Ankle Replacement Surgery

Hi Cindy.    Yes      My surgeon informed me that keeping your knee bent after this surgery could cause blood clots.  

 I had my second ankle replacement (left) December 1. I had my first one (right) done on the other side or year ago. I used the knee scooter all the time. It has been great. I have not heard this recommendation previously.    Perhaps your surgeon has had experience with people falling off of them. You have to go slowly and be very careful because they are unstable. I find that it is best to put my weight as far back on the scooter as possible and not lean on the handlebars 

My Dr strongly urged using a scooter and his office arranged the rentals. I used it for a couple of weeks and it is much safer and easier than crutches. If you are doing your exercises, I don’t see how you could be at risk for a blood clot by using a scooter. 

Wow James, you and I are a lot alike. Had the first ankle done last Feb and last one done in Nov. Like you, I would have been lost without my scooter. Only time I fell off is when I took to many pain killers.  Out of the boot for a couple weeks and things just keep improving. Shoveled snow off the drive way yesterday when it was -5 below zero in MN. Even with new ankles my feet still got cold, should have had heaters put in too. 

New ankles have helped made this a very Merry Christmas. I hope that was the case for many of you too. Its going to be a great New Year!

Thank you Bruce. 

I just did a PubMed (NIH National Library of Medicine search engine) search using key terms: DVT and knee walker, thrombophlebitis and knee walker, knee walker and DVT, knee walker and thrombophlebitis and came up with zero hits.  I googled the question and  came up with a couple of anecdotal notations, one by a podiatrist who suggested that his patient may have had his DVT caused by keeping his knee bent using a knee walker.  This is all hypothetical and conjecture.  There is no question that any lower extremity trauma or surgery can predispose to DVT.  Years ago, there was a lot in the literature stating that DVT could be demonstrated in greater than 50% of patients post hip surgery (I can't recall the exact number but it may have been more like 70%.  I think unless a person has a contraindication to anticoagulants, everyone should discuss with their surgeon post op anti coagulation for a month for DVT prophylaxis with lovenox, coumadin, xarelto, or one of the other anticoagulants which have been approved for this use by FDA.  (Aspirin has not been shown to help). While anticoagulation is not without risk, particularly bleeding (GI, cerebral, etc) which can be life threatening, the risk of DVT and PE is very real, and probably of much greater risk than complications of anticoagulation.  They have been shown to work and clearly reduce DVT post op lower extremity surgery or trauma.  One must never take NSAIDS or aspirin while on anticoagulation, and always check with your physician before starting any other meds, prescription or OTC, while on anticoagulation because there are a lot of potential interactions.  Also,with coumadin (warfarin) there are serious dietary interactions one must familiarize yourself with. Frequent exercise of your legs throughout the day can also help prevent clots.  Hope this is helpful.

 PS: with regard to ice machines, I would not waste your money. Remember that you will only be using this for a few weeks. Certainly icing and elevating the leg are very helpful in pain control and reducing swelling. You should follow your doctor's advice on this.  Rather than an ice machine I recommend a Chattanooga I track later call pack which you can buy on the Internet for around $20. Below is one site that I found a company selling them for $21. You just pop them in the freezer for an hour and then it says call for about a half hour . They are cheap, simple, easy to use, we could be using the pool all sorts of problems. They last a long time. This is what most physical therapist use.

 With regard to ice packs, I would not waste your money. Certainly icing and elevating legs are recommended by most surgeons because both reduce pain and swelling and help wound healing. I suggest a Chattanooga I Dryke later call pack Instead of an ice machine. This is what most physical therapist offices use. They are simple, easy to use, last a long time, and are very effective. You just pop them in the freezer for an hour or so and when you take them out they last a good half hour.

Hello! 

I had TAR this past September 1st.  Although I have some upward movement of my foot and am able to bed my knee when standing flat I do experience some of the same things you are. After sitting for even a short amount of time my ankle stiffens up tremendously.  I’ve become accustomed to working it back and forth the entire time I am sitting so it won’t be as bad, but at the end of the day, if I sit down to watch a show and then stand up it’s almost like it has seized up. Takes me a few minutes to actually take a step. I also have the downstairs down hill issues, but- I also had a partial fusion done last December so I feel that contributes to the difficulties. My dr wanted a 30 degree movement as my recovery goal and at the end of my pt I am at 40 degrees so I’m happy with that. I find that the more I move during the day the better off I am in the evenings and also the next day. If I take a “me” day and binge watch Netflix all day then it’s stiffer even the following day. I do feel like I have progressed greatly and still have more months to continue improvement. I have not had any muscular/tendon problems though. They say after the one year mark you actually have days where you don’t even think about it. Can’t wait for those days to arrive! Good luck!

I am 14 months out from right TAR and subtalar fusion.  I had no Achilles problems from that, but developed an entrapped flexor hallicus longus tendon which has caused a severe flexion deformity of the great toe, which stresses the great MP joint, causing severe pain when I walk.  My surgeon tomorrow is going to sever the FHL which hopefully will improve this situation.

I am also 7 weeks out from left TAR (no subtalar fusion).  I have been walking for 1 week.  My left Achilles is very tight, and yesterday I injured it walking slowly on a flat surface.   I am have been stretching it several times per day manually with a heavy rubber stretch band, using a treadmill at a slow pace, and using an elliptical machine with low resistance.  I find the elliptical particularly to be very helpful.  I think yesterday I did not do enough stretching before the walking and will focus on more aggressive stretching multiple times per day.  Have you tried an elliptical machine for this Fankle?

Hi I actually have an elliptical machine which I was aloud to use eventually after my last two surgeries. and I will mention this to my doctor this week to see if that will be an option.  I did get on it about a week ago and feeling alot of pain in front of ankle so not sure Im ready for it yet but definitely want to try all options! I was doing alot of stretching at PT initially and did the treadmill gait stretch alot, but it just seemed that all efforts still didnt stretch it "enough". Wall stretch was always excruciating so was unsure if that is good or bad! So sort of let it rest for awhile only walking and a few stretches here and there for the last month. Anxious to try something else!