Any experiences with ankle fusion? (Human not horse)

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MadJ

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Not strictly c&t but I'd like to know if anyone on here has had the above procedure and how much it has affected/benefited them with regards to riding and competing.
I really don't want to consent to something that is going to leave me unable to do what I want with regards to the horses. I'm aiming to start BD next year and would like to return to jumping again one day but I'm well aware of the extra strain jumping puts on the ankle, hence why I haven't done much since the injury.
I'll be having further tests and it's early days but my consultant has already suggested fusing the joint maybe the best option for my problem.
Can anyone give me any views or personal experiences on this please?
 
I will be watching this with interest as my consultant has also suggested this for me and I am hesitant too.
There are now ankle replacement ops being done which was another option for me - has this been suggested for you?
 
Not quite what you are after info wise, but may help.............I broke both my ankles many years ago and as the result of osteophytes they have more or less fused themselves. I looked at having them 'scraped out' but decided against it as the success rate wasn't great and many were left worse than when they started. At the time the surgeon I was recommended in this country was Patrick Laing based in Shropshire.

Sooo, with more or less fused ankles I have zero degrees dorsiflexion which has an impact on your security in the saddle. I have to use custom made orthotics from USA and cannot walk barefoot one step. Soft tissue damage in the ankle is a source of constant pain as sometimes the tendons/ligaments allow a certain degree of movement that the joint does not.

Had not heard of ankle replacemen ops EllieK....any info appreciated as this maybe something I need to look into in the future.
 
I'm afraid I don't have a huge amount of information on the replacements other than the fact that they are newly available and just starting to be used in a handful of patients under the NHS. I don't think they are total joint yet though (I do stand to be corrected!).
Thank you for your experiences - it is really useful to know. I'm guessing we've probably all done different damage to the joint so outcomes etc will vary but its great to get an honest view!!
 
I'll keep the replacement in mind next time I see the consultant as it's not something he mentioned. I have to go back for a CT and he wants to inject the joint with an anaesthetic to see if there's an improvement in the pain.
I just can't get my head around riding with an ankle that can't move.
 
MadJ said:
I just can't get my head around riding with an ankle that can't move.
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It's doable.....though I guess it depends on what you are used to doing! I still hunt and show jump; you have to adapt your position and consequently I nowadays am careful about the horses I get on as my lower leg is no longer as secure as it used to be. Having said that, I acquired a new four year old three months ago. Time will tell!
 
I have an ankle replacement. Patrick Laing at Oswestry orthopaedic hospital is my consultant
At first he suggested fusion but when untold him I needed the flexibility to ride he agreed

Because of other complications it hasn't been plain sailing. In fact ive just had more surgery to correct another problem in my foot

It is a complete replacement google 'ankle box joint'

All in all I have no regrets. And recommend him to anyone

I just visited my gp and told him I wanted a federal to him.

There are people in his clinic from ALL over the uk. And somehow his waiting lists are still shorter than most
I will do everything I can to avoid fusion. Even more sonafter seeing so many people having to go to Oswestry for repeated attempts at fusions. The bones often don't fuse together leaving people in casts non weight bearing for upto a couple of years. In fact one lady had been in a cast for 3.5 years. She said she had no medical reason for the bones not to fuse either

Patrick already knows that if ever it comes to fusion (which it probably will in 15-20 years). He will have one chance at fusing it. If that doesn't work I will be considering amputation
 
Although I am cross with him ATM. I was supposed to be weight bearing. But when I came round was told no weight bearing for 4 weeks
 
I badly broke both ankles about 6 years ago, within 2 years I had developed pretty severe arhtritis.
I have now had both ankles fused - the first about 2 1/2 years ago and the second last feb. Prior to the fusion I had pretty limited mobility (up down movement of my feet) anyway as I had massive soft tissue trauma (only thing intact on one ankle was skin, all tendons and ligamanets down the outside were torn - sorry if tmi). Following fusion (tibia/talus joint) I have a little less movement but enough to ride and walk.
I had several opinions as was not keen on fusion for the second ankle (it can cause a few issues to have bilateral fusion apparently, I've not had too much bother) and was told that replacement (the other option) wasn't going to be suitable as I'm too young (30), too active and would most likely dislocate any replacement causing more trauma. The other reason I went with fusion is that the revison once the replacement fails (they last between 5-15 years depending on type and which literature you read) is to fuse the ankle, however, because of the amount of bone removed to sit the replacement in the joint, the fusion is much more complicated and has a much higher complication rate.

Walking wise I find steep ground (both up and down) difficult and rough ground can be difficult - running is impossible with a fusion, driving isn't a problem.
Riding wise I use toe cups on my stirrups - because of the lack of flexion I can't push my heels down properly so was finding my feet were sliding through the stirrups, toe cups stops that. I also use flexible stirrups as I find that reduces how stiff/sore I get. I've only jsut started riding again following my most recent surgery (mare had a foal) so am just getting used to riding with equal ankles but prior to that I found I didn't really have any problems with riding - I haven't ever really jumped tho so can't particularly comment on that side of it. I did have problems with balancing whilst stood in 2-point but I think that may be my lack of practice/poor riding rather than ankle related.

I still get a lot of stiffness and pain from my ankles but much improved since the fusion however I have huge amounts of scar tissue and soft tissue issues on top of the original arthritis because of the severity of my original injuries.

I will say that I would have the fusion again, I didn't have any problems with the bones fusing properly. I had each ankle done by a different surgeon who had slightly different approaches but in general I had 8-12 weeks in cast/support boot while non-weight bearing then a couple of weeks on crutches building up strength and teaching my ankle to walk properly again. The first fusion I was back riding (without stirrups) after about 12 weeks and then gradually introduceds stirrups a month or two after that, this time round I was fully recoevered before Roo was able to start ridden work.
One of the biggest problems I have riding is that I can't get on from the ground becase I have no spring so need a fairly big mounting block - I also have to hold on to the saddle and slide down as can't absorb the impact if I jumped off.

Good luck with whatever you decide
 
Mynutmeg. That's interesting. Glad ur soing well!

Even with the replacement I have no spring either so have to mount and dismount same as you

I can however get my heel down(hope I still can when I get out of this cast)

I have wondered about how difficult it will be to fuse after the replacement. However I also have rheumatoid arthritis so a fusion will cause rapid defenerative arthritis in the other bones of my foot if they don't flex properly. So the idea is keep them going as long as we can.
Lucky in that a lot of surgeons would not have considered the replacement because as you say under 60 is usually considered too young and riding is definetly too active

I think I am a bit of a pet experiment to see just what the replacement can cope with
 
soulfull said:
Mynutmeg. That's interesting. Glad ur soing well!

Even with the replacement I have no spring either so have to mount and dismount same as you

I can however get my heel down(hope I still can when I get out of this cast)

I have wondered about how difficult it will be to fuse after the replacement. However I also have rheumatoid arthritis so a fusion will cause rapid defenerative arthritis in the other bones of my foot if they don't flex properly. So the idea is keep them going as long as we can.
Lucky in that a lot of surgeons would not have considered the replacement because as you say under 60 is usually considered too young and riding is definetly too active

I think I am a bit of a pet experiment to see just what the replacement can cope with
Click to expand...

That makes sense - a replacement would definately be a better option for you - my arthritis is a result of trauma, coming off a tb at full gallop and landing on my feet was not a good idea. I dislocated both ankles as well as fractures - it damaged the joint surface pretty badly so developed arthritid pretty quickly, there wasn't much damage to the other joints so they are coping pretty well. I also lost very little movement when the joint was fused - I had very stiff tibia/talus joints following the original injury, something to do with 3 months in cast and tearing almost all the soft tissues around the joints so I have lots of scar tissue :rolleyes: I think my future will involve further fusion of sub talr joints etc but so long as I can continue riding and walking well enough to look after my girlly I'm happy :p

What I was told about the fusion revision was that because of the amount of bone removed to seat the prosthesis it's very difficult to get enough bone to graft in and you almost always end up with a shortened leg. There can also be difficulty in getting the bones to fuse because there is such a gap between the talus and the tibia.
 
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