Hi! Everyone here was so helpful before my surgery in October 07 that I am hoping for more advice as I head down this what appears to be a never-ending road ...

I am now 5 months post drilling and debridement surgery for my OCD and have had 2 xrays for the lack of ROM (only +5 dorsiflexion) and to see why I still have a lot of pain (and those heart stopping sharp shooting pains too).

The xrays show no bone fragments causing a problem (which is good) but my questions are:

- how were you at 5 months post surgery? How was your ROM? And pain?

- Do we know of anyone whose drilling was successful and didn't need to have the OATS procedure done?

- When did you stop using crutches completely? I seem to walk better with one as my walk is still completely off and with a bad limp.

- Did you OS talk about Achilles Lengthening surgery at all with you? Mine mentioned it to me since he said my ROM isn't what he'd like it to be, but said it was too early to tell and we'll see how my ROM comes back over the next 6-8 months more of PT.

My other ankle now hurts after compensating for my left for a year now (friday makes one year) and my OS took an xray and I have an OCD on my talus in my other ankle too! Nothing appears loose from the xray and I can't even begin to think about that one until the left one is fixed, but has anyone ever heard of having it in both?? I think I should play the lottery, how can I be this lucky :) My hope is that it hurts less as my other feels better, but I am not optimistic, but don't know after 5 months if what I am feeling is normal.

Any advice/experiences you can share would be appreciated. I am not sure if I am just having a really bad ankle week or with my upcoming 1 year anniversary of what I am calling 'the skiing incident' that I am just extra aggravated and impatient.

Thanks for all your help and for being a place to come to talk to about this ... it makes me feel better that I am not the only one with this rare problem.

Thanks,
Kim

Hi Kim
Can't tell you about drilling but I had Oats (Cadaver) 16 months ago and I can relate to your frustration no doubt. It took about 4 months for me to get rid of the crutches completely but I developed PF with my first few clumsy attempts at walking and I think that delayed me.

I would suggest that you talk to your OS and ask about an ankle gauntlet and I may not have the name right but its a velcro contraption that you put on like a fighters boot and it has velcro straps that wrap around it, it provides great support to the ankle, I believe that it helped me walk better as it didn't allow my ankle to roll.

Unfortunately my OS said that since my OCD couldnt' be traced to injury and I have odd bone structure that I am likely to have it in the other ankle as well, I have noticed lately that its exhibiting signs and I know its because I put too much pressure on the good leg / ankle and its starting to revolt and it scares me to think that I can have it in my good ankle as well.

I wish you the best and take it one step at a time, try heat like a hot shower and then move your ankle around and see if that helps, ankles are difficult no doubt and if you have good ones you can't understand but this board is a great place to talk to people who have walked in your shoes!

Take care
Carol

Hi Kim
Can't tell you about drilling but I had Oats (Cadaver) 16 months ago and I can relate to your frustration no doubt. It took about 4 months for me to get rid of the crutches completely but I developed PF with my first few clumsy attempts at walking and I think that delayed me.

I would suggest that you talk to your OS and ask about an ankle gauntlet and I may not have the name right but its a velcro contraption that you put on like a fighters boot and it has velcro straps that wrap around it, it provides great support to the ankle, I believe that it helped me walk better as it didn't allow my ankle to roll.

Unfortunately my OS said that since my OCD couldnt' be traced to injury and I have odd bone structure that I am likely to have it in the other ankle as well, I have noticed lately that its exhibiting signs and I know its because I put too much pressure on the good leg / ankle and its starting to revolt and it scares me to think that I can have it in my good ankle as well.

I wish you the best and take it one step at a time, try heat like a hot shower and then move your ankle around and see if that helps, ankles are difficult no doubt and if you have good ones you can't understand but this board is a great place to talk to people who have walked in your shoes!

Take care
Carol


Hey guys. Kimberb, I don't mean to steal your thread, but I have a quick question for Carol. How is your ankle feeling after the OATS? What is your activity level like, and how long is that supposed to last before another surgery/procedure is likely? I had a failed drilling and will probably get an OATS done in a month or 2... Oh, and 1 more thing, why did you go with an allograft (cadaver) rather than an autograft (from your knee)?

Kimberb, where was I when I was 5 months out...
I was off crutches after 6 weeks and into a walking boot for 2... I can tell you at first that my ankle was very stiff and so moving without crutches was muuuch slower. Over time with the PT I was able to get almost all my ROM back, and eventually got back to running on the treadmill and jump roping...unfortunately I have a new larger OCD so...I'm getting pain back. At 5 months though my ankle was definitely weak, tender and had instability...just keep up the PT, and I would recommend water aerobics (try running in a pool) or riding the bike or even just walking on the treadmill to build strength slowly...

Hey Mak06
I seen your posts on other threads and was going to jump in there to respond there...

In response to your question about why I used Cadaver in lieu of my own, it was my Surgeon's decision. He had told me he stopped doing OAT's using the knee about 7 months prior to seeing me as he found that while it was successful for the ankle it was not successful for knees and in his studies he found using healthy cadaver bone / cartilage from the same weight bearing area that is damaged works better.

As far as my activity level goes... Its hard to say, I developed a wicked case of Planters Fascitiis with those first clumsy steps after surgery and I haven't shaken it completely (*&^%$$ Sometimes I think WOW...its been a few days and maybe its over and out of the blue it will stop me in my tracks and cripple me. I think I can do just about anything in moderation! I can bike on my stationary bike for 8-10 miles no problem and I can walk distances but the PF gets me before the ankle does. I hope to do scuba diving this summer and that will be an indicator as I gave that up 7 yrs ago after my ankle started locking up with the swimming motion using the fins - have your ankle lock 70-80 down and try not to drown! haha I do alot of non-impact activity as you see and I think I can do it all. I wish I was more impact active but having this issue since the age of 13, you learn quickly that its not worth the pain.


If your doing this surgery and going for Cadaver check your insurance, I was dual insured at the time BCBS and Aetna and both denied the surgery stating it was experimental... Better yet they stopped paying for PT after 20 visits stating that they didn't cover services resulting from an uncovered procedure. I went thru appeal after appeal to no avail... I have a home equity loan on my ankle. I can tell you it was worth it, I can walk nearly pain free and my ankle moves with a smoothness that I never can recall, so yes it was worth it.

I know I didn't give you the answers you wanted but I am not a good person to say about this surgery as my complication of PF definately has changed how I recovered and continue to recover.

All my best to you!
Carol

Hey Carol,

Thanks for your response, it was great! I'm glad to hear you're doing well (other than the PF!). Which brings me to another question...what exactly is PF?

When I go in for my final appointments before surgery, I will need to ask the doc about using a cadaver for the OATS procedure...I am a bit aprehensive about taking cartilage out of my knee, but if it's what I have to do to slow down the degeneration until cartilage regeneration techniques become widespread, so be it. I'll also have to check my insurance! I also have dual coverage and one is Aenta and I know they don't cover that!

One last quetion...the drilling and debridement was a pain the first couple of days, but by day 4 I was at work, and within a week or 2 I was crutching around to the grocery store, library, etc. and doing everything on my own. How is the pain for the OATS procedure? Did you feel like you couldn't really crutch around very much at first? I've heard people saying that they couldn't hang their foot down for more than 5 minutes...

PF= plantar fasciitis, I assume, heel pain. Occasionally, people who can't use their ankle for a long time develop problems with that or with the Achilles tendon, because it gets stiff and then gets hurt when you start walking again.

Thanks! One last thing...with a cadaver transplant do you not need to take immune-supressing medication (as you would with an organ transplant)?

I don't especially want to be on medication like that for the rest of my life...

Hi Mak06

No you need not take any rejection drugs for cadaver transplant, they say that your body doesn't reject tissue or bone and I have been fine in that regard and that was a big question for me as well...once I got past that part when the doc said "You need a cartilage transplant".....


As far as pain goes, its harsh...Yes I was one of those who couldnt' put my foot down for more than 2 min for a long long time... my toes would turn a bright red and then purple and the pain would be off the charts.
I didnt' go to work for 5 1/2 months

The oddest thing was the car.... I have a very smooth driving vehicle and about 2 weeks after surgery I needed to get out of the house and my husband said we'd go for a ride knowing I can't put my foot down we thought this was good, when he started my car my ankle felt like it was going to vibrate apart. Driving down the road it felt like we were on a coblestone path not a smooth blacktop road. That lasted a long time.

The only drawback is that I feel the hardware, I am petite and the doc said I have not much fat or insulation around the ankle and those screws are temperature sensative, they pick up the cold fast and that is uncomfortable, I've ask to have them removed but was told NO.

Remember when you see your OS, ask questions and lots of them and none of them are stupid, just keep in mind this is your ankle and your freedom to walk or not walk when its done. Its a serious surgery and you have to be comfortable in moving foward with it.

I wish you all my best.
Carol

Hey Carol!

It's funny what you say that about the car and it's vibrations because I also find it very noticeable now and irritating to my foot. I'll hold my foot with my hands just so stop the vibrations for a minute.

I have got the same issue with needing my foot elevated all the time. It's really starting to wear on my back muscles! What a pain .....

Well better go!

Abby :)

Hey Carol I believe I asked you a question about a year ago way back when before I had my surgery. I am now 2 weeks post up from a partial ankle cadaver transplant. The pain is still bad, about as bad as preop plus some. But what really worries me more is the ankle does not seem to be moving smoothly. It still cracks and crunches when I move it around. I thought this would be gone and thus indicate that the eroded bone had been removed. So I am really worried. Anyway, did you have this same experience? Did you notice any differences in your ankle preop to post op? Thanks. Daniel.

Hi, Kim,

I think I'm in the minority here, but my ankle debridement/drilling seems to have been a success. I'm now 10 months post-op, and where I still have some pain, and occassional take-your-breath-away jabs, overall I'm doing GREAT! I've returned to ultramarathoning (did a 50 mile run last weekend), and am overall pleased with the result. No, it's not 100%, and I don't think I'll ever be able to play soccer again, nor will I return to the level of competitive running I had pre-injury, but my ankle is fully functional in day-to-day life (with no high heels!), and I'm beginning to enjoy some of my favorite activities again.

Maybe I'm one of the few lucky ones, but it worked for me. I hope you all find the healing procedure that works for you!

Hi Daniel
Are you in a removable cast? At 2 weeks post op... Whew.... I was still in incredible pain as well. My ankle was casted from 1 week post op thru 7 weeks post op, then into the Boot for 11 weeks and then a brace for 3 1 /2 months.
When the cast came off and I started PT, my ankle didnt' move and my toes barely wiggled but over time things started to move. It didnt' happen over night so don't panic, it took alot of time and alot of patience.

Keep your foot elevated and iced, it will help with the pain.

Keep me posted on your progress!

Hey Abby - Glad to hear your doing good, have you started PT yet?

All my best to you both!
Carol

I am still in a plaster cast. I get my cast off on friday actually. But i get curious and try to move my ankle around inside the cast as much it will allow. And even then i can feel some popping, maybe its just the swelling moving around. I must admit I get worried easily. It is my 3rd surgery. The first two just made things worse so I am very easily discouraged despite the fact I am with a brand new doctor who apparently is one of the best. Where was the majority of your pain? Did it center on the area in which the allograft was inserted? That is where mine is. But of course it is also where most of my pre-op pain was so you can see how I worry that the surgery might not have been successful. How is your swelling now? I have had a permanent swollen ankle for a while now, I wonder if this surgery will be able to alleviate some of the swelling. Did it do that for you? Did you have the crunching and grinding in your ankle as well? Look forward to hearing form you. Dan

Hey Carol!

Nice to hear from you! I start PT next Wed. so 1 week. I'm very excited to move on to a new phase of healing. I was also 7 weeks in a hard cast and as of tomorrow, 5 weeks in a boot, 12 weeks total NWB. I saw the Dr. last week and he said to start PWB this week and then try to shed the crutches. So starting tomorrow, I'm going to try putting full-weight on my foot. He said to wear my boot one more week and then try tennis shoes. Very cool! I have never had a grinding/crunching feeling in my joint pre or post op, only pain. These last 5 weeks I could move my foot a bit and the joint feels very smooth - just stiffness. With PWB I do feel some pain in that same spot where the lesion is, well was, but I assume that's pretty normal. After all your problems with PF, after the hard cast came off I would stretch my toes back, stretching my arch all the time to try and keep it from getting too atrophied. So you inspired me to make sure I kept the flexbility going! Thanks for all your listening! I'll let you know how PT goes ...

Abby :)

Heinsel,

I am glad to hear you are doing well, but have to admit I am a bit jealous.

I saw my OS last week, which was exactly 6 months post drilling and I can honestly say I feel as bad, if not worse than before the drilling. I can live with stiffness and even reduced ROM but the pain is incredible. I have though begun to categorize what I feel -

1 - the dull deep aching pain
2 - the discomfort of stiffness
3 - pain from swelling
4 - the sharp stabbing pains that make you stop breathing

I can honestly live with probably #1 and 2, but numbers 3 and 4 are hard to live with .. at night especially the pain from swelling is so bad that I can't lie my foot down on the bed, its still propped up hanging off a pillow.

My OS sent me for an MRI to see what could be causing the pain. He said that depending upon what we see he may give me a shot of lidocaine right in the joint and if the pain stops, the OCD is what is causing the pain. The upside is that I may have the best 6 hours of the last year .. no pain. If the pain continues after the shot, we know the pain is coming from a muscle, tendon, ligament, etc.

I asked him his gut feeling and it was that I will need the OATS procedure and while I am scared to death of it, I just want this to be done already.

I trust my surgeon, respect his opinion and honestly just like him as a person (very compassionate, caring, warm, etc), so if he says I need it, I just need to then decide when.

I find out next week what the MRI revealed and have to admit, the wait is killing me.

I'll keep eeryone posted when I find out what needs to happen since I know sharing our stories can possibly help someone else.

Kim

Hey Abby!

Congrats on the weight bearing:D That is excellent! You lucked out if only 5 weeks in that boot! I was 11 weeks in that crazy velcro contraption!
Glad to hear I was able to inspire you, shocking actually considering I was so miserable during my recovery! But Kudos to you if you can get by without getting PF. PT said they see it alot with patients who spend alot of time in the boot. PT for me was alot of bringing back the range of motion, let me know if they "score" your ankle. They used to do these measurements and come up with this score.. The intent was I was to at last get to low 70's and I never made it past 61!

Dankn:
Did you get the cast off today- how did it go? I remember my ankle looked gruesome and I thought I was moving it around alot in the cast and I was suprised to find that I couldnt' move it at all once the cast was off.
I understand your thoughts about thinking the worse, I was the same exact way and that is so not like me to behave that way but I sure did - Doom and Gloom was my daily attitude for a long time. So I have been there!

My ankle still swells and feels "tight", My ankle pain is deep in the center where I assume they put the plugs. I have good days and bad days and the good days are becoming more and more. I think honestly if it weren't for the PF that won't (*&^@_! go away that I would be better off.
I am anxious to hear how your day went.

Abby and Dankn have a great day and keep me posted, I wish you both all my best... Stay positive!
Carol