Ankle Replacement Surgery

Excellent! this is very motivational and important, such trips to Caribbe (or to the pub) are great ways to healing!

I firmly believe our bodies respond to environmental changes, either for the good or for the bad (i.e. weather change-ankle pain), but also believe the proper environment (places and friends) makes a whole lot of a difference in people's behaviour, surely helping into the healing process. Good for you to go for the 10 miles, I too want to get back cycling again and I agree that doing it on stationary bike is not at all the same thing.

To the point, I hope our example can serve well to our friends-in-pain out there, for sure we will always have limitations after such difficult surgery but we must pursue best directions to healing that fit each specific case.

Regards,

G.

Dear Bradley,

I think I am the first one to respond to you in this forum. My procedure was done end of December 2014, so it is now practically 6 months since. I don't know if this is your first (foot) surgery ever, but I am kind of "veteran" in the field of foot surgery, four so far, and as such I am no stranger to problems such as numbness. I think this is part of the trade off, unfortunately, you can ask around here and you will find that many of us went/is going through this. Imagine, there is a network of tiny nerves in our body, cris-crossing everywhere, almost impossible to avoid them with a scalpel.

One thing I can asure you, the TAR recovery is expected to be a slow one. I have friend who had knee and hip replacements and soon enough they are up and active, but ankle somewhat is harder. If my experience counts anything, I say just be patient because you will overcome the difficulties and the unpleasant feelings you have now. In my case I am very satisfied with the results, but I still hope to see better times ahead. The very fact that I do not have arthritis pain in my foot joint today is already a welcoming accomplishment, the rest is manageable.

Hope this helps to elevate the spirits.

Gilbert

Gilbert,

Thanks so much for the reply.  Greatful I found this forum.  And I appreciate your words of encouragement.  Yes this is my first surgery of its kind.  I am only in my 3rd post op week so of course just waiting as patiently as possible to start attempting to walk.  My surgeon expects that after 4 weeks when I see him next.  I have to say psycologically I do not think I was well prepared for this.  I scheduled out 2 months in advance but I think I just pushed it back in my mind during that time.  I find out I am phobic with a wrapping or a cast on.  Also was not at all good with the pain or the pain medication (narcotics).  It was very rough in the beginning.  My surgeon had an earful that first week from me.  He decided to not put me in a cast because of my phobic condition for this third and fourth week and instead I got what people here refer to as the moon boot right away.  Told me not to take it off and that it would help me not get that panicky feeling knowing I could take it off.  But he was very clear about keeping it on.  Was uncomfortable at first and I did take advantage of the straps and air pump / relief valve at times only when not moving around.  Thankful my surgeon did this for me.  I am through the toughest post op period I believe now pain wise as I do not take pain medication all that often.  If I need some help, ibuprofen helps.  No Narcotics.  I realize I am improving just writing this stuff down and that helps.  Glad to hear that you are doing well and wow, what you have gone through had to be challenging.  I will be updating here as I go through my recovery.  The surgeon says my procedure went well and after 2 weeks the X-Ray showed no problems.  Said I should heal up good.  But yes, understand this is the toughest of the big three joint replacements to recover from.  All the Best Gilbert 

Bradley

Bradley,

I think it is all the same for me, been there done that, feeling claustrophobic, not narco-friendly, but these are all phases we have to go through - you might still have to get used to the feeling of your friends face frowning when they hear for the first time you had an ankle replacement.... but the fun part is yet to come, next is physical therapy sessions. Little by little you will see the progress you make, just as a caution, do not expect fast results at first, so don't get frustrated too soon, but work hard and persistently, as soon as the doctor gives you the okay to do so.

Best recovery,

G.

Yes more challenges ahead.  Must keep my attitude adjusted towards the positive.  My wife reminds me of this too.  Glad to have met you here Gilbert and thank you for your comments.  I will let you know how things are going in a couple weeks.  

Bradley

 

There is no need to to cut the nerve during surgery. this to me looks like bad workmanship. Consult with you attorney.

I have read other comments and have also been told that this is not uncommon by Gilbert himself who has much experience with ankle surgery. I will pay attention to this numbness of course and discuss with my surgeon next time I see him.  I had the STAR replacement which requires going in from the front of the ankle.  Do you know specifically what nerve that was not necessary to cut?  Thanks

The answer is a pack of cheap frozen peas forget the ice

Hello Leon,

Thanks for your words of encouragement.  I did remember reading your past post.  I will take seriously your recomendation to get custom shoes/insoles and whatever else it takes in that category for sure.  I was just thinking about it before I saw your post and got that idea from you from your prior post.  I am sure I will start with seeing about replacing all my shoes with this.  I feel that this is something that can help tremendously and also possibly extend the useful life of the ankle replacement.  

I am to minimize my ankle movement per doctors orders for a week yet and then I will see him.  He will then start me off most likely with some weight bearing and exercises.  But I can tell you that I test the ankle at times with a bit of up and down motion with no pain from the ankle joint area.  Just everything around has some pain and numbness at times but understand that it is from the surgery.  This procedure has to be a major shock to the body...the reason for the long recovery time.  Thus "Not for Sissy's" description is perfect.  For some reason it bothers me more at night.  I am glad that your ankle situation has improved and continues on that path.  It is important that the positive results get out for people to read.  But glad also that people post their dissapointments too because we have to remain grounded in reality.  There is no replacing the original ankle God gave us with something of equal function.  The body is an amazing machine.  Anyway thanks again Leon and continued success to you.  

Bradley

Leon - my old friend, good to hear from you again!

As usual, you serve as a model to me when it comes to the TAR recovery process, you present it quite well in your note to not over stress the area in the first two-three weeks, since all is still tender, plus we have "fresh" screws/pegs attached to the bones, you don't want to cause a problem there - I remember having a fall in the bathroom in my second week, boy, that scared me (and my wife too) but rushed to hospital for x-ray, all was fine. I also relate with the issues with stiffness and discomfort while doing long walks (my gait is not 100% yet) but amazingly enough I do not feel pain if I stand for a too long time! I was recently in a museum exhibition, walking slowly and standing for hours with no problems. I recall this would be no fun for me before my surgery, since pain would force me to cut it short.

Like you, I also keep my exercise routine in the mornings, at least 15 min., achilis elongations, ankle lifting combinations. It always feels bether after that. I also go to the swimming pool sometimes and practice 'jumping' on my toes (left leg) in the water, followed by more tendon stretching on the pool wall, holding on the side of the pool. this  feels really great! rewarding workout.

As for numbness, it is my own experience after all my surgeries that some feeling is lost on the skin, in the vicinity of scars as well as other parts of the foot. This used to bother me, but today I think it is a small token to pay, considering that the alternative (living with chronic pain) is much worse.

My struggle to healing continues, with the help from you and other TAR patients who share their experiences in this place.

Gilbert

It is some time since I contributed to this forum. Not because of disinterest but because there seemed to be so much discussion about ankle breaks and the like that I decided to opt out as TAR is a different kettle of fish in my opinion. It is now 3 years on from my own operation and I have to say that I cannot report such good news as many of you. The problems that I was encountering with swelling and discomfort(as opposed to outright pain) still persist and a number of X-rays and scans has revealed some bone fragments loose in the ankle which perhaps are contributing to this as well as extreme scar tissue which again may account for a lot of the soft tissue swelling. They seem at a loss! and are preparing to do an exploratory "keyhole" procedure to see if they can find out what is going on. Tis may end up with a positive result but they also reserve the right to open the ankle completely and perhaps replace the existing implant. Not something I am really looking forward to. The nerve damage has left my toes almost completely numb and on occasions extremely painful..as if they are being sawn off! All in all not such a bright picture to paint for those either about to or having just undergone surgery. My message is ensure that you get the best possible aftercare you can and exercise the joint as much as they tell you to...no skimping. Articulation of the ankle is in my view the answer to a successful outcome a view which seems to be expressed by a few contributors.

I'm in exactly the same boat as yourself, had my TAR done Nov 14 and in chronic pain ever since. I have had lots more xrays done and most recent was a PET scan that showed I have some infection/ inflammation going on beneath the replacement ankle which they seem very concerned about.so I've now been told that the ankle may need to come out,and I may be facing possible amputation below the knee.wishing I never had the opp in the first place now. Wayne

hey buddy that is rough and I have every sympathy. Not perhaps what I want to hear at the mioment as I'm still considering the second op, exploratory or not but nontheless I think people need to learn both sides of this equation. Sometimes it works well. For others it fails miserably. I just hope that your situation can be improved without the drastic action you mention.

Hi Wayne

I take it that you had your TAR November 2014. Was it the STAR (from the front of the ankle) the Zimmer Trabecular Type (from the outer side of the ankle)?. I have had a lot of concern’s regarding this particular scenario you are possibly faced with. I also had  a discussion with my surgeon regarding ''plan B' should the implant fail and you basically echo his words regarding possible amputation etc. It is true that the cavity left by the implant is relatively big and cannot easily be filled. I did understand from my surgeon that it is possible to do a fusion if there is enough bone, but it can leave you with a relatively shorter leg and a long recovery period. I am not sure if it's possible in all cases though. I would also seriously suggest you go for at least one other opinion before you make any decisions.

I hope for the best and that the infection clears up and you heal 100%.

Please keep us informed Wayne.

Regards

Leon

Hi Leon, it was the star that I had.they are running a few more tests in the coming weeks so should know more then. I'll keep you posted.regards Wayne

What is your exercise routine for your TAR?  I am 9 weeks out and started PT about 10 days ago.  Could not put any weight on foot for about 24 hours but it did feel better by day 3.  Just interested in gathering info on various exercise patients do.

Hi Luchie

I am a bit busy currently so not on the web too much. Please excuse me for not replying sooner.

After my TAR last year I obviously had to take it easy for the first two weeks with no exercises. I had a boot on when I went home after 14 days in Cape Town and because I am 1000 km from my surgeon he briefed me pretty good on what to do and what not to do. I had to use ice on my foot for the next two weeks. He gave me a very nice purpose made covering that takes two frozen plastic bags (blue freezer gel in it – I got 4 – two on the ankle and two in the freezer) and it all wraps tightly around the ankle with velcro. It is extremely useful and comfortable. My surgeon basically gave me only two exercises to do. The one is to take my towel in the morning after I showered, roll it up and hook it on my front part of my foot and then pulling back on it for 50 seconds and I repeat it 10 times. Simple but very effective. It stretches the Achilles tendon and it increases the movement on the joint. I started doing that about a month post-opp. The other one is standing in front of a wall and then bend your knee trying to touch the wall ..also 10 times. At first I could not get close to the wall, even with my toes against the wall. I have been doing that exercises ever since every day and today I have my toes about 5 cm from the wall and my knee can still touch the wall, heel down on the floor all the way. I have had more intensive treatment for 3 months also but I have found that there is not much that can be done and it only made my ankle become painful..

Interestingly,  yesterday  I walked around on my office floor and after a while I realized for the first time that I had actually completely forgotten about my ankle while I was walking. No pain or any discomfort. It comes and goes and sometimes I have a bit of pain but it goes away as soon as I have walked a short distance.

Regards

Leon  

Just a correction...5 seconds and not 50 seconds.

LDT

Very interesting information . Had ankle replacement only 5 weeks ago and it is nice to know what you have to look forward to. Keep up the good work . i cant wait to get back to walking a biking again, Regards Mr Ankle

Leon, thank you for info.  I wish I had started PT sooner but my Dr wanted me to wait til. 8 weeks out.  I have to say that since PT I have increasingly had less pain and more mobility.  I also have orthotics which also seem to help. I am going to do the wall exercise, have been doing the towel one.  Look forward to pain free walking in the future.  My Dr told me last week that majority of pain should be gone by 6 months but it takes about two years to see what end result will be.  Again, thank for your response.

Hi Gilbert

Many moons ago that I have posted on this forum and I hope all my TAR friends are still hanging in there. Now, where do I begin?.

I had a an incident with my TAR ankle about 3 years ago where the plate on my Fibula bent and actually broke a few screws. The prosthesis shifted. My home surgeon took one look and replied that the replacement is loose and needs to be taken out. I was quite upset and went for a second opinion at one of SA's leading ankle expert. He also said it has to come out, cavity to be filled with donor bone and an external fixation (Taylor spacial Frame) , must be installed. It all needed to be done 1000km from my home. Long story short, I was in Cape Town, in hospital and at six in the morning first on the theater list. With the anesthetist taking my bp, weight etc. for the doping exercise...I decided to leave it. Yes, I walked out of there and went on a week holiday with my wife before driving back to my home city. Now you would probably think I was crazy but you know, if one has to go for such a radical intervention and to be stranded with such an instrument attached to your leg for 9 months + one would at least expect that the surgeon who was responsible for the installation, would come and talk to me once?. Never happened because he was always too busy. So I decided that nobody will have the opportunity to treat me like a piece of beef and I packed my bags. Now, 3+ years along the line, having being diagnosed with Hemochromatosis for which I had DNA tested and I am a C282Y/C282Y Homocygote . That means I inherited a gene from both parents that mutated and gave me extreme Hemochromatosis (elevated blood iron levels). I have been bleeding a lot as Phlebotomy is the only way to get the hugely elevated iron levels out of my blood. I went from a Ferritin count of over 2000 to a mere 54. Slowly I regained much of my 'normal' life and I prevented any damage to my organs, except for arthritis in my joints. I also received an injection once when my non TAR ankle had inflammation and I lost all sensory ability under my left (TAR) foot. Now over two years, very weird and uncomfortable at times but live with that too. I have been popping 100 Mg Tramahexel slow release pain killers for the last 3 years..daily up to four plus anti-inflammatory pills.

Today: My left ankle is no longer loose and I walk daily on it. Sometimes it does become a bit worn out and painful, especially when I am very active during the day. My right ankle is bone on bone and I will have to get it fused. Three weeks ago I went for a check-up at my physician and I mentioned to him that have for years heard from doctors after blood tests that I have elevated uric levels in my blood. Nobody ever gave me anything for it up until then. He gave me a prescription and now, after 3 weeks I am starting to feel so much better. I have not taken a single pain killer in over a week. I have almost no discomfort in any one of my ankles and I feel a new person.

I have lost all faith in the medical profession because I had hell fro many years and it's only by God's grace that I have no liver/kidney damage. No one ever addressed the uric acid levels and it gave me more arthritis and worn out joints, all while is was right in front of them many times. But now I am OK and I must say, though my TAR is not perfect, it's much better that what I had and I can walk with it. One must give a TAR real time to heal ,,which perhaps did not, but I still made the right decision to walk out and keep what I had. If that removal went pear shaped, I could have lost my leg.

Looking forward to feeling better every day also.

Regards

Leon