Ankle Replacement Surgery

Hi donna18009

Having read your story I just felt I had to make a quick comment. My story is somewhere on this link but I also have a TAR, it is not very successful although it is far better than what I had before. My other ankle is screaming for a fusion or a TAR as well now. I also have a Total Hip replacement for 10 years.

I like what I see of the Cadence system. My advice to you will only be two things and that is first, to please keep weight off that ankle for at least 3 months to give your body time to grow bone into the spongy metal coating on the prosthesis and only when you are 100% positive that it is 100% fixated, then you can start with weight bearing...secondly, please don't smoke any cigarettes while your body is healing and getting accustomed to the prosthesis as one draw on a cigarette constrains bone growth for 17 days, according to my ankle specialist. 

You have the rest of your life to get the muscles going and the ligaments supple again but you only have one chance to get that piece of metal to properly become part of your body, and believe me, the prospects of having a failed TAR removed are grim...very very grim. Rather over do it than risk loosing what you have now. The forces at play when you walk on the ankle prosthesis are tremendous. Give it time to heal, you will never regret it. I gave my hip 6 weeks without bending more than 35 degrees (doctor's orders) and very little weight bearing (normally you walk with a hip replacement in a few days) and after 10 years, it's still the best joint in my body. Sadly I did not do the same with my ankle due to circumstances and I profoundly regret it . 

Regards

Leon

South Africa

I completely agree with what you are saying about ankle replacement recovery. It is a slow process and recovery to the point where it is safe to weight bear takes time.

I had my TAR five years ago when I was 71 and I think I was drinking at about seven weeks. It was a manual car BTW. You can see how I was walking a d coping with stairs in a short video by putting yogesh total ankle replacement into Google.

A year ago it was found that I had advanced osteolysis in the bones to and bottom of the prosthesis. I am going in for my pre. Op tomorrow with rescue surgery in mid October.

Frankly this is not a good situation to be in because a revision looks unlikely to work and a fusion for the same reasons looks doubtful due to the condition of the bones due to the osteolysis.

For anyone considering a TAR please, please only entrust the work to a surgeon who is really experienced at doing this procedure and is doing a lit of them.

The top part of my prosthesis seems from what my very experienced revision surgeon says was put in at the wrong angle and displaced which could have been responsible for the osteolysis taking a hold.

Osteolysis is thought to be caused by microscopic wear debris from the prosthesis. The body can deal with a small amount it seems but if the joint is incorrectly installed there is likely to be more wear debris than the body can handle.

I gad a hip replacement twenty years ago which has only just been revised as the plot cup had worn through ad e did not suffer from osteolysis over all those years if hard physical work.

Cheers Richard

Auto correction changed driving to drinking in the second paragraph!

Cheers Richard

Thankyou SO MUCH for your response. I am petrified of it not working so I have followed my doctors orders to the T. He is the one who has instructed me to do weight bearing in the boot with crutches. Should I not be doing this?? As I said, he is one of the group of 4 doctors who developed this implant. I trust him fully. Of the three doctors I have had he is the one I trust 100%. I think I am trying to get further along quickly so I can get back towork for monetary reasons. I don't want to screw this up. I realize this is it for me. If this doesn't do the trick then I will most likely just have the foot and ankle removed. Not what I want at all. I do feel pressured tho to "get along with it".  I thought since he knows this device like the back of his hand that what he's telling me to do was okay. I'm going to continue to slowly weight bear in the boot using crutches but I'm not going to push myself like I have been. God I hope I haven't already done damage. Pray it hasn't. Please. And thankyou SO MICH for your response. I would love to hear from someone else who's had the INTEGRA CADENCE ankle replacement. I know back in the beginning of this year there were issues with the procedure if the implant. Not necessarily the actual device itself.  Those have been corrected. My dr has put in well over 100 of these so far. Only 400 total have been used to date. I'm excited and worried and nervous. Thanks be to god that I found this forum. You people are wonderful. 

Dear Donna,

Bless you??.  Fear is such a powerful emotion.  I'm four weeks out from my replacement.  I had a great deal of pain from nerves in foot, they were on fire.  I was prescribed neurotin to help, it has. Plus I couldn't wear the cast, my foot swelled tremdously.  Last week had my stitches out, moving foot back and forth. Still no weight baring now and for another four weeks. Doc wants bone to adhere to device.  

Please be patient. Talk to your doctor about your anxiety and depression.  When my fear pops up, I tell it to go into another neighborhood.

You are not alone my friend. 

Blessings??

Please don't get me wrong, I don't want to tell the doctor what to do, but it is exactly what my doc also told me and I followed his advice to the letter. I had a Fibula that was not completely healed after the operation and my doctor told me that the plate with 5 screws will keep it in place and I can walk on my ankle... one screw broke and the Fibula caved in shifting the prosthesis 11 degrees... and that obviously caused it to become loose because it is not well aligned anymore. Now the fibula is healed ..not straight...I  never did anything my doctor did not approve of but I know I could have given it an extra 2 months and if that little bone was healed, it would have been a total different story.

Point for me is that no doctor really knows what is best because these implants are pretty new (mine 2nd in Africa of this particular type) so my reasoning is, give it max chance of complete recuperation and then you will not have it on your conscience if things do go wrong. Keeping it still a while longer will not hurt but stepping on it one day too early will result in a lifetime of wanting to kick your own backside.  

 

I totally understand what you're saying.  I KNOW that this is my final chance at getting this right. i am feeling a bit of  pressure from the employer and the husband at times, understandable but they just don't get it. and they mean no harm, and I am probably putting this pressure on myself. The lack of income creates a stress on my husband and the lack of help puts a stress on my employer. I just feel so torn. I'm not quite 4 weeks out yet I feel like I've been down forever. When I put weight on it in the boot I feel pain in the same area I had before the surgery which terrifies me and makes the first thing that comes to my mind is that it didn't work. I haven't had the nerve pains that you have but my big toe is basically dead. I can't raise or lower it. They say this should come back after PT. Fingers crossed. 

Dear Donna

I can quite understand where you are coming from but as someone who had a TAR five years ago and it all seemed to be going well but was not I would just say this.  Take time and DO NOT RUSH your recovery whatever the pressure from work, money or home.

Also you only have one real chance to get your recovery right but the doctor does not have to live with your problems but you do.  That is important to remember.   If you read what I wrote to LDT 10 hours ago you will see that I seemed to have made a good recovery but perhaps because of surgeon mistakes I now have to suffer the consequences..... the surgeon does no have to!

Please take your time.  

Good luck

Richard

Hello again! So. I am now 8 weeks post TAR and doing well!! I am out of the boot and the first week out I wore a compression sock to help control swelling (and to help fit into my tennis shoes) and now this week I am just wearing my tennis shoes and socks. I have not started PT yet but plan on doing so within the next 2 weeks. I have been doing my own stretches and am back to work nannying 7 hours a day! I’m taking Aleve and a tramadol in the morning and another one at bedtime. Yes, I still have pain that’s bearable, but it’s mainly because I haven’t walked properly on this foot for well Over 3 years. Tendons, muscles, and fatty tissue in the heel and side foot haven’t been used so they’re getting used to it again. And I’m good with that. Yesterday after working 7 hours on my feet I actually went to a target and shopped for an hour or so. I cannot even remember when the last time was that I went into a store and walked around and shopped. I used to be too exhausted and in too much pain. It’s a slower recovery process than I thought it would be but it’s happening and I am beginning to have great confidence in my ankle again!! I don’t go back to see my doctor until the end of November. I am part of a study they are doing in this particular device. Learning how to walk correctly has been a lot like feeling like a toddler, or Frankenstein. The knee on my opposite leg has been giving me a fit because I have relied on that leg so much and walked “off” for so long it’s having to retype strengthen and adjust as well. I still have a ways to go but I am happy with my progress so far!! 

I’m so proud of you.  I’m 7 weeks out, start PT tomorrow. I’ve been walking in a boot for 6 days with some pain and discomfort, I wore a compression sock yesterday and discovered it aggravated my ankle. However, I’m elated to live without pain and be active again.

I’m looking forward to PT tomorrow and expanding my physical abilities.

Thank you for your update, keep us posted.

Great that you are already back at work after 8 weeks. Very broad range of recovery times with different devices and doctors.

Can you tell us what device you went with?

Thanks Jeanette! As this is the 3rd surgery to my left ankle I was SO LEARY of it really working. And some of the initial pains I was having were so similar to the pains I was experiencing before surgeries that I was afraid it had not worked. My dr kept saying to be patient and take baby steps so I resigned myself to a goal of pain free in one year. Not sure if you read my initial cry for help above but I have had a partial fusion done (the left/right motion) and then they had to go back in and remove the screw once the bones fused because I could fee it in my heel when I walked. Some people create scar tissue to accommodate that but I didn’t. Now the replacement. I will def stay in touch and keep everyone updated.  

Hello again,

Yes, my Dr is Dr Selene Parekh with Duke Hospital in Durham,NC.  My device is a newer one. Integra Cadence. My Dr is one of the team of four who created this device so I fee like he had a personal stake in making me a success story and I a to succeed. ;o). I’ve heard that once you stop complaining about the pain and about the ankle that you are there. Well I’m here to tell you that I’m not there YET but I do find myself not thinking about it now and again which is HUGE for me!  I will continue to report here as I progress. Thanks again for all the support everyone on here brings. You are right, there are MANY degrees of recovery and I really think it all depends on what issues you began with. Mine were quite severe so I cannot expect to just recover within a few months when it took years to get me to where I needed the TAR. fingers crossed!

Hi

I had the Prophecy Inbone. I start PT today. 

Have a wonderful day.