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Hi all, looking for someone with first hand experience and thoughts - but feel free to add any updates!
?About 16 years ago I had a bad accident when I was knocked off my motorbike. I suffered multiple fractures of Tib + Fib, Talus and Medial Mellolus of the left leg/ankle. Over the years I have had internal nailing and fixation, tendon graft, tendon lengthening and a successful subtalar fusion. All the metal work has been removed.
?My ankle joint (tib/fib to talus) is in a very poor state of osteoarthritis. In Feb 2016 I had a debridement to remove spurs and to tidy things up. At that point I had 10 degrees of movement (plantarflexion) and could get the foot to neutral. Obviously not movement side-to-side following subtalar fusion.
?Now my foot is getting more painful again as the ankle joint is becoming more deformed and is pretty much bone-on-bone. My Consultant has ruled out doing any further debridement as just being a bit of a waste of time/money. My options seem to have come down to 1) Do nothing, take painkillers which can't go on forever, 2) a Total ankle replacement - which my Consultant is a bit hesitant about, I'm too active, tib/fib/talus alignment isn't as good as it could be and given I now only have about 5 degree of movement I'm unlikely to find any improvement in range of movement 3) Ankle fusion - most stable and pain free but with the subtalar already fused I'll have a solid foot with problems going up/down gradients, risk of further joints becoming arthritic etc 4) perhaps consideration to have BTK amputation, possible to recover to be able to run and walk and good function but of course not an easy route to take and has its own cons.
?I'm really struggling to make a choice. I know everyone is different but as someone who is active - gardening, running, cycling, walking the dogs and still young (46) I'm really worried about the outcome of a fusion. I'll not have the pain but how much will I be able to do? An ankle replacement might keep some motion but runs the risk of further surgery quite soon because of my activity levels (or at least desired activity). Maybe an amputation would ultimately result in a better outcome, no pain, learn to walk/run again and be quite active albeit with modifications to support living at home/work etc.
?If anyone has any thoughts or advice please share! Thank you!
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