Ankle Replacement Surgery

sounds like the gp was at fault there. did you not have a follow up with consultant after 2 weeks? sounds awful im so sorry for your experience. did you have any steroid injections prior to replacement as they can increase your risk of infection. im trying to decide between replacement or fusion

I had a TAR and all seemed great for five years then it had to be pulled out due to osteolysis and poor workmanship. Found a top quality revision surgeon to do the rescue work. All going great at nearly two years thankfully. If going for a TAR make VERY sure that the surgeon is really experienced as so many especially in the UK are not! Cheers, Richard

do u mind telling me the name of the Rescue surgean. yes i have looking at national joint register

If you message me I can answer your question. Cheers, Richard

Deedles

no I did not have any steroid injections I had so many consultants while I was inhospital they would look at the wound and the pictures I had taken each week and with the look of belief but I guess they really couldn't speak badly about another physician I guess the biggest problem was I had faith in my doctor

I really do not understand why patients make a secret out of the names of incompetent physicians. The good and the bad should be known all of us.

emileo4479

I am not trying to be secretive as I am not healed as of yet and really don,t want my comments to effect my healing with the other associates taking part in my recovery

I'm more than happy to share names and offered but no one has messaged me! Cheers, Richard

i messaged you. did u not recieve message ? 😃

No message received however I've sent you a message with the information you want. Cheers, Richard

****I should say that at 5 1/2 weeks I have taken some careful steps **without the boot. Everything feels very solid with zero pain. I almost can't believe it myself!

Really excellent news! Well done. Cheers, Richard

Hi thad33721

I see you also had a Zimmer Trabecular implant, same as me. Had mine done in 2014 (age 53). I also had great movement and no pain etc. Great doctor the works. Was done in Cape Town, South Africa. It went so well that my physical therapist 'fired' me stating that he can not do anything more for me as my ankle is 100%....about 4 months post-op. My story is somewhere on this forum. I then went carp fishing for a weekend at six months post-op. The edge of the dam was a bit muddy. One obviously is in and out of the water..some inward and outward bending of the ankle in the mud but no painful incidences etc. I must say, the fishing was excellent, lots of nice big fish caught (we only do catch and release treating the fish with great care). We returned on the Sunday and the next day when I got up, I could feel that there was something wrong in my ankle. After x-rays I was told that the metal plate on my Fibula bent and broke one screw. My prosthesis was no longer lined up 100% and there were indications that it became loose. What happened was that my Fibula did not heal properly where it was cut during the operation .. even after 6 months and that caused the metal plate to bend. Since then I have had a nagging painful ankle, still much better that what I had before TAR but the flaw is there and it gets tired sometimes. I am literally walking with it now until it either gets better or falls out.

The reason I am telling you this is because I have been there and I know how easy it is to fall in the pit of complacency. One struggles with extreme pain for years and as soon as the operation was done and the pain goes away, you think you are healed. Please be extremely careful with your ankle and don't over do it. It only takes one mishap or one stretch too far to mess up a fantastic operation. Having revision for that implant is not an option, except if you go for the extreme in-bone implant etc. If they have to take that prosthesis out, you are looking at an inch (3-4 cm) hole that needs to be filled first before a fusion can be done, unless you are willing to settle for a shortened leg. It's an ugly affair and I know it's in my future.

I also have a replaced right hip, much like you with the knees and it also put me under the impression that after a joint replacement, one has to get up and start walking asap. I mean heck, I was up the next day after the hip replacement.....it is exactly the opposite with an ankle, no matter what they tell you. A Zimmer Trabecular has to attach to a flat piece of bone and it is not kept in place with screws or anything so an enormous amount of fixation between bone and metal has to take place plus if you calculate the amount of pressure on your ankles when you walk, it is staggering and by no means the same as knee or hip replacement.

I had a fusion of my other ankle on 20 November 2019. I took off the cast on 31 December 2019 and I am wearing a Moon Boot. My surgeon expected 100% no stepping for six weeks (in bed flat on my back) plus another six weeks in the boot with light stepping on it. Going okay and I am really trying to do everything by the book this time.

They say it takes at least six months for a fusion to heal and if you look at what they do compared to the TAR (plates and screws etc.), how can they expect a TAR to heal within anything less than six moths..or rather 9 to 12?. It does not make sense and I have the T-shirt to show for it.

Take care, it's worth it.

Leon

Hi did your TAR get better after more time or? I had my one done sept 19 and 4months later am worse than before the op can barely put foot down am still in boot and have had to get knee scooter just to get around.. I hope it will get better and not have to wait for nothing and then still have to get fusion.

Hi coljc

Good question. I would say that my TAR did marginally get better after the fishing incident and I can walk on my foot mostly painless. It does get tired and uncomfortable if I walk too much though. I have never been worse than before my operation though. For me, the operation was a huge relief because I could not step on my foot at night and I had terrible 'still pain' at night. That is all gone.

Middle of last year I have developed a pain on the outside of my lower leg just above my ankle. I had x-rays taken and it showed a stress fracture of my Fibula. In other words, because the prosthesis is not lined-up properly anymore, my foot tend to bend to the inside when I walk, especially barefoot. That puts too much strain on my Fibula and causes the stress fracture. I have an inner sole that assist my foot so my alignment is a bit better when I walk with shoes. The stress fracture pain comes and goes and I am used to having the pain. I am going to have the inner sole re-done and hopefully they can lift my foot even more on the inside so that the fracture will have less tress and can heal.

I actually had to support myself on the TAR ankle for six weeks while on crutches from 20 November 2019 till around 3 January 2020 due to the fusion of my other ankle. I had some discomfort here and there . I tried to put as little as possible concentrated body weight on it but I obviously had move around so I did put 95kg's on the ankle frequently. What I consider great about my TAR ankle is that no matter how tired it is at night sometimes, it always is painless and operating well the next morning. My surgeon says that it is 'eating' into the bone and needs to be taken out, although I still feel it's much better than it was before the operation and I will continue using it until it caves in...or perhaps adapt fully and sticks around for a few more years.

I think you must get X-rays done and look at the radiologist report yourself. Make sure the prosthesis is not loose or even infected. At four months you should not have so much pain. There must definitely be something wrong. One has to also make sure your Vitamin D levels are high enough and take a daily calcium supplement because it promotes bone growth....and don't smoke any tobacco cigarettes... that is very important.

Fusion after a TAR is extremely complicated.... you are possibly looking at 9-12 months with a Taylor spacial frame and donor bone. Not something I look forward to and that is why I protect my ankle at this stage. If can have the choice for my left ankle over again, I would go for fusion and never in my life consider TAR.

I hope this helps.

Leon

Thanks so much for your reply.. what you've said is the absolute truth I should never have gone for replacement and I seem to be in worse pain than you have been.. am so glad to hear what you've said and listening to next stage of fusion is worse.. am so upset but your advice is so good thanks for that. Before my op I had that side pain all the time it was slow stress fractures so do get that orthotic that keeps foot aligned. Thank you so much for your advice I haven't heard anything as clear from my surgeon thanks hon and wish you well with everything thanks again.

Sorry to hear about your problems but I think I should just say that a TAR correctly carried out by a surgeon skilled in TAR replacements provided that you are in good health, not over weight there is no reason for a bad outcome.

I had a TAR in 2012 and had what to most would be a fantastic recovery but four years later the TAR was causing osteolysis and two years later had to be removed and a revision prosthesis had to be installed in a complicated six hour surgery. My recovery has again been outstanding with far less discomfort the second time around.

I'm swimming for an hour most days, can do brisk six mile walks without any discomfort. Six months ago I did a weeks walking in the Swiss alps with an active partner twenty-five years my junior. I am 78. Hope this information is of interest to some here. Richard

That's an unbelievable outcome and you had 2 operations.. will see this week what surgeon says .. thanks for sharing how replacement is supposed to turn out.

To give you and others a reason to be positive about a TAR Google Yogesh total ankle replacement. Please read the update notes and be aware of this.

Total ankle replacement is it seems often carried out by surgeons with insufficient experience of this very demanding and technically challenging surgery. I suggest that you should. find a surgeon who does many TARs each year and that their performance record is good. If you are not already aware the recovery is pretty tough and you will come through it best if you are fit, healthy, not overweight, and have a determined positive attitude.

Good luck everyone, Richard

Thanks for your help .. went to surgeon op a complete fail he will do a fusion in couple of months.. but I will go back to see if he can fast forward that .. couldn't bare thoughts of more delay followed by months recovering. Everyones response here was great to see if I was going insane or not. Weeell even more insane 😈🤯 thanks all.