At a crossroads with my ankle problem

Good day!

I am currently 27 and had ankle surgery in March of this year, I had a screw placed in my medial malleolus to fix a non-union.

I just received a cortisone shot 2 weeks ago to try and relieve some of the pain in my ankle, And it did not help, seems like at times it has gotten worse.

I seen my family doctor yesterday, and he has referred me to a sport surgeon for a second opinion on my ankle. What bothers me the most is, the doctor told me my ankle will probably never be at 100% again and I will have to attack the pain after it happens, likely meaning staying on pain medications for the rest of my life.

Have any of you had the same problem as me, if so, what did you do? Did you look into any other methods to help with your pain or to try fix the problem?

I'm at the point where I almost think it is time to give up on trying to fix my ankle and move on with coming to terms with always being in pain.

Thanks for any help and tricks that may be out there!

Dear Matthew

Sorry that you are having bad ankle issues at such a young age. I wonder if you could give us more detail as I cannot really grasp what the problem has been. All the best, Richard

Good morning Richard.

Thanks for your well wishes.

Before the injury, I was more of an athletic person, I played hockey, ball, enjoyed running and working out.

I have not been able to run, much less jog in almost 2 years, I can not jump or do a basic hop on my ankle.

Walking or standing on my foot isn't much better, as i get constant pain through-out my ankle after only a short while. Resting my foot is hard, as letting my ankle loose causes pain and keeping it straight causes pain as well.

Maybe my problems seem insignificant to most, cause there are people with far worse scenarios than mine, but starting to get frustrated with my foot and not sure what to do.

Thanks again all!

Dear Matthew

Thanks for telling us more about you but all we have to go on in medical terms are what you first wrote as follows:  I had a screw placed in my medial malleolus to fix a non-union.    Can you give us more details please?

Cheers, Richard

I had my surgery in march, which I mentioned was a screw placed in my medial malleolus to join a nonunion, and the screw will stay there permenantly. At the time he said i had a stretched tendon, but did not want to do surgery on it as he was hoping it would fix itself. At my 8 week follow up, my surgeon said that my nonunion was joined and there was nothing else he could do to help me, as my other pain was from presurgery and would have to be worked through, At this time he released me from his services. I went through physio for a second time and they released me as I gained mobility back quickly.

The doctor I have been seeing, has not given me much information as to what is wrong now, as he thought time would help it heal. I have gotten a two cortisone shots to try help, one during surgery and one a few weeks ago, but neither has seemed to do anything. Now I am at this point, seeing a sports surgeon now, hoping he can maube help me .

I had a spiral fracture of the fibula no op so no screws or anything.  Been a nightmare, tried everything from acupuncture to physio still very little improvement - dont believe I will be there for the rest of my life but have been told it will be at least a year before normal again.  It has been 7 months, still swells up and is sore most of the time!  I wish I could give you positive news but stay positive!  I broke mine in April this year!  The worst thing ever!

Sorry to hear about all the problems you are having, I feel your pain and it sucks for sure!

My initial injury happened in June 2016, and i tried dried needling and physio with no help, then got an MRI and surgery afterwards.

Hoping the new year brings some positive news for you and hopefully youll notice some improvement as well!

Hi Matthew,

So sorry for your pain.  I think we all know what your going through at some point or another.  The first thing to me that is concerning is a cortisone shot in your ankle. From what I understand and I may be wrong but that is the worst thing you can do for an ankle. My specialist would not give me one because it actually does something to the

ankle that isn't good for you or it and also will give you more pain! 

  I went to a Orthopedic surgeon who was wonderful after playing around with doctors who had NO idea on how to help me. After a MRI a yr after my accident , he confirmed that I indeed needed surgery ... and now I'm 3 weeks out and doing much better. 

 Go to an Orthopedic surgeon and have them do the MRI. It could be something is not healing right and so on. It can't hurt. You are so young to be living like this. 

I wish you luck! 

Rose

Dear Matthew

Thanks for explaining.  Hopefully this will result  in some useful suggestions for you.

All the best, Richard

Hi Matthew,

My husband has always been active and worked out with weights everyday. He retired from the police dept 2 yrs ago and it seems as if everything is having to be replaced. We started with the left shoulder complete. He did well with that. The next year the left knee started in. After every possible fix, it came down to a TKR. That was in May. He lives in constant pain daily with this ankle. He had rehab long enough where he almost was off the walker or cane. But with the ankle now he has to have walking assistance daily. The pain is unbearable. Believe me he lets me know. After 3 different foot and ankle ortho it has come to a complete replacement. Yes it will rid his pain  but they can’t tell me he will walk alone without assistance. I really would like to hear from anyone who has had to undergo this surgery. 

Matthew so sorry to hear that you are still in pain. It is 10 months now since my surgery and my ankle is still swollen and  I still have a lot of pain, been diagnosed with CRPS now, so the pain thing is going to be part of the rest of my life, but you are a lot younger than me and can fight back. Do NOT give up, I am regarded as elderly, but I am not going to give in to my limited movement or pain. I will not take the nerve blockers or painkillers offered by my doc because I want to be in full control of myself. Good Luck x

Dear Stephanie

Am I right in understanding that your husband is planning to have a total ankle replacement? I had a TAR five years ago but it has gone wrong and I'm waiting for what will be a very difficult revision.

If it is of interest you can see how I was doing at twenty weeks by watching a short video on YouTube by doing a Google search for Yogesh total ankle replacement. I'm happy to answer any questions you may have.

All the best, Richard

Matt, I don’t know how severe your break was, but it sounds like you have more hardware than just a screw holding it all together. I broke my ankle in 3 places this last April, and am working on my 2nd infection on the right side of my ankle. Granted, the  first one was due to a pin that came loose and started coming up thru my skin. After they took that out I thought I was fine. Then about 3 months later I went back to my doctor due to swelling and pain. I did put some ice on it which did help with the swelling and pain. But one month later, I was back again with a low-grade infection covering up a hematoma. I’m now scheduled for a CT scan this Monday to see if the bones healed completely. If it has, she’ll be taking it all out in January. I think my body is rejecting all the metal in my ankle, and you know that leaving all that stuff in there can lead to arthritis among other problems. I’d check with your Dr. and ask about getting all your hardware out too. Good Luck!

Dear Rusky

I'm sorry that you are in pain. I do respect your feelings about not relying on pain killers however it is generally considered that the body heals a lot more quickly if not in pain.

Cheers Richard

Hi Rose,

May I ask kind of surgery did you have on your ankle? My husband has a build up of arthritis and we are now looking at a TAR. 

He’s also had a cortisone injection, an ankle boot and many others. 

Thank you for any advise. 

Stephanie 

Hi Richard, 

I did watch your video along with the other 2 surgeries that were offered. You appeared to be quite fit if indeed you had a complete AR. What type of complications are you undergoing at the present. Have these problems come up later after 5 years?  We were told he would be great for a minimum of 10 years. 

But honestly you looked fit and no signs of any limping or pain. 

The dogs looked healthy also. 

Thank you 

Stephanie 

Rusty when you say CRPS what is the meaning. I wish my husband could tolerate some of his pain, but nothing helps him. Cortisone injection only lasted 24 hours. It is unbearable and leaves me feeling helpless. I pray for a miracle but...

Thank you

Stephanie 

I was in the same situation and I chose to have an amputation.   I’m now walking again pain free. 

Dear Stephanie

Thanks for your kind words! Yes I think I'm pretty fit or was as the last year what with the ankle going wrong and whilst waiting for the ankle revision my twenty year old hip on the other side wore out so I've been far less active. Yes the dogs are lovely but sadly they are only in my thoughts now.

Yes I had a total ankle replacement at 71.... now 76. I will try to post a picture tomorrow from my laptop of a recent X-ray that shows what the problem is. Sorry but I cannot see how to upload pictures to this site from this phone.

I was hoping for at least ten years use of my new ankle as it is a pretty tough recovery for most people and this revision is going to be very difficult.

The issue is osteolysis, something that surgeons will not warn one about although it is not that unusual. It is thought to be caused by wear debris from the joint resulting in the body reacting and producing cysts that destroy the bone material and then the prosthesis breaks or falls out. All artificial joints are at risk of osteolysis I was told by the makers of my prosthesis and my research reinforces this statement.

As you will see from the X-ray I will try to remember to post tomorrow my prosthesis was badly positioned and at the wrong angle by 20 degrees. This would have caused potentially more wear debris to be produced not helped by the fact that I was very active.

For anyone embarking on a TAR it is absolutely essential to find a surgeon who has and is doing a lot of these surgeries and their level of success is high.

Here in the UK many surgeons dabble in TAR s but never become expert in what is an extremely critical procedure as they only do a handfull each year at best. Please pick your surgeon based purely on his/her record and not if you like them or not. I really cannot stress this enough.

I hope this helps but ask away if you want anything more. If you would find it helpful to talk on the phone just send me a message.

Cheers Richard

Hi Stephanie,

I had two ligament reconstructed Nov 13th. Also a lot of "cleaning" up in there also.  I haven't spoken to my surgeon since the surgery I go on Wed to actually find out what I had done.

I did however, have arthritis on my left foot and had that scraped and repaired. He also took 40% of my bone on that foot. That was August 2nd... and it still hurts like holy hell! Not easy.  Regardless of what is being done when it comes to ankles /feet its a long, tedious recovery.  

Best of luck to you and him!

Rose