Ankle replacement or Fusion

I have had two finger joint replacements and a third is due. My surgeons view is that he does a replacement and only considers fusion when the joint fails and cannot be replaced. 

I am now pain free and wouldnt hesitate having another one done. But the physio is mega important to get movemnet back in the joint 

I too have severe OA in one ankle, as a result of a serious injury which destroyed the cartilage.  I've been told that my only options are either suffer the pain or have the joint fused, which as you rightly point out will be Permanent and irreversible and will indeed cause major loss of movement in the ankle and thus affect how I walk.  There is no other option I’ve been told that the technology doesn’t yet exist to replace the ankle joint in the same way they can with knees, hips, etc.  There is research being undertaken to develop an artificial ankle joint but as far as I am aware it is not finished and not available yet.  Funding has mainly gone into developing hip and knee replacements because they are much more commonly needed.  My OA surgeon told me that ankle joint degradation is usually down to injury rather than progressive wear and tear and is thus much less common so in terms of research, its way down the list for urgency.  Many more people benefit from the development and improvement of replacement hips and knees and so the funding goes into those.  I have refused ankle fusion as it would cause me permanent loss of flex in the joint and the altered gait will have a knock on effect in everything I do.  He also told me that the disability caused to my walking style would indeed cause excessive wear and tear on firstly the knee in that leg and also put added wear onto the other leg, again leading to OA probably in both knees, which I don’t have at present.  Every case is different but for my case, I’ve decided that the pain I currently suffer is preferable to being permanently disabled by fusion and to having it cause future need for joint replacements that are currently unaffected.  If there is ever an option to actually replace the joint with a device that will provide movement in the same way other joint replacements do presently, I will consider it but I honestly dont think it will be in my lifetime.

Hi sorry to hear about your condition. Is there not an option to have a replacement? 27 is young for fusion. I've just had a replacement joint for my big toe this week as did not want the fusion option. I'm only 35 and like you said that is pretty much final! I took the risk as there have. Even good results re movement and couldn't take the daily pain anymore. Like you-the injections I had didn't last long at all😡

Recovery is a slow process and I've got to keep my leg elevated for min 10days as risk of DVT and to help reduce swelling. I'll be honest, when my local anaesthetic wore off the pain was horrendous but just ask for pain relief. My consultant advised it could be months before I get any proper movement back but I'm having my dressing changed and stitches removed in 3 weeks and I'm expected to do gentle exercises then (which I'm dreading!) it will be a long road but I think if you want rid of the daily pain surgery will be worth it in the long run. I didn't want to be living the way I was forever. Plus I wanted to wear some normal shoes again!

Good luck and keep us updated.

Hi Charlotte

I am just recovering from ankle fusion which was done in April 5th. I to went through the should l get a replacement or fusion but as my consultant said because of my age and yours ( l am 44) a replacement was not the best option. Firstly the sucess rate is not very good and if the do a replacement they remove a lot of the bone snd ankle so its very hard to fix. If it does not take at all you are looking at anputation......yes that word scared the life out me as it's the last thing l want to happen to me and l am guessing you at 27 years old. A ankle replacement has not been around for a long time and has no where near the sucsess rate for hip and knee replacements.

I will tell you my story Charlotte. I was a totally fine normal 41 year old generally qyite active used to walk 7 miles every night with my husband worked full time as a bank manager went a couple of holidays a year then my world fell apart as l developed ostioarthritis in both my hips. I had bupa luckily as a benifit through my work. So l had both hips replaced within 8 weeks of each other. I recovered well and while recovering found outvl had it in my knees.....same again l needed both knee's replaced. I got ine done in august 2016 but it was much harder and more painful than my hips. But again l bounced back quite quick and though l would off for a while and go back to my work and try and get some normality back. However l just could not work full time hours l was getting.to sore and tired by time l got home at night l crashed on the couch and slept l was also taking stong painkillers. Then from knowwhere l got the pain in my ankle. It got worse and worse taking shoes of were so sore and boots even more. I though the pain was coming from my knee repacement...but xray showed arthritis in my ankle and was told about my options. But my consultant advised me not to get it replaced. Because of the risks and my age. So needless to say i am a month into my ankle fusion. My consultant said not to right yiur foot movement off as there are loads of bones in your foot and you will still have a lot of movement. He also said l will be able to drive my.manual car. I am currently wearing a moonboot 24/7 but l can move my foot so l.would not worry at all about that. He also said l will probably not have much of a limp.if any. So l would defo go for fusion.

I will warn you the recovery is dementing. I have been stuck indoors since 6th April. Its took me so long to being in this boot and using crutches. I have mastered it now but still.have 2 weeks of it. But hopefully it will be worth it charlortte as l was in so much pain and could hardly walk. My.time at work was getting less.

But anything l can help you with or you just want to talk it through contact me or pm me and l will doy best to help.

Laura

X

Hi

I don't understand why people ask for help and advice but don't reply to any of us with your thoughts. Why ask if you don't want help.or advice. I thought l would be best person to ask and speak to since l am fairly young and have jusr had ankle fusion done. Charlotte this forum was the most helpful thing for me when l.was going though hip amd knee replacements you shoud try take our help

L x

Hi Charlotte, ihave had arthritis for years in several parts of my body. I had surgery on back with lamenectomy, diskectomy and fusion. It has helped to where i am not in miserable pain for taking a wrong step or how i sit. I have arthiritis in my ankle joint that has just been confirmed. My stems from an injury i did when i was a child of 12. Iam now 63. I have always kept active was a runner and played a lot of sports growing up. But running has always been my favorite thing to do. Walking hurts where  

running didnt. Was having a lot of pain recently especially when i got off my feet for the day. Saw the orthopaedic docs and he told me about this surgery to take out the joint and screw it back together. Said it was a very painful surgery with a long recovery. He confered with his colleagues and said to do the cortisone injections first to see how i went. I had it today and i sure hope it helps cause i do not want to have the surgery. That is why i am here to see whom else has this problem and if they opted for the surgery and if they did have it what their opinion was and if they recommended it. 

Ok,well I'm only 31 and i also had an ankle fusion, and which I can't even walk without the use of crutches bc it's 2 painful oh. Yeah and I was only 28 at the time of the surgery and so yeah I would definitely not even consider that option because now my orthopedic surgeon is telling me that I'm going to have to eventually get my leg amputated from below the knee. So instead I asked for an ankle replacement and they are sending me to Duke to see what they can do.

Hi, 10 years ago I was in a terrible car accident and was told by surgeons there was no way to save my leg, that my ankle injury was too bad to ever consider saving. I fought the amputation and to make a long story short, I researched and found the most incredible ankle surgeon at Duke University Hospital, his name is James DeOrio. After a lot of remarkable work, he put my ankle back together and it looks amazing and normal again. I did have a lot of arthritic pain though and it was something that was very hard to live with. He continued to suggest that I fuse my ankle, that it was a much better solution to my own situation than an ankle replacement, though he does ever so many of those annually... I was just not the very best candidate due to my specific injuries. I couldn't imagine what it would be like to fuse my ankle to 90? because I have always been active, but I decided that I needed to go with it to get rid of the arthritic pain (something that came about because of the injuries themselves). The ankle fusion was actually amazing… one day I was in awful pain and the next day I was no longer feeling any pain at all. Of course there was recovery time and I don't really recall how long that was, but once everything healed, I was able to do anything again and limping really wasn't an issue for me. You simply learn how to walk with the fusion and your mid foot joints take over as the flexing point. The only things I can think of that I cannot do because of the fusion are running or jumping up and down....and of course, no more high heels. In the grand scheme of things, I'm completely okay with that! I do not use crutches, though I did for a long time, as well as a wheel chair, walker and knee scooter during my 13 surgeries. My husband reminds me, even today, that he can't get over the fact that it looks like I never had injuries at all as a walk along just like normal again. I hike, swim, ride horses and my stride is faster than my husband's when we take long walks. Everyone's situation is different but I have to highly recommend ankle fusion if you are having a lot of pain and you want to get back in the game again. I honestly forget that I ever had the terrible injuries that I did 10 years ago. Though I can only speak for myself on this matter, I do hope for you all the very best with your decision and your recovery! Allyson

hi.i had a fusion in my left ankle 2 years ago. it took 6 months for me to get well enough to get back to work.

i still get very tired and have a lot of pain in both my ankle and both knees which was replaced 10 years ago.

they now say that i need the metalwork replaced to try to help with the pain and that this may not help as there is a lot of arthritis in my feet.  i do limp if i stand for a would  i have it done again?? no the benefits dont match the pain you have to go through, and it damages other joints   so dont have the fusion unless there is no other choice

 

I'm so sorry to hear of your joint problems, I know how awful that can be. I had decided to go through with my own ankle fusion after I met a guy at my physical therapy gym who had been through the same procedure and he said it made all the difference in his life, fusing his ankle. I am from the south/east coast where there is certainly a lot of humidity, but we moved out west after hearing that many people do so much better where it is dry. For me, I'm like a brand new person and I have no joint pain, something that I certainly suffered with back east. Try visiting the west, if you are not from this area, and see how your joints feel… you may be very surprised. My previous painful arthritis in my ankle and knees which were both damaged also (from my injury) are nothing but a memory these days. My surgeon had told me it was nothing but an old wives tale about going to dry places to help with arthritis, but I'm here to say that it's absolutely real. I wish you the best.

I had a Wright’s Infinity Total Replacement Ankle 4 months ago and it has been brilliant.   I am 71years old and am now walking so much better than before the op.   The first surgeon I saw was recommending a fusion but I got a second opinion and the second surgeon  recommended a complete replacement.   So glad I went for that option.   Post op I was two weeks non weight bearing in a back slab then stitches out and two weeks in a walking boot, rather like a ski boot.   Am seeing a physiotherapist for strengthening exercises which are so important.   I already had my own crutches but borrowed a K9 knee walker to get around the house which was brilliant after a little bit of practice.   We organised to have a bed downstairs for a month and as we have a downstairs cloakroom, I was able to wash etc.   I have very good movement of the new joint, pretty much equal to the other ankle, no pain, and the wound  has healed as to be nearly invisible.   I do still have some swelling around the joint, more at the end of the day, and some numbness in a couple of toes but t doesn’t bother me.   I walk my dog over rough ground for about half a mile every day just using one crutch for balance.  I hope to do away with it at some point.   I don’t know whether you have decided to go ahead with your surgery yet but hope the above is some help!   The pain control is very good, I  had a nerve block at the knee and a light general anaesthetic as I didn’t want to be awake during the op itself!  I think for me the worst bit was the indecision, once I made up my mind to go ahead, I feel I sailed through it.   Best wishes.