Live in Thailand and the only prosthesis used here is the Hintegra....

Dear Thom

The Hintegra has a strong following but regardless of the prosthesis used the critical factor in any ankle replacement surgery is the experience and ability of the surgeon.

The Hintegra was as I'm sure you know designed by Professor Hintermann in Switzerland and his reputation in installing this device is right at the top. I hope the surgeon who will be carrying out your surgery will have the necessary experience.

Everything to do with a total ankle replacement is critical especially alignment.

Osteolysis is going to be more likely if the prosthesis is not well positioned for the simple reason that it will be at greater risk of generating wear debris and it is thought that the greater the amount of wear debris produced the less the body is able to cope and osteolysis is the result.

Osteolysis in my case started to be noticed at about nine months post op and was not obvious and it slowly increased then seemed to stabilize. But between year three three and four it suddenly got much worse and that is why I'm soon to gave a very difficult revision with a very uncertain outcome. It is something that you need to constantly be aware of and remind your surgeon about.

It is interesting that most surgeons appear not to mention the possibility of osteolysis when discussing this surgery. Is it that they are not aware of it or just don't want to frighten their patients? There is no excuse for not knowing as there are a number of research papers on the subject available.

Good luck with the surgery and your recovery.

Cheers Richard

Thank you for that input....not sure how many of these implants this particular surgeon has done, but he is the best in the area according to many. I will email him about the osteolysis issue and my concern about that. I have noticed that Hintegra has an option for sensitive patients, but not sure if that is even an option here. It appears to be gold in color, unlike the SS grey of the original. I will update as I find out more. Again, thanks so much for your reply. Thom

Well I've pretty much been glued to my computer researching everything I can find about 1) the surgeon that's supposed to perform the procedure, 2) osteolysis, 3) Hintegra, and 4) reviews/comments from those having/had this done.

From what I've gleaned from forums here in Thailand, lots of OS will refer the really intricate, difficult surgeries to the fellow that's going to do mine. He is a foot only, specialist. I'm trying to find out just how many of these he has done, and that's not real easy to do, so far. His credentials are as follows: Instructor at the Department of Orthopedic Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 2005 – present  Consultant, Orthopedic Trauma Division Department of Orthopedic Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 2005 –present

I guess the osteolysis is one of those....ya pays yer money and takes yer chances sort of thing. I originally had bone spurs removed (1996?) from what is giving me problems now. Not sure how this would/will play into it.

Most of what is available on Hintegra are follow-ups published by the designers themselves (not too much by independents).

And from what I've read on this site  concerning post op results is about 50/50 and leaves me wondering if I should just do an arthrodesis instead. Hmmmmm......

I guess I have a couple of weeks to make up my mind....will keep reading and keeping score. Thanks to all for inputting on this. Thom