Ankle replacement surgery

I am wondering if anyone has had ankle replacement surgery? How has it affected your golf game? Three years ago I had partial knee replacements. My quality of life went from a 3 to a 9. My golf went from an 8 to a 7. Well worth it. With my arthritic ankles, I can hit shots without too much pain and shoot 78-82. Would like some feedback from fellow wrx'ers that have gone thru the same physical issues. Thanks

I had a hip replacement last year at only 25 , the surgeon messed it up and damaged a nerve i now have something called drop foot and no feeling in my left foot and most of my leg. Golf wise i can still knock it round in mid 70s but i feel my life has been ruined i am finally starting to do normal things again. I hope everything goes ok and good luck with the surgery

Sorry to here about your bad luck. Hope things get better as time goes on. My two knee surgeries went very well. Just never know.

Hey Bro, I hope that you are well and things and your ankles are doing better.

Regarding an ankle prosthesis, let me say that I had an orthopedic implant distributorship(hip/knee/shoulder) for 19 years prior to selling it in 2011. I personally "covered" over 3400 hip replacement surgeries, 2800+ knees and 900 shoulders(far fewer of these done). I also was the only non-MD on the University of Pittsburgh Medical Center(UPMC) Orthopedic Grand Rounds Lecture Schedule, where I lectured for 7 years on the pre-operative versus post-operative biomechanical changes of a hip and knee. My point is that across those basically 2 decades I was fortunate to share both the OR and the lecture podium with the finest surgeons on the face of this earth and from across this great country(seriously, our health system may be screwed up but there's a reason that surgeons from all over the world come here to train and we send ours nowhere outside our own borders).

I will make this short and sweet-

One of those Iconic surgeons, Frank Jobe(look him up, it'll be good to learn about someone outside your industry or the PGA Tour ), when asked about an ankle Implant stated simply, "We as surgeons have an insufferable arrogance and cannot accept that indeed God may have given us a part of the human body that is not meant to be replaced."

Simply, there are wayyyyyyyyy too many forces & stresses incurred by the ankle joint to be able to insert a piece of metal to be able to withstand those forces and stresses working over time and NOT fail. The clinical history and outcomes are horrid and I don't care what you read. I'm talking cataclysmic failure(catastrophic in medical jargon). Think about the size of the joint, even on the largest man, carrying one's body weight in addition to the forces and stresses caused by dynamic movement and when that "blows out," and trust me here, it does indeed "blow out," well it ain't pretty. It's horrific most of the time.

Remember, "insufferable arrogance."

I don't care who is sitting in front of you telling you whatever the latest line of insufferable bulls*** is that accompanies the latest attempt at attempting the impossible, lol.

The options for the ankle are not nearly as positive as the other joints of the body due to it's location and those forces and stresses.

Unfortunately, the procedure of last resort, though it will give one a semblance of normalcy is the basic salvage procedure, an ankle fusion.

My only other word of caution is to be careful with the cortisone shots-

Believe me, I've had several hundred over 17 years of football, in my knees, shoulders, elbows, wrists and yea, both ankles-

Sometimes it's a great "quick fix."

However like everything, there is a downside to these.

They can mask the pain and damage that is occurring, which is the body's way of saying, "hey a**hole, I'm broke, fix me"

They also eat away at the soft tissues in the effected joint, ironically making it more unstable long term.

I'm sorry is this isn't what ya wanted to hear Bro, though any Pod worth his weight in s*** would tell ya the same thing

If he doesn't, and you're sitting with him and he snidely asks ya "and where did your friend go to med school," I'll give ya my number and you can give it to him and just sit back and enjoy the conversation, lol.

Seriously though, I wish ya the best both with your health and your Game!!

God Bless,
Richard

Richard, that is exactly the kind of information I am looking for. I want to thank you for taking time to write it. Very informative. I have an appointment at UPMC for an assessment in a few weeks. Everything I read comes from people who benefits financially. Your response gives me reason to pause. I will go to hear what the doctor has to say, but with a different mindset.

I doff my hat to all you chaps that have these ailments and continue to play golf and post good scores !

Great post from Richard as well.

[quote name='jeggolfer68' timestamp='1442626485' post='12333552']
Richard, that is exactly the kind of information I am looking for. I want to thank you for taking time to write it. Very informative. I have an appointment at UPMC for an assessment in a few weeks. Everything I read comes from people who benefits financially. Your response gives me reason to pause. I will go to hear what the doctor has to say, but with a different mindset.
[/quote]The very best to ya Bro-

UPMC has a solid orthopedic department, though you've got a better one up in Cleveland at the Clinic.

UPMC has an unbelievable marketing machine-

I like that with a corporation though I am very leery of it with a health care delivery system or hospital.

Your looking at 12-15+ years with a well done primary(first time/virgin) hip or knee replacement, with many now hitting 18-20+ years on the hip side(this is the "easiest" joint, surgical protocol wise, to replace).

The clinical studies are not nearly as favorable on the ankle.

I would say that 5 years would be the mean if all studies were combined.

And the big issue is that you are young and that prosthesis IS going to fail while you are still fairly young!!!!

What next?!?

There is only one option-

Ankle fusion-

While there are Revision hip and knee implants that have excellent long term results/outcomes(10+ years), there is no viable Revision Ankle Prosthesis.

And the bigger issue is that when that primary ankle prosthesis blows out, there will not be any good bone left to anchor an implant to anyway, lol.

The surgeon that would tell you otherwise is a charlatan!!!!

As I said earlier, I would ride it out, use the cortisone as needed though sparingly, and IF you get to that point pain wise and/or loss of daily activities wise that your standard of living just sucks, I'd go with the fusion and be done with it-

That, you can ride off into the sunset with

Well, I'm splitting my time between the Cleveland Clinic and Hillman(Shadyside Hospital, Pgh) for my chemo/radiation and therapy, but PM me and I'll give ya my number if you'd like to meet for a pop while you're in town

Take care Bro and the best to Ya, whatever path that you take!!

God Bless,
Richard

Richard, my sister knew someone who had 2 ankle replacements, I thing 07 and 2010. I did talk to him. He said so far so good, golfing and walking. I don't know what level he plays the game at or how often. I have given a lot of thought to the replacement failing. You bring up many good points, especially that I am 62 and this replacement will fail. I look at a guy like Jordan speith and see the stress he puts on his left ankle. I'm sure all of us stress that ankle during the swing. You mention the use of cortisone. I have only had injections once, in both ankles this past spring. For 2 months my ankles were a non-issue. I know it damages tissue and bone over time, so I have avoided anymore shots. Currently I wear ankle braces 100 % of the time golfing, a mixture of biofreeze and some oil my wife uses gives me some relief. A hot soak helps too. I am trying to not complain, I know many people are so much worse off. Hopefully this thread helps others as much as it is helping me.

[quote name='jeggolfer68' timestamp='1442670134' post='12334994']
Richard, my sister knew someone who had 2 ankle replacements, I thing 07 and 2010. I did talk to him. He said so far so good, golfing and walking. I don't know what level he plays the game at or how often. I have given a lot of thought to the replacement failing. You bring up many good points, especially that I am 62 and this replacement will fail. I look at a guy like Jordan speith and see the stress he puts on his left ankle. I'm sure all of us stress that ankle during the swing. You mention the use of cortisone. I have only had injections once, in both ankles this past spring. For 2 months my ankles were a non-issue. I know it damages tissue and bone over time, so I have avoided anymore shots. Currently I wear ankle braces 100 % of the time golfing, a mixture of biofreeze and some oil my wife uses gives me some relief. A hot soak helps too. I am trying to not complain, I know many people are so much worse off. Hopefully this thread helps others as much as it is helping me.
[/quote]Hey JG, thanks for responding-

The questions that I would ask the individual is obviously what implant was used, because just as there are total Knee prostheses, which cover the two distal(bottom) portions of the femur(thigh bone), including both the lateral(outside) and medial(inside) condyles, those two large bony prominences at the distal(bottom) end of the femur, along with the proximal(top) portion of the tibia(shin bone), referred to as the tibial plateau, there were "hemi(partial/half) implants designed for use with the medial(inside) condyle and medial(inside) portion of the tibial plateau, due to the fact that the medial femoral condyle is the more prominent condyle and this is, 80-85% of the time where the most severe cartilage/bone wear and damage is done.

So, the thought was instead of doing a total knee when only 1/2 the knee was really damaged, let's make an implant that will "fix" the damaged portion(medial), while leaving the functional and usually pain free area(lateral) untouched.

Well, as many know, what works in theory or the laboratory(in vitro) does not always work in application(in vivo) or inside the human body.

Simply, these hemis did not work-

Failures-

So, and remember please, "Insufferable Arrogance," the companies and docs forgot about hemis and stuck with the tried and true Gold Standard, the total knee prosthesis.

Well, that arrogance reared it's head about in the 90s and into this century as now the companies(and the docs on their payroll) said that they had the material and improved implant design to make a viable hemi knee implant now, LMFAO(and I can count on less than one hand the times I insert the "F" in this acronym, lol).

It's that variation of "it's the economy stupid."

IT'S THE HUMAN BODY STUPID

It ain't about the material-

It ain't about the implant-

And it sure the hell ain't about the surgeon(Insufferable Arrogance, LMAO)

It's about our body, and the intrinsic stresses and forces that are transferred across that medial portion of our knee that make it virtually impossible to successfully(long term, 10+ years) anchor a hemi prosthesis there.

Even though I use the knee, if I were speaking to surgeons or surgical residents/Fellows, I would use this same analogy with the hemi versus the total ankle implant. The correlation is appropriate and accurate. It is still the belief of the finest Orthopedic surgeons on the face of this earth that ankle is a joint that is not meant to be to be replaced.

And here's the other issue and this was ingrained in me when I was 11yo and asked my Father why he did one procedure versus another as a Renal(kidney) Transplant Surgeon.

He said that every single surgeon, no matter their specialty or area of expertise, had to asks the question that WHEN this procedure ran it's course, and though we have clinical studies now going back over half of a century on most joint replacements, what is the condition of that patient going to be and what am I(or whomever) as the surgeon, going to do next for that patient. So in essence, you plan for eventual failure. It may be 5 years, 10 years, 20+ years, but if the patient is still on earth, the day is gonna come.

Now I realize, and never saw it clearer than at my Father's side when a little 3-5yo child has one option to livin and dyin and it was the man standing next to me, and he had to do what he had to do to give that little child the best chance to survive, and he probably was not thinkin really hard about what the hell he was gonna do if it rejected and an infection took, but these are extreme cases, and the exceptions, not the rule.

The bottom line is that when you Sis's friend's ankles go, and I take he's middle aged so they're gonna go, what is going to be left bone wise to work with?

Answer:

Not much-

Option-

Fusion...

Which isn't that bad as long as he didn't lose enough bone to cause a limb length discrepancy, or it was trauma induced causing secondary vascular/nerve damage or enough bone loss/damage that he's gonna have to have enough rods, plates and screws slapped in him that he'd have the SWAT team on his a** quicker than he could bat an eye goin through the metal detector, lol.

As I said, I just was fortunate to have scrubbed in with the most elite of the elite Orthopedically, and these men were as close to God sent as it's gonna get on this earth, and to a man, while they were magicians in the OR, and most if their best work couldn't be duplicated much less taught to others, they had a fundamental conservative streak that basically future outcomes could be accurately predicated on past performance.

And while evolution comes into play, along with the surgical, material & prostheses improvements that come with it, there are some basic immutable physiological & biomechanical laws that should not be violated-

They are what they are, and short of God intervening, or a magician waving a magic wand over one's ankle, no amount of in vitro(laboratory) studies are gonna change that-

Besides, I never ever took my next hip or knee for granted just because I'd been in thousands of them. I looked at every MRI, every CT, every XR and every clinical note to determine the implant to recommend to the surgeon.

My point is that I would want to speak to this Gent and find out the particulars of both him, his pre-op conditions and symptoms along with the implant used-

Well, sorry to ramble Bro, lol.

It's just that this stuff is a little deeper than the average WRX post and I wouldn't feel right not at least voicing my thoughts and opinion.

Again, you're in my thoughts and Prayers

Fairways & Greens My Friend,
Richard

That was a good read , thanks for the info .

I am slowly on the mend now and the main thing is i can still play but need a buggy.

I hope the op goes well , best of luck

I have had 4 surgeries on my right ankle. 66 years old and still walk golf when I can. The first surgeon recommended an ankle replacement, this was 20 years ago. I said no then.
My worst pain is plantar fasciitis caused by tight calves. The last surgery involved cutting the gastronemius muscle to release tension, That did not work and My right calf did not recover, it is 1/3 less size than now before.
Hopefully I am around in 10 years, then, maybe I might look to a replacement, have read way too much negative over then years and have had surgeons tell me how much better I will be after surgery, NOT, the ankle is too much load bearing, twists etc

First off, I would like to thank the moderators would allowing this conversation to continue. I believe it is important to the senior golfer who is trying to find a way to continue playing the game despite what his body is telling him. I would like to see "health issues" as a main topic. One person may post a reply for a problem that could help someone get back on the course.
In one of my previous posts, I mentioned a friend of my sisters having both ankles replaced at UPCM. They were agility ankles by Depuy. Both my knees were replaced with an implement by Zimmer. They were both done in early 2013, medial partial knee replacements. They were done by Dr. Roger Palutsis. He is the team Dr. for the Mount Union football team. He is very sports oriented and understood my concern to maintain my golf game. I believed then and still believe it was a sound suggestion, and am very happy I followed thru with it. My ankle appointment is a week away. I am hoping that Dr. comes up with alternatives to ankle replacement (not fusion yet) that will offer relief. Thanks for all your post.

Visited doctor today. Great news, no ankle replacement recommended. Bad news, both feet need tmt fusions on the 1st, 2nd and number 3. Also my right ankle need lateral ligament reconstruction. Ligaments have detached from the ankle. He feels this will keep that ankle from getting any worse. Minimum 2 surgeries total for both ankles. Each one will keep me off the course about 6 months. Hopefully all my recovery will be during the next two winters. As a great 89 year old friend likes to say, "such is life".

I do foot and ankle surgery for a living. It is my job. I am good at it. I would say I'm very good. With that being said, I don't perform TAA (total ankle arthroplasty). Richard has stated succinctly the reasons they fail. The results are great in a 100lbs woman with RA who is sedentary. Ankle fusion is STILL the gold standard. When a solid fusion is achieved, it will last a lifetime. It is very stable. I can think of one patient of mine inparticular whose ankle I fused several years ago who is a big horn sheep hunting guide. He walks rough terrain for a living and is fine with his fusion. If you really do require ankle surgery for an arthritic ankle, go with the fusion. It will last and be hassle free generally speaking.

[quote name='jeggolfer68' timestamp='1443490827' post='12381626']
Visited doctor today. Great news, no ankle replacement recommended. Bad news, both feet need tmt fusions on the 1st, 2nd and number 3. Also my right ankle need lateral ligament reconstruction. Ligaments have detached from the ankle. He feels this will keep that ankle from getting any worse. Minimum 2 surgeries total for both ankles. Each one will keep me off the course about 6 months. Hopefully all my recovery will be during the next two winters. As a great 89 year old friend likes to say, "such is life".
[/quote]

Ask him to perform the TMT fusions and ankle ligament reconstruction surgery at the same time. This would mean less overall recovery time and two fewer trips under anesthesia.

Chiva, he is going to do the tmt fusions and ankle ligament reconstruction at the same time, early December. I am 5'8", 172 lbs in pretty good shape. I did very well with rehab after my knee surgeries. That said, just as a general educated guess, when do you think I can golf again? I am a 62 year old right handed player. More a tempo player with average swing speed. Around a 7 handicap. thanks for replying on this thread. Great advice and information john

A little inspiring story for you - a friend of mine found out he had melanoma in his eye. It had to be removed. He was having it out on a Monday, so the Friday before, he was at the driving range wearing an eye patch. When he was done, he walked into the clubhouse and said, "it [i]can[/i] be done" and went off on his way.

I understand that you have a good surgeon that you have confidence in however I would say to others looking at future ankle surgeries, I would give a serious look at a Podiatrist, and not just blindly go with an Orthopedic "Foot and Ankle" specialist.

While I have been in thousands of hip and knee surgeries, and seen almost as many on live distance video feed, I have "only" been in 550-560 ankle surgeries(My distributorship had the instrumentation and hardware) and THE three finest Ankle surgeons that I observed were Pods.

And one was out of HSS(Hospital for Special Surgery, NYC), one of the Meccas for Orthopedic Surgery, world wide-

He was as smooth as glass, lol

And s*** hit the fan that day, medically, and he never lost his focus and let the other docs do their jobs and he did his. While anyone who puts on gloves is trained for this happening, I have witnessed renowned surgeons, regardless of specialty, fold like a cheap suit in a similar situation.

I have also been with excellent Orthopedic F&A Specialists, however I will say right here that THE Crème de la Crème of the future Orthopods, surgically, do not leave Med School and say "Boy, I wanna go find a F&A residency," LMAO

Nope-

The "sexy" sub-specialties and programs, and not to mention the ones with annual compensation of north of $500K with the top dogs still north of a mill, are the sports meds, total joint arthroplasty(Hips & Knees) and Spine has exploded, where it was once the domain of the Neurosurgeons, that is no longer true and again, the two finest Spine guys I spent time with were Orthopods.

You're gonna have to do some research cuz you got Pods who just do "nippin & chippin(Nails & Corns & Callouses)" and then you'll have some who do forefoot(toes).

But a top rear foot/ankle Pod can run with any Orthopod, and he/she'll be better than most-

The other thing, and this is no way directed at You Jeg, however for those looking for a surgeon, don't be overly influenced by their sports teams affiliations, be they college or Pro. For one thing, 75% of the orthopedic surgical groups that are the "Orthopods for the _ _ _ _ _ _ _ _ _ " PAY the teams/NFL tens of thousands of dollars for the privilege of using that team in their advertising.

Between you and I, it's total BullS***, LMAO!!!

The day that I'd go to hell and back to hang my shingle as an Orthopedic Surgeon and then PAY some jerk-off in a suit for the privilege of treating their Players, well, I think ya know where I'm comin from.

And the kicker is, aside from running onto the field, most of those orthopods don't touch those guys with a scalpel. These are multi-million dollar babies and they're either flyin to NYC, or down to Alabama or out to Denver, Utah or LA if it's a knee, shoulder or major blow-out.

Yes, some, such as Jim Bradley of the Stillers, are World Class, but he's the exception, far from the rule.

Your best Orthopods would laugh at that stuff and are off in a hospital running 2-3 rooms doing more surgery than most could handle and they have no shortage of patients. Plus, and I know and play golf with Jim Bradley(well I did when I was playin ) and while he is world class, he runs what I call an "assembly line practice."

True story:

He did my Father's knee(ligament & cartilage repair)and following surgery, went in to speak to my Father and Mother in recovery. Well, talkin to my Mother about Orthopdics is like talkin to the wall(I Love her Dearly but come on ), and my Father was 8 sheets to the wind on dilaudid(Good s***). So Jim says, "Bada Bing, Bada Bang, did this that and the other" and I'm being facetious but you know where I'm coming from.

So, later I'm in my Father's room with him and he's b******* up a blue streak how Jim spent less than two minutes with him(according to my Mother) and he was higher than a kite and couldn't remember any of it, LMAO.

He was genuinely pissed and had earlier called Jim's cell and b*****(Jim was with me on the course, LMAO)-

Now, my Dad's a good friend of Jim's, they golf together, go on ski trips together, they're coomps.

Plus My Father as the Chief of Renal Transplant UPMC Presbyterian, figured well, he figured that he deserved more than 2-3 minutes, LMAO-

Now I had told my Father this pre-operatively, that while Jim was an amazing surgeon, he wasn't going to hold his hand and take a seat and run through the procedure with him in recovery. Besides, that's a waste of time with most patients cuz they're looped anyway, lol.

So I just said, if you feel like this, how do you think Joe Smith from McKees Rocks feels, LMAO-

He looked away from the TV & told me GTFO, lmao-

However you don't need a bed mate or golf partner, you just need a magician

Look and choose wisely Ladies & Gents!!

Well, the Best to all

Fairways & Greens My Friends,
Richard


Later Ed: 10/05/15, 6:52pm-> I forgot but Jim said my father "sucks as a patient. He's higher maintenance than my wife," LMAO. I swear to ya, that's a quote, lol, and the God's awful truth, haha.

Take care Bros
RP II

[quote name='jeggolfer68' timestamp='1444006882' post='12410366']
Chiva, he is going to do the tmt fusions and ankle ligament reconstruction at the same time, early December. I am 5'8", 172 lbs in pretty good shape. I did very well with rehab after my knee surgeries. That said, just as a general educated guess, when do you think I can golf again? I am a 62 year old right handed player. More a tempo player with average swing speed. Around a 7 handicap. thanks for replying on this thread. Great advice and information john
[/quote]

I keep my patients non-weight bearing for 6-8 weeks off the fused foot with a TMT fusion. Then a walking boot for 2 weeks. Usually in a shoe at 8-10 weeks. Don't rush it b/c you'll screw it up. Be a patient patient!! TMT fusion is a big deal. Let it heal. Ankle ligament reconstruction is no biggie. Maybe 10-12 weeks before golfing again. Chipping and putting at 6-8 weeks. Full swings 10-12 weeks.

Wow, that is really good to hear. I have an Ohio winter coming up and can catch up on reading and Seinfeld reruns. That's for that reply.

Well it's been almost 3 years since this thread ran it's course. I did have tmt on my right foot, along with ankle ligament reconstruction. Tough recovery but all went well. Dr set up an ankle injections every 3 months. This would go on until my quality of life plummeted. That occurred early this summer , and against the advice of forged, I had a right ankle fully replacemant. My left foot and ankle will probably be addressed next summer. If I can have left foot tmt and ankle fusion at the same time I may consider it. At this time in my life, if I can play with my 4 year old grandson and take him to a museum or two, I'll be one happy papa.

Well it's been almost 3 years since this thread ran it's course. I did have tmt on my right foot, along with ankle ligament reconstruction. Tough recovery but all went well. Dr set up an ankle injections every 3 months. This would go on until my quality of life plummeted. That occurred early this summer , and against the advice of forged, I had a right ankle fully replacemant. My left foot and ankle will probably be addressed next summer. If I can have left foot tmt and ankle fusion at the same time I may consider it. At this time in my life, if I can play with my 4 year old grandson and take him to a museum or two, I'll be one happy papa.

Been following this post, and wish you well.

While I have not had anything replaced ....(yet)......I completely demolished my left ankle in '82, when I was 26 yo.

Thought that I would have more problems with it than I have, but I spend time each and every day doing stretching and rotation exercises for both ankles, and can't imagine what a fusion entails.

I hope that you continue to be pain free (always the best thing to keep in mind) and if I can help you figure out how to move your golf swing with the "new" ankles...please let me know.

I've taught people with infirmities, prostheses, fusions, etc for many years, and hope (at least from what they have told me) that they have learned how to enjoy golf more despite their physical limitations.

You know how to reach me!

Good luck

jeg, glad to hear your doing ok. Hope you can find a way to still enjoy the game after all the docs get through with you!!

Thanks for the replies and especially to Augustgolf for his offer. I feel bad for going against Forged's (who is a tremendous asset to this website) advice against partial knee replacements and total ankle replacement. Those decisions were based on having a good chance of getting on the course and maintaining my previous form.

Well it's been almost 3 years since this thread ran it's course. I did have tmt on my right foot, along with ankle ligament reconstruction. Tough recovery but all went well. Dr set up an ankle injections every 3 months. This would go on until my quality of life plummeted. That occurred early this summer , and against the advice of forged, I had a right ankle fully replacemant. My left foot and ankle will probably be addressed next summer. If I can have left foot tmt and ankle fusion at the same time I may consider it. At this time in my life, if I can play with my 4 year old grandson and take him to a museum or two, I'll be one happy papa.

Medical opinions are no different than any other opinion, lol

Clinical studies??

As I've said elsewhere, for every one that I could show ya that says that option A is bad, you could show me just as many saying that option A is the panacea, haha.

Such is the black/white world of medicine/surgery, lol

At the end of the day, it comes down to the Man/Woman holding the scalpel-

The Very Best to Ya and continued good health and improvement.

Thoughts & Prayers,

RP

Interesting read. First note that I am a medical "idiot" so everything is laymans terms. I broke my left ankle in high school (1975) and was okay physically until about 10-12 years ago. Spent a few years of ankle pain as the joint became more and more painful as it was becoming out of alignment and near bone on bone on the outside of the joint. In December of 2012 had it reconstructed as the surgeon told me that replacement was both not there as a viable option quality wise and that to have the replacement I would need this surgery done first to have it properly aligned. At the time it was an 8-10 year fix knowing that I would need replacement or fusion at that later date. The hope at the time was that the replacement tech would improve enough to be a viable option. Had the ankle examined a few weeks ago and all is still good and straight but I certainly do no not have a lot of time left as the joint is compressed with little cushion of cartilage. Lol don't laugh I told you this was layman's terminology. :) Anyhoo it would appear the tech for replacement has really not come along at all to speak of and I will likely need a fusion within five years. He told me that with my still somewhat active lifestyle, mostly golf and some hiking, a replacement would last less than five years with the current tech.

Joint replacement success rates mirror the simplicity and function of the joint: knee > hip > shoulder > ankle. Think about how these joints work and how complex the motions are and what the stresses on the joints are. Like Richard, I wouldn't hesitate to have a knee or hip replaced, would consider but try at most costs to avoid a shoulder, and would avoid at all costs an ankle (unless I was a little old lady or man who just wanted to get around less painlessly).

Interesting read. First note that I am a medical "idiot" so everything is laymans terms. I broke my left ankle in high school (1975) and was okay physically until about 10-12 years ago. Spent a few years of ankle pain as the joint became more and more painful as it was becoming out of alignment and near bone on bone on the outside of the joint. In December of 2012 had it reconstructed as the surgeon told me that replacement was both not there as a viable option quality wise and that to have the replacement I would need this surgery done first to have it properly aligned. At the time it was an 8-10 year fix knowing that I would need replacement or fusion at that later date. The hope at the time was that the replacement tech would improve enough to be a viable option. Had the ankle examined a few weeks ago and all is still good and straight but I certainly do no not have a lot of time left as the joint is compressed with little cushion of cartilage. Lol don't laugh I told you this was layman's terminology. :) Anyhoo it would appear the tech for replacement has really not come along at all to speak of and I will likely need a fusion within five years. He told me that with my still somewhat active lifestyle, mostly golf and some hiking, a replacement would last less than five years with the current tech.

Actually, regarding the ankle, it has never really been about technological break throughs per se, regarding designs, materials, etc, as much as it has been that they cannot put a piece of metal, or in actuallity, two pieces of metal, in that joint space, and have them absorb forces of 3-4 times body weight for a normal person in daily activities and 5-6+ times body weight in athletes engaging in athletic activities.

The easiest, most painless and long term the most successful is to just fuse the ankle. Yea, yea, yea, I know all about the drawbacks of not having flexion in your ankle however one can learn to adapt and work and live around it and they will eventually forget about heir ankle cuz here will be no pain or discomfort.

An article in the Journal of Bone and Joint Surgery(JBJS), the Bible of Orthopedic periodicals, had a 3-8 year follow-up on the cementless/press fit STAR(Scandinavian Total Ankle Prosthesis) ankle prosthesis.

51 STAR ankle replacements were done and an independent pod, uninvolved with either the operating surgeons, patients or implants performed the clinical follow-up.

TWELVE ankles had to be revised!!!

FRIGGIN TWELVE!!!

TWENTY THREE POINT FIVE PERCENT FAILURE!!!

36-96 months!!!

That's incredible, lmao. I don't care if you're the shattiest surgeon on God's green earth, using second gen implants, that failure rate is a disgrace!!!

Bear in mind that the revision rate for a cementless hip at 10 years/120 months is less than 4%(3.8) with your top dogs, 9-10% everyone else, a cemented hip less than 2/%(1.88), again, the Best against 7-8% for the herd and while a knee replacement is about 9-10%(9.65%) at 10 years, that number includes ALL of the surgeons in the National Joint Registry, which includes a lot of friggin chops. Your big Dogs are at about 4-5% so ya definitely wanna go to a go that specializes in the particular joint that you're having replaced. If I had to have a knee, hip and shoulder replaced, I would go to three different surgeons though if my knee guy would do my shoulder, I'd let him because one, the shoulder is the easiest of all of the joints to replace successfully, from a procedural standpoint to rehab to post operative results. I hate to use the word vanilla however a total shoulder is as close to "vanilla" as a joint replacement will get.

The main reasons for TAA(Total Ankle Arthroplasty) are aseptic loosening(38%), technical error(15%), pain(12%) and septic loosening(9.8%).

The difference between aseptic and septic is that aseptic loosening is caused by some type of infection while aseptic loosening is not and contributing factors can be bone fracture, brittle bones(osteoporosis), which can be a byproduct of aging and especially in females, hormonal changes.

The loosening goes back to my comments regarding having a joint that can be machined to accept, hold and support an artificial prosthesis. Forget the 15% error rate that goes to show ya that guys are doin this procedure who have no friggin business anywhere near an ankle with a scalpel, because it's higher than that, as that's just what hit em in the face and they had to admit to, lmao, however a portion of that loosening along with the post-op pain is a direct result of a poorly done prosthesis.

Look, hips are basically 90% good at 10 years and 80-82% at 20.

THAT is incredible and a measure of the quality of our top Dogs.

The failure rates of a TAA are more related to the joint than any of the other joints because of its location, its diminutive anatomical shape and function.

It is what it is though I hope that I and a lot of world renown orthopods are proven wrong and we've turned the corner with TAA's.

At this point in time, the numbers do not bear that out.

Stay well Bro and Madison sends thoughts and hugs?

Me??

You'll have to settle for a fist bump?

???

My Best,

RP

Fist bump back at ya Richard and thank you for the detailed write up. So far I'm doing ok but know a fusion is in my future, especially if I keep playing golf and that ain't going away. My wife would never stand having me home all the time! :)

Hope your medical is going as well as possible.

Hilgy

I had an ankle fusion on my right ankle about 5 years ago and have had nothing but pain in it ever since. I am now 63 years old now, 6'-2" and about 250 lbs. I played a lot of baseball and the operation was necessary after spraining my right ankle probably 30 times over the years. The ligaments in the ankle were shot. Started out by getting a calcaneal osteotomy and that worked for about 2 years and finally had to get the fusion. I now walk with a limp and the ankle is constantly sore. I love playing golf but my game has gone to complete s*** since the surgery. My limp has changed my gait and my lower back is constantly sore. I'm in a lot of pain. I was once a 14 handicap but I am now a 25. It's no fun to play and I think a good part of that is because of the physical ailments. I have worn a brace while playing and that helps somewhat but the ankle is even more sore after I take the brace off with throbbing pain. I live on Aleve. Any suggestions to help me? I have gone back to the ortho doctor but they said the problem is more arthritis in the foot further toward the toes from the ankle. I'm so sick of the pain and could use any suggestions I can get to help me. Thanks!!