Ankle Replacement Surgery

Dear Irishjig

I don't want to worry you but thirty ankle replacement is really not many and one has to consider over what time span and was this using the Zimmer or what? I hear alarm bells ringing quite loud.

It is essential to really know before you commit to the surgery this and what the outcomes were.

I'm speaking as someone whose surgery was done by a very nice surgeon who had done about twenty-five TARs all of the same design over a shirt time span.

I made a very fast recovery but it failed after five years and the problems a very experienced ankle revision surgeon had in taking out the original prosthesis and putting in a special revision prosthesis was considerable with my surgery taking six hours. Thankfully I seem to be making am excellent recovery.

Please learn from what I've had to deal with.

All the best Richard

I found Dr Flemister very good to work with.  When I had issues, he was very responsive and very receptive to reviewing literature I came up with on my Medline searches regarding my right FHL issues.  Also, before my 2016 right TAR, there was a question of whether or not I needed a subtalar fusion.  I had received different opinions on this. A doctor in Syracuse never even considered that my 3+ years of disabling heel pain was anything more than plantar fasciitis and just wanted to give me shots.  I did not think I had plantar fasciitis and did not want shots (the treatment is stretching anyway).  Dr Flemister carefully examined me and agreed with me that I did not have plantar fasciitis, but had subtalar arthritis causing my heel pain, Dr F then recommended subtalar fusion as a solution for the heel pain.  I sought opinion from Dr DiGiovanna at Mass General who advised against it.  Dr Flemister was very willing to call me when I was in Boston to discuss this, and then discuss it with Dr DiGiovanna as well.  At that point we decided to not do it.  However, over the next few weeks it became very clear to me that I did need the subtalar fusion, and Dr Flemister got me right in to examine me again, and agreed.  I am glad I had the subtalar fusion on the right, because that was where a lot of my pain was coming from.  Conversely, I did not need subtalar fusion on the left side in 2017, and Dr Flemister agreed with me.  I can't say enough about him because he would invariably answer my portal messages personally the same day, and gave me his cell number to text him if I needed to, which I only used a few times.  He called me at home post op without any request from me.

I believe Dr Flemister has done more then 30 TAR's.  2 years ago he had told me he had done 40-50, and I believe he has done quite a few since then.  I know he has done at least 2 .    I initially saw Dr Judy Baumhauer at Strong Memorial, who is past president of the national Association of Foot and Ankle surgeons. She has a lot of experience, but told me that she was doing more research than surgery lately, and referred me to Dr Flemister for the surgery.  I liked Dr Baumhauer a lot as well.

He did not have me do any PT with either of my TAR's, but he knew that I already had a well established exercise program with equipment at home.  This worked well for me.  I am not sure PT would have done much differently for me.

PS:  I just finished my daily workout in my gym and feel pretty well today.

I'm six months out from my TAR and I'm still in PT two times per weeks ($35 co-pay). The PT is finally starting to pay dividends, along with other forms of moderate exercise. Remember that your ankle joint hasn't functioned properly in years (most likely). So, all the ligaments, tendons, and muscles have atrophied a little and/or haven't been moving in the proper manner. You body will need time to stretch and strengthen all those soft tissues. In my case, I am finally getting some strength back in my calf muscles. And, while I've had tightness and pain in my Peroneus tendon, probably due to lesions/ scar tissue, that problem is slowly getting better due to constant work by my physical therapist. So, stay the course.

Actually, I mis-spoke, sort of.  I have not done PT until now, but I am having problems with my left Achilles related to my left TAR done 6 months ago and am going to start PT since I can't resolve the issue on my own.

Irishjig:  I have always found the elliptical to be a great machine for my ankles and knees because it does not seem to injure them.  I also am a firm believer of going into these surgeries with my body in as good of condition as possible.  Going in weak from lack of exercise will only make your post op period more difficult.  I recommend that you involve yourself in as vigorous of a conditioning program as your ankles will allow.  You will get through the surgery and recover much more quickly.  Since we are both from Upstate NY and both using the same ortho department at Strong Memorial, perhaps you might want to engage me more privately over email..  Here is my anonymous email address:

Moderator comment: I have removed the email address as we do not publish these in the forums. If users wish to exchange contact details please use the Private Message service.

I suffered with severe heel pain as my first manifestation of the ankle arthritis when I was walking Oak Hill for 4 days during the 2013 PGA championship.  I thought at first it was bad shoes.  It didn't feel like plantar fasciitis.  I didn't see anyone when it went away, but a year later started with ankle pain along with heel pain. It took a while to be properly diagnosed.  The surgeon in Syracuse did not do much of an exam and just made the assumption that it was plantar fasciitis.  Dr Flemister did a careful exam isolating each joint and pointed out on exam how he thought the heep pain was subtalar arthritis, and the xrays showed it pretty clearly.

It sounds as if have done well. For me the replacement hip twenty one years ago, and then the TAR five years ago was like getting my life back. It was devastating then two years ago to be told that the TAR had all gone wrong due to osteolysis and that the prosthesis would have to be removed. I'm under a different much more skilled surgeon and had the new surgery in February and am making fantastic progress.

All the best Richard

Wonderful!!! Congratulations.  

Great to hear such a good result.

Which brand TAR do you have where and by who is it done?

 

How are you now RichardKen can you walk do you have pain how does it compare

to your previous TAR?

What TAR did you have the first time and which one do you have now?

 

Mine was an inbone type and the company that made it was fantastic. I have had a lot of operations in my lifetime but have never seen the professionalism that went along with every one involved. That had a 3D printer mock up of my leg bone so every part was designed just for my leg. My doctors were marrie Williams and and dr Holwinski. They are fantastic doctors and they repair a lot of tar that have been done wrong

Thanks, after searching the internet and judging the design myself that particular one was the type

of my choice.

Unfortunately, living in the Netherlands it is not available and is not covert by the insurance.

I still have to make a decision for myself but I am really happy for you.

Hello Edmund

Thanks for asking. The quick answer is that my surgery taking six hours was very successful and was ten to eleven weeks ago.

Three weeks ago I had the weight bearing cast removed and was put into an Aircast boot. Within a few days I was perfectly able to walk without any support but walking to the shops I put the boot on to protect the ankle.

2.5 weeks ago I was cleared to drive on the basis of a video I made of me walking at couple of days out of the cast.

My surgeon has advised that I use a light weight ankle strap for driving and walking and if walking for more than ten minutes at a stretch to use the Aircast boot.

There is minimal discomfort, no swelling and my front and back movement is not yet quite as good as my good ankle but really not that far behind it. I've been instructed to not rotate the ankle for the moment though the surgeon tested the motion and it was excellent.

Well there you are. My progress has stunned my surgeon and all around me, got a new girlfriend years younger than I am and we are making plans for the future so life is good.<vbg> I will be 77 this year.

All the best, Richard

My apologies Edmund for missing out several points but if you Google yogesh total ankle replacement you will find answers in a short video showing me walking and running up and down stairs.

I would say that my recovery is in many respects twice as quick as the first time but it was a far more demanding operation and I'm five hears older now. Cheers Richard

Who was this Dr. in Miami - I live in Lakeland FL need a great doc for TAR. How old are you? What insurance do you have?