Ankle replacement v ankle fusion.

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I would be interested in hearing from anyone who has made a choice either way.

I saw the consultant yesterday and i have 2 weeks to make a decision. The other option is to do nothing. I am 59. 

I was initially attracted to the fusion procedure as I think it makes more sense for me. However, I am slightly put off by the fact that I would not be able to walk on the ankle for 3 months, whereas with the replacement option you can start using the ankle almost immediately. I also note that there have been only14 ankle replacement operations in the last 3 years in my part of Kent so it's relatively new. That worries me. I am fairly active. After the op I would like to get back to being more mobile although I accept I will not be able to do extreme sports! 

Have you been through either procedure? Was it a success? What do I need to think about? 

Thank you. 

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  • Posted

    Good morning I am 61 and just made the decision to do the ankle replacement which I just had done December 6th which I am still recovering from. I am in a walking boot and one crutch now. My ankle was shattered 6 years ago when I was hit head on in a car accident that changed my life in an instant. I had 4 surgeries but it got worse it was so bad I could hardly walk and was in constant pain I hardly had any range of motion can't do steps or inclines so after reading on both procedures and having 2 opinions I went with the replacement because 1) it was a shorter recovery time and 2) it might give me some motion back that was my main goal. Before the procedure the doctor said he wasn't sure I would get any more motion back the area was so severely damaged but to both of our surprises after I woke up from surgery and he came to see me he said he was able to get a little motion back! I had to be put in a cast because after my 1st post op visit X-ray revealed a fracture which he said had to have happened during surgery my bones are just not very good since the accident so that put me back 3 weeks but I have no pain which is a miracle just that horrible nerve pain which is not my ankle and it just means the nerves are trying to reconnect so far my toes and parts of my foot are still numb but I can wiggle my toes just can't feel me touching them it may change it may not it's not really bothering me. I was the first person at the hospital to have this done so yes it's new but I'm glad I decided to do the replacement once I start walking without the boot which will be in 2 weeks then I will know more and I started driving 2 weeks ago but you can't dtive with the boot on so that's a pain changing in and out of it but I live alone and at least I can get around town town. I wish you luck with whatever you decide it took me 2 years to finally make the decision it's a big decision my injury was severe I don't know your situation but just get as much information as possible on both procedures and get a second opinion good luck I'm here if you have any more questions Debi

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    • Posted

      Thank you very much for replying. It's great to hear that you are doing so well after such a relatively short time. It gives me hope. My main problem is going to be finding someone to look after me at home following discharge. I'm not sure how I'm going to manage that so I will give it some careful thought. Thanks again. 

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    • Posted

      My daughter only stayed 4 days with me then I was on my own. I prepared by getting my apartment wheelchair ready and the walker was great I'm not so good on crutches lol. I also bought paper plates cups and plastic utensils less dishes and some TV dinners easy to microwave and things easy to make. I was fine alone don't worry good luck oh and get a grabber thing it came in handy to reach for things and get a chair for the tub

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    • Posted

      I like the paper crockery idea. Great!  I'm going to give it a go. I'll have to get the dog walker to collect my dog as she will go mad without her walks!  Thanks debi 

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  • Posted

    I was told the replacement would only last 10 years but the fusion is for life. You can also be more active with the fusion you must be very careful with the replacement. I live in Canada and docs here don't recommend the replacement as it is not perfected yet. I had a fusion in Dec and in my week 8 of no weight bearing. It is definitely not easy. I have about two weeks until I can start putting some weight in the walking boot. The question you have to ask yourself is do I want another surgery in 10 years? I'm 52 so we don't heal as fast as we used to lol. Good luck with your decision.

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    • Posted

      That's interesting my doctor told me this latest implant lasts 10 to 15 years and also depends on how I take care of it by not over doing it. He also said I would have more mobility than with a fusion guess it depends on the doctor but from all the reading I did replacement gives you a better chance at being closer to normal. Glad your happy with your decision I'm thrilled with mine I finally have movement again

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    • Posted

      Thanks for your responses. Mr Southgate did say that there are pros and cons with both procedures. He did say the down side of having the replacement was that I was likely to outlive it.  I've looked on line and people are saying very positive things about fusions in terms of outcomes. I think a fusion would probably work for me if it wasn't for the long period of non weight bearing. I limp now as I find it difficult to bend the joint. I think it would be just like it is now without the pain. There's also the issue of arthritis contagion over time with fusion, although this isn't a definite. Thanks again.  

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    • Posted

      I have already replied

      My ankle and foot were twisted and set, they are now straight as the pain has gone. My gate will be normal afterwards

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  • Posted

    Hello

    I had my ankle fusion surgery 8 days ago.

    My choice was for fusion due to he longevity against replacement.

    Factors such as age, bone density and weight will also contibute to decision making.

    I severed my left foot 12 years ago, severed ankle deterioration has meant that my ankle crumbled and left foot had set to the side and dropped at an ankle and unable to move it.

    I had ruptured all my ligaments.

    I was recommended fusion due to it having a better more stable outcome.

    8 days in and doing ok. Three months non weight bearing

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    • Posted

      Hi Julie. It's great to hear that you are doing well just 8 days post op. I hope you continue to make good progress. 

      The problem with the ankle replacement is that I would need another major op in my seventies whereas, as you say, fusion would last much longer. My main concern with fusion are, driving (it's my right ankle), shoes, and limping. 

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    • Posted

      I have walked with a terrible limp as my foot has been set twisted outward and down for twelve years. The bone had crumbled in my joint and had set. This meant I have been on and off crutches and permanently in pain. My tendons were so tight my hip and knee were all also hurting.

      My leg and foot are now straight and despite the pain from the operation my foot is now at the correct angle. My consultant said with help, my gate when I walk should be almost normal once I'm healed.

      He has removed all the arthritic bone and released the foot. It was a five hour op.

      I had a spinal not general because I'm allergic however definitely have the spinal. You get pain block for almost a whole day after the op as they numb your legs. I slept through too so didn't even realise what was happening.

      Trust me when I say I walked bad. I couldn't do stairs, gravel or walk far as my walk was so bad. Day nine and my pain I had is gone already and foot points upwards. My legs where my tendons and Achilles were so tight are fine. I had a look at Day six as I needed a cast adjustment. I was amazed and cried at how it looked. I felt I could have hopped off the table and walked. I'm very hopeful.

      My post op issues are pins and needles, numb toes and simple getting about. Putting your leg down after elevation can be painful but pain meds help. I'm on nepofam it's non opiat so it doesn't make you dizzy or sick like tramadol etc.

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    • Posted

      Clearly your ankle was much worse than mine is at the moment. I walk with a bit of a limo because I cannot flex my ankle.  I am expecting my gait to be similar post op but without the pain. I have been on pain killers for 4 years. 
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    • Posted

      My ankle had no movement. It's weird but I think after fusion has healed I will have more movement than I did.

      I really hope it works out for you.

      I was terrified but to be honest despite everything I was amazed at what I saw after just 6 days.

      My consultant has been simply fantastic and he really is interested in getting me sorted. He removed so much rubbish from the ankle. He is more concerned about blood vessel scaring from my previous accident and now this on top so it's a case of waiting and seeing.

      This morning I have got up and the pain has reduced again.

      You will may also need clexane injections everyday for three months which you object yourself but they are not too bad.

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    • Posted

      I am terrified too. Terrified of either procedure and worried about making the wrong decision. 
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    • Posted

      Hi Julie. 

      If if I have my ankle fused, can I wear normal shoes once it has healed?

      thanks

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    • Posted

      Hi

      Yes. To begin with they will give you an insert in your shoe to help with support. I've been told I will need a heel support but this is only whilst heeling. Many people end up being able to walk and some even jog in trainers after fusion as the joint ends up being so strong but you still have full foot movement which many people don't seem to think is the case. Being a woman I was interested to know would I be able to wear heels and many have said they can wear up to an inch and half heel as you will have more movement in your foot that you think. I'm amazed how much my foot moves! It's only the ankle so normal shoes once heeled are fine smile

      There's a short clip on you tube which shows someone rotating their foot after fusion you would never know the ankle didn't movesmile

      I'm two weeks and no pain and I mean no pain! Just nerve twinges in my toes. I'm really happy with my progress. It's fantastic.

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    • Posted

      I'll have a look at the clip on utube. Thanks. I'm leaning towards fusion at the moment. The only thing that put ps me off is the 3 months in a cast with no weight bearing. It's such a long time. 

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