Total Ankle Replacement?

I didn't have an ankle replacement but I broke my ankle in 3 places in January 2013. Incidentally I broke it during an obstacle course run, so I considered myself very fit at the time.

I was in the hospital about a week. Of course I needed 3 days of medication and ice to reduce swelling. I had the surgery and was out the next day.

It was pretty painful until I had the surgery and was in the cast. I had a cast up to the knee. Once I was casted there was little pain (other than the itching!) and so I got off the painkillers ASAP. I had an appointment at the surgeon's office about every other week when the cast would come off and he would look at things. The technician would clean my leg and put a new cast on. I guess I went through 4 or 5 casts, I always chose a different color.

All the time I had the cast on I opted for a wheelchair and crutches. The chair was a good way to get around in the home but it was a major pain to go out. For short trips out (like to lunch) I used crutches. But mostly I used the chair. I can tell you it was a loooooooooong 6 weeks.

After the hard cast I went into an air cast. I kept the chair for this but mostly used the crutches. I was far more mobile at this time for a few reasons. The air cast was lighter. Plus I could take it off for sleep so I slept a lot better. The hard cast was difficult to sleep in for a variety of reasons. I eventually stopped using the chair and sent it back at this time.

Beginning to walk again was a process. I limped for a long time. I also had a follow up surgery at this stage, around May. One screw bothered me so he removed it and he did something else to remove scar tissue.

Once I healed from the second surgery I started rehab. My leg was noticeably smaller than the other and 6 weeks of rehab really helped bulk it up. It also helped with range of motion and flexibility although I still had a slight limp.

By December I could walk at a normal pace. The limp was almost gone and my leg was almost back to normal. I could feel some of the hardware in my leg so I opted to have it removed at this time. I think I am in the minority on this but the surgeon did it anyway.

By February 2014 I was running a little bit. Progress was slow though, I might have swelling or pain at times. By October I was back to "normal" and ran a 10-miler and did ok.

Long term I've lost some flexibility and also some balance but overall the ankle is as good as new.

A few tips. Make sure you have a shower with a hose and a shower chair. I got these and they helped a lot. At first I used a pee bottle quite a bit since it was a pain to get up in the middle of the night to pee. So make sure you get one. Also, they will give you way more pain meds than you need. They gave me oxys and I hated them. The side effects simply weren't worth it. After the second surgery I requested a different painkiller and they gave me Vicodin. I did a lot better on these and really only needed them for a day or two. I think I have a bunch in the medicine cabinet still.

Drink a lot before and during recovery. I think staying hydrated helps a lot. And if you're on any kind of painkiller you're constantly thirsty anyway.

Good luck and keep us posted.

 

Dave, ankle replacement surgery has come a long way over the past few decades. Wrights system appears to be a good one from what I've seen. I assume your ankle joint is so far gone that other alternative surgeries or treatment wouldn't be beneficial. Duke is a good center as I'm sure your surgeon there has a lot of experience putting them in. Key afterwards is to get rehab ASAP as periods of inactivity or immobilization can lead to other complications. Your surgeon will go over them if he hasn't already done so. Good luck and best of health to you.

Best,
Tom

 

I would also ask if the procedure can be performed under spinal/epidural or if you have to go to sleep include a nerve block. This has been shown to reduce pain not only in the short term but also from the chronic perspective. Do insist on multimodal pain therapy including COX2 inhibitors and meds like Lyrica/gabapentin. I am guessing Duke has an acute pain service to handle this-but definitely ask and insist on it.

 

Good to hear Dave. Good luck with your recovery.

In my experience the nerve block unfortunately wears off pretty fast, after a day or two.

Are you home now?

 

Amazing stuff, thanks for sharing. And I wish you a quick recovery.

 

Looks good! Hope your recovery goes well...I have had many surgeries and my leg, ankle, knee surgeries have been tough to get through, worse then arms and elbows...

 

Hi! Great post and congrats! May I ask who your surgeon was at Duke? I realize it's been forever but my mom has had not one, but two failed TARs - in 2012 - STAR and 2015 - INBONE. We're in the DC Metro area. Thx in advance for any info you can provide and stay healthy!!

I'm sure it has. My mom has had two failed ones that have both shifted (loosened) not even 2 years later - STAR in 2012 and INBONE in 2015. :/

WOW - that's awesome. That's the doc we should have seen.... :/

 

Dr Robert Mills at Holy Cross in Ft Lauderdale. He's the ankle guy for all the South FL sports teams.

https://www.holy-cross.com/provider/robert-h-mills-md-orthopedic-surgery

 

((Interesting that the CEO of Wright attended my surgery (with my permission) to see some of their products being installed...)))

You get a deal on the hardware?

Recover quickly and well...