ankle fusion or replacement surgery recovery

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Five years ago, just after losing my husband, I managed to sprain my right ankle quite disastrously. The NHS was, I'm afraid, totally useless, so I went privately for physio and paid to see a consultant who recommended surgery with its very long recovery period. As I was suddenly living alone, I refused. At that time, I was able to get around physically, and hoped the situation might resolve itself naturally.

Fast forward five years. About six months or so ago, the slight limp I'd been developing got very much worse, and stairs became an issue. I found that the weekly yoga class which had helped so much with my grief was no longer possible, although swimming still was - I still had to negotiate stairs up and down to the pool, though. I do work from home, but being a creative writer has very lengthy periods of nothing happening, so I've become very depressed and reclusive. Hoping for a more acceptable diagnosis, I went to see two more consultants, but they all said the same thing.

Think I've reached crunch time, but still can't get my head around recovery and care. Care is expensive, whether in a rehab place or at home, it's at least £1000 a week, and I'm not eligible for social care. I'm in my (otherwise healthy and still working) 80s, and the prospect of that much dependence horrifies me. I'm scared of the immobility, and what it might do to the rest of my body - muscle-wasting etc. It's also, I've been told, a painful op. How much worse can it get if I do nothing? Xrays show I've lost all cartilege around the joint which will not regenerate. Advice, thoughts etc are very much needed - thank you - as I am quite desperate.

 

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19 Replies

  • Posted

    Hi Literate,

    I sorry to hear of your worries and can speak from experience that all of them are valid concerns. However, while an ankle fusion has a long recovery of 12 months minimum of which living alone will be a extremely testing for you mentally and physically (I would vehemently recommend against it) there's is another option. An ankle replacement would have a higher likelihood of success and the period of convalescence/recovery is much lower. You can have physio and exercise your hips, legs and back to reduce muscular atrophy and the pain associated with a healing ankle fusion doesn't exist to anywhere near the same degree with ankle replacement.

    I'd speak to my doctor about the replacement route instead.

    Good luck.

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    • Posted

      Hi I  am 14 weeks post opp from foot reconstruction. Bone graphs screws etc etc 

      It has been a nightmare but now wheight bearing 

      The construction  had to be done before the ankle replacement which  my surgeon  has fully explained to me 

      4 weeks  in a cast then partial wheight bearing. They will want you walking ASAP 

      Good luck 

      Lee x

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    • Posted

      Oh forgot to mention 

      My operations have been done at wrightington ortahapiedic hospital Wigan 

      NHS. Which was referred  via surgeon in London  private clinic ? 

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  • Posted

    I just wanted to say how much I feel for you. I am on the same path and in exactly the same position  - and I am 55.  So 25 years younger than you. It's extremely difficult to deal with in every single way. Have the surgeons talked to you about how much worse it can get if you do nothing? I was told that it can lead to the joint just fusing together - a sort of natural fusion without the surgery - but I understand that there are risks attached to this as well, including the joint disintegrating.

    My thoughts are with you. I soo know how this all feels. Only meditation and an ayuvderic diet really keeps me going, as well as swimming, reformer pilates and strength training. 

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    • Posted

      Thanks Ariane. I need to find out more about this risky 'natural fusion', so I will ask my consultant. Are you limping, though? I am, most horribly, and it's exhausting - an old  woman's waddle - hate it, especially in this heat. Please stay in touch and tell me what you decide. I find the whole thing horrifying.

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    • Posted

      Hi there again. Yes, I have old woman's waddle and limp in the heat! I am giving myself another 3-6 months before I decide whether to have a fusion.  I am persisting with strenght training and physio and pilates and trying to create muscles around the joint, stronger ones in my feet, and improve my biomechanics and gait to work with this 'natural fusion' and strengthen the bones. I am just  powering through the pain (although some days I  really really dont feel like doing this at all. )

      I will see where I can get. Today I am optimistic, but as you well know, one goes up and down like a yoyo!!  

      The good news is that I am not creating any further damage in the joint which gives me hope and I seem to be getting moe flexible too, which is great and stronger.

      But this is a long long long and very unorthodox approach as well as really exhausting. I dont know if it will work at all. No research on this.

      What surgeons often don't tell you is that by fusing a joint, it throws out the rest of the body and of course causes wear and tear in parts which now have more pressure.However, this is part of the whole picture of us getting older and having degeneration in our joints  so it is likely to happen anyway without fusion because our body is getting older and worn out. It's all so so tricky.  I send you much love.

      Yes, the whole thing is horrifying. One has to keep strong - and it is so difficult too. I find meditation, and particularly Indian breathing really really helps. I am also on an auyvderic diet which also helps keep down any inflammation. But in general no wheat, sugar and dairy, caffeine, and stick to vegetables and chicken and fish and eggs as protein. xxx

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    • Posted

      I would love to discuss this with you further, Ariane. When this first happened, I began taking Ibuprofen, which - looking back - was helpful. They were supermarket ones, and I didn't think I was od-ing on them, but then I began an SSRI and the combination was a disaster -  three duodenal ulcers about a year later, which landed me in hospital as an emergency - a totally nightmareish experience! I've recently, and VERY cautiously, gone back to very small doses of Ibu. Yes I do know about the downside of fusion, which is why I'm opting for replacement, but recovery is a major problem. If you can recommend any sites for physio/breathing etc, I'd be very grateful.

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  • Posted

    Gosh yes swimming  although it might feel a bit daughnting  getting in the pool

     but just take your time 

    It Does definitely. Help 

    Surgery sometimes isn’t always the answer 

    This forum is  helpful 

    To  get other people’s  experiences 

    With  there issues 

    And problems  but they all get through it 

    Good luck 

    Lee x 

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  • Posted

    So sorry to gear about your situation. I had a total ankle replacement five years ago which seemed to be good but at the four year mark the surgeon announced that osteolysis had set in and major work would need to be carried out to save it.

    I discovered that actually there were other issues and realised that I needed to find a really experienced revision surgeon to redo the surgery. I found the right man and had the surgery which was very difficult and lengthy carried,out in February.

    My recovery has been amazing and I am having to hold myself back. I think the best way I can help you is to offer to speak on the phone. Jf you are interested please send me a message and we can go from there. Cheers Richard

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    • Posted

      Thanks for your comment, Richard. The more info I have, the better. Still trying to avoid surgery, but it's getting worse, and managing the recovery period is daunting.

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    • Posted

      My offer stands as I honesty think you would gain far more from a phone chat than any amount of back and forth messages and to be honest I do not have the time for that at the moment. It is up to you. All the best Richard
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    • Posted

      As kind as your offer of phone help is Richard I'd never recommend anyone take you up on it if they don't know you personally. Know what I mean?

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    • Posted

      Exactly. And there's no phone number quoted unless Richard needs mine which I only share with people I know.

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    • Posted

      Well if you are all that concerned then I'm rather sad because you know if someone is interested I would be prepared to give you my number but NOT on list. it is very easy to message me and for anyone still doubting my sincerity then Google yogesh total ankle replacement and you may be surprised. Cheers Richard.

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    • Posted

      Hi Richardken,

      Yes it is sad that we live in a world where trust has to be earned. It isn't personal, just a declaration of honesty.

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    • Posted

      Well now as far as earning trust, if you have been on this or the other Patient forums that I post to you will be aware of my posting record of the past couple of years.   As it seems that there is now no longer the facility to send private messages and to assist anyone interested in phoning me I am going to try to put a contact number at the end of my profile details which I will only leave there for a short time.  Cheers Richard
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    • Posted

      If you go to my profile you will find that I have put my phone number at the very end of it to help anyone who wants to talk, but it will only be there for a very short time!!  Cheers Richard
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