people are encouraged to wait on surgery but it does have its downsides. It took 4 years from initial symptoms, surgery for removing a bone spur, and another a year later to debride the tibiotalar joint. Neither one of these really worked. I progressively went downhill until TAR was my only option.

By waiting, I was walking with an altered gait, my right calf muscle atrophied, and my body adjusted to this new normal. After TAR when the pain was gone, and it is thankfully, my body had to readjust again. As my activity ramps up I have found that my stamina is poor and I have pain in my back, right knee, and left foot. I am working through those in physical therapy and getting used to heavier activities again. The point is that waiting on some of these surgeries has its related issues as other parts of the body work too hard and potentially become injured making things worse and then there is the getting back to normal after the final solution which in this case was TAR.

Good luck. I will follow you yoyage.

 

[orthopest]

@Georgiahiker Wow I thought I was doing well at 10 weeks post TAR op But you seem to be smashing it. Walking on trails and out with the dogs !. Tips please on best and most useful phsio for ankles please. Also was you walking in your air boot or just a sneaker at 10 weeks. Many Thanks I hope you are still going as well.