TAR surgery in near future

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I've read the ankle replacement forum for some time now (about 20 pages worth).  My wife had a tri-malleolar break four+ years ago.  The cartilage is gone.  She's a candidate for TAR, and has investigated two docs here in Virginia:  Dr. Cooper at Georgetown and Dr Schipper at Anderson (Schipper operates out of Inova Fairfax).  Cooper performs the STAR replacment; Schipper installs the Infinity.  I would be very grateful to hear from those with personal experience -- which hospital is better, which surgeon, which system.  She (and I) are tending toward the Infinity because it is a fixed bearing system. I did do some research on the Zimmer system -- the significant improvement might be the highly crosslinked poly as opposed to the ultra molecular poly alone (for the spacer), but I'm not an engineer nor a doctor...just doing due diligence.  Thanks for responses in advance - John.

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  • Posted

    I am also moving towards a TAR using Infinity but in Atlanta. It is best to make sure the surgeon has done at least 100 TAR's or more and get testimonials.  And then trust God for the rest

    I about killed myself doing research about TAR's and in the end have delayed it now hoping for a natural healing or "holding".      I wish you the best and will pray for you and all TAR folks

    David

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    • Posted

      Well dave I had tar In 2017 actually twice on same foot they called it a revision I had a star put in. To be honest if I had it to do all over again I would never have done it. Doc told me I would be back to work in six months well I just got approved for premnate disability I am 57. It changed my life forsure 
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    • Posted

      So sorry to hear of your bad outcome. That truly sucks. No way to have it redone by a different surgeon? 😬

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  • Posted

    I’m 12 weeks post op on my first TAR. Had back to back TKRs last summer so was nervous about getting a new ankle so soon after I got my new knees. But ankle was so bad it was inhibiting knee recovery so I went for it. I’m 56YO previously active woman who hasn’t taken a walk in over two years due to issues with severe knee and ankle pain (lost all cartilage in my major joints due to another medical issue). I consulted with five different ankle surgeons before going with the one I used out of denver. Very pleased with results so far. The crippling pain is gone tho I do have a fresh case of plantar fasciitis from trying to weight bear too quickly. My doc used the Infinity implant and the Prophecy system (TARs are way more precision-oriented than TKRs, so apparently the “system” used to perform the TAR is also important.) Also, unlike TKRs and hip replacements, it’s much harder to find a surgeon who’s done the same level of volume that u can find with Knees and hips. I personally think the surgeon is critical. The one I went with knew and had experience with a number of implants and he explained why he wanted to use infinity for mine given other health complications and replacements. I was stunned at how little pain I had (except for when nerve block wore off so nurses upped my oxy dose). I stayed on oxy for a week preventively bc I had such extreme pain last summer with my knee replacements. Weened off super fast and haven’t needed anything beyond occasional Tylenol since.  Biggest issue for me was the boredom of required elevation 23/hours a day, above heart, for upwards of 4 weeks. Then I got cleared for submersion and made the gym’s outdoor pool my best friend. Helped with ROM and overall body movement to overcome the stagnation of a month on my ass—literally. Unlike TKRs which require immediate weight bearing to heal, TARs need time to chill—which means less pain overall. I’m still on crutches due to weak glutes and quads (and the plantar fasciitis), but I began doing weight machines and stationary bike and it feels awesome! It’s too soon for me to say how well this will work out in the long term but so far I’m thrilled. I was out of options and tired of sitting on the sidelines and popping pain meds. So my advice is to really be thorough with choosing your surgeon. You don’t want to be anyone’s Practice case. Also—be prepared with mobility gear—walker, crutches, knee scooter were the ones I used. I put a basket on my knee scooter so I didn’t have to always ask people to get me good etc. (tho truth be told it’s kinda nice to be waited on). Sorry for the long winded reply. I know I was desperate for TAR info before mine and was only able to find a couple folks who’d had them and could share their experiences with me. One was 11 months out and had just hiked four miles then made dinner without any issues. And finally, everyone is different so “results may vary.” Me? I’m glad I did it. Good luck!
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  • Posted

    Well, after much more research and reading technical papers, my wife has decided to go with the Vantage TAR -- and Dr. Mark Easley at Duke as the surgeon.  He was one of the inventors of the device two years ago.  Her first appointment is in a couple of weeks, and we'll see if she is even a candidate for the Vantage.  I think that's one of the problems associated with Implants Gone Bad -- that the surgeon chosen is effective for a particular TAR device -- but it may not be the right one for that particular patient.  Of course...no one owns up to this dirty little secret.  But that will be our first question to Dr. Easley, and we'll evaluate his answer carefully.  Thanks for the replies -- Lauren, your reply especially convinced her to go with a more experienced surgeon.

    - John.

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    • Posted

      I totally agree re: the dirty little secret. Docs often  get trained on one device and stick with it bc they’re comfortable with it. That’s why I liked my guy: he’d worked with 4-5 different devices and knew a lot about 7-8 of them. Also, here’s a 2013  list of who the ankle docs would go to if they needed ankle surgery. Top 26 foot and ankle surgeons in North America. There’s one in Charlotte, NC if u decide to meet more surgeons. And not that this list is the be all end all. Also, Duke itself has a strong reputation and is a research hospital so they’re likely always researching the latest and greatest. And—you’ve done a ton of research. Since the Vantage is so new, I’d dig into how they know it won’t fail, etc. since it hasn’t been around long enough to have a proven track record. That said, could be that they created it by making improvements on already proven devices, which would be a good thing. Me, I’m a tad nervous of those who were involved in inventing it bc they have a built in bias. Doesn’t mean they’re not damn good surgeons with a damn good implant. Just worth noting.  Best of luck to your wife. And you—because you’ll be waiting on her left and right for a couple months since she’ll be non-weight-bearing or on crutches and unable to carry stuff. 🤪

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    • Posted

      Thanks, Lauren -- confirms our process and belief.  Especially the part about waiting on her hand and (ahem) foot...!
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  • Posted

    Ps. There’s also a Facebook group for total ankle replacements. I just joined and got some decent tips and insights from others. Cheers!
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  • Posted

    P.s. Any chance your wife's doc at Duke is Dr. Easley? If so, some folks are saying good things about him in the Total Ankle Replacement Group on Facebook. Just an fyi. 

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    • Posted

      It is Dr Easley.  I did join the FB TAR page; Aldo Apache there.  We might have “talked” already!
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