Ankle surgery - calcaneal osteotomy, is it generally a success?

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I am interested in getting feedback from anyone who has experienced a calcaneal osteotomy (without bone fusion) and whether they are now pain free after one year and able to return to things like running / jogging for say 5km without pain or subsequent swelling. I would define that as a significant success.

The searches I have done online give a lot of feedback and details of significant problem issues / severe pain for the first few months and even up to one year post-op.  I gather, however, that the healing process can apparently take up to 12 months.  I'd therefore be particularly interested to see feedback from those who are beyond this initial first year healing phase or see any links that covers this post op period. 

I am not sure of the guidelines on this but, if it is allowed, I would be very interested in any surgeon experiences and recommendations or useful web links.   Many thanks in advance for anyone able to offer any feedback. Here are some more details.

I was born with what are commonly termed flat feet with the left foot issue being more acute. I wouldn't need an op on the right foot.  The left is quite extreme and the genetic condition has got worse though very recent years. I have, however,  got by for 50 years (I am now 55) without any pain or problems and have played a lot of sport. 

I think the supporting ligaments have now become damaged and stretched to an extent that exercise,  orthotics and physio will not correct.  I still play singles tennis at decent club and league level and intensity but the ankle swells and a day or two free from sport is required after playing. I could not do jogging and running as these are more high impact.

It's a dilemma regarding whether to proceed and have the operation because the reasonably mild aching pain and associated swelling doesn't incapacitate me to the extent compared to the issues I have read from some others who have had the operation. 

As mentioned, however, the off-putting online feedback I have ben able to research appears primarily to be patient experience prior to a full one year healing period is completed. Also, I can only see my issue getting worse and I suspect the current inward angle of the foot might create an arthritic condition in the next few years if I avoid surgery. 

It would obviously be good to be pain free and able to do things like jogging so it would be helpful to hear from anyone who has had the operation and have found it a success. I would define success as being able to do jogging for say 5km and play sports like tennis without subsequent swelling or pain after a year or so post operation.

I had an MMI scan recently (findings below) but obviously it's not performed weight bearing. I have no idea whether more minor operations are able to rectify the findings and thereby get a successful outcome and avoid the major surgery involved in a calcaneal ostomy :-

“There is an osteochondral defect at the medial talar dome measuring 0.54 cm. There is likewise an interval appearance of cystic changes at the medial malleolus. There is thickening of the anterior talofibular and deltoid ligaments.

There is an os trigonum.

There is tendinosis with tenosynovitis of the tibialis posterior. There is fluid surrounding the peroneus brevis and longus at the level of the calcaneus.” 

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  • Posted

    I had the flat foot and also bone deformity from club foot . They put me in a brace as a baby but did not surgically fix it so the bones were crooked. I tried the orthotics then a brace for my leg . It was getting worse with more swelling and pain. I did get the surgery and it did involve partial fusion of the heal. I'm not sure if I would have had the surgery if I would have k ow how incredibly hard and painful the recovery was.Im almost at month 5 and still in walking boot but still need crutches or walker for support. I can do a few steps but still painful and very exhausting. Be prepared if you have the surgery it will change your life ,for yes, I would agree one year. I don't hear many jogging 5 km at that point, but I could never jog on my bad foot so it is not an expectation of mine. If you have little pain or swelling now I don't think I would take the risk, so many things can go wrong. I have to have another surgery for plate removal in one mo th which will set me back again. Consider a brace or watch a video on Exosym brace might be better option. I wish I saw that before this surgery. I hope all will be well with my foot at the one year mark, it is much straighter and I can see a bit of an arch even. I'm 52.

    Consider you won't walk u til about the 6 month mark as wHat I'm hearing from the forum is a milestone. It is a long, hard, painful journey.

    Margie

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    • Posted

      Thanks Margie, that's interesting and helpful.  

      I have heard many patients get much improvement in terms of pain removal and comfort after the metal plates are removed so I hope that applies in your case.  

      I will research the Exosym brace and I believe an Edinburgh based consultant specialises in that. I am in the south west of England but I do think getting a highly regarded surgeon is essential in such a complex area of surgery. I will also try a two or three months of cycling, physio and low impact foot exercise to see if that can help avoid an operation.

      One interesting thing I found from my research today is that, if my understanding is correct, NHS Choices means that patients can choose to be treated in any particular hospital in the UK.  So if there is a renowned and highly skilled consultant it is possible to select his or her hospital in the hope they will take on the operation.

      Given that I can see ankle surgery is probably the most complex and difficult in terms of achieving good outcomes then getting a highly reputed surgeon is essential to maximise the chances of success.

      Hopefully you are over the worst phase of rehabilitation and will see good results in the coming months.

       

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    • Posted

      I am in Canada so I picked my surgeon, who has an excellent track record. I also like that I see him through all my follow up visits
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  • Posted

    I had this surgery done in 2010 with a tendon transfer as I ruptured my posterior tibiallis tendon from a fall.  The tendon had retreated up my ankle and was not usable. Surgery was 7 hours long and rehab was a b***h. I wore 3 casts over 5 months on my L ankle. The surgery was a complete success and and as an Ultra Marathon Runner I have ran The American River 50 mile in California 4 years in a row since the surgery. The time between surgery and the 50mile race was 10 months.  I am now 60(male)and I still run daily.  I hope your surgery went as well if you chose to have it.
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  • Posted

    Magnu, many thanks for your feedback and really good to hear your op was such a success. It sounds like putting in hard work throughout the rehabilitation, however testing and uncomfortable, is key to giving a successful outcome the best chance.  

    The good news in my case was that i am now pain free without an op.  I researched the best shoes for hyper pronation and also had some excellent insoles recommended to me by a local podiatrist and it solved the issue.  These were 'off the shelf' but much firmer than any I had before including custom made orthotics via the NHS. 

    I am now back playing competitive singles tennis at a decent level with zero pain.  That's remarkable as various speciality experts said there was absolutely no alternative to having an operation.  My suggestion to anyone is to give their injury a good six to twelve months or so to heal before resorting to surgery unless it is so severe that other options are not worth pursuing.  Nonetheless, it's really good to hear the calcaneal ostomy operation can have an extremely successful outcome that enables a return to extreme levels of exercise intensity as it has done in your case.

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    • Posted

      Glad you made it back to your sport. Surgery is not an easy choice to make. Best of luck!

       

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    • Posted

      Hello nickE, Can you share the "off the shelf" brand of the insoles you found?  Thanks

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