On Friday I had my 4 month post op check up following Mosaicplasty surgery on my ankle! It was great... the bones are healed, the donor bone fused and their is adequate spacing being maintained in the joint, meaning the cartilage is generating, so I was deemed a success. I felt relieved finally to hear that... it was a long time coming and then I asked about this persistant pain in my foot / heel that seems to be getting worse and after the Doc pushed and poked my ankle and foot and nearly sent me to the moon with the pain, he said I have Planters Fasciities .... I said are you sure? He said no doubt, so he gave me some handouts on stretching and I purchased a night splint but so far I haven't had any relief. Pt is also working on it with me. I figure if I made it thru that brutal surgery I can make it thru this too. I just have to give it time.
So I just thought for those of you considering this surgery it does work, even with the setbacks I am thrilled that I have an ankle that moves. I can deal with the rest!
Take care and thanks for all your support and encouragment in the past, it really ment alot.
Sorry to hear about your son needing this surgery. I did not have drilling prior to this. After years of having my ankle lock up, swell and being discolored I had debridment surgery at which time they indicated I had DJD, a cyst and a lession on the talus but the fix then was fusion. I had hoped by giving it time, restricting my activity that medicine would catch up and provide a better alternative to fusion. My ankle was behaving the past 8 yrs, granted I didn't push the limits and then the simple task of walking up the steps to bed, my ankle locked after years of it not doing this and normally it would unlock within 1 hrs time and it would be ok, no pain.... This time however it locked for 1 1/2 days and it was excruciating and when it unlocked I developed stabbing pain, burning, pins and needles, grinding of the bones, discoloration and swelling. I was put on crutches until I could see the Ortho. I had an MRI which showed the lession was at a level IV and I was offered Distraction or Mosaicplasty. I decided to go with Mosaicplasty. During Surgery they realized why my pain was so intense, even though the cartilage appeared to be intact in the MRI it was not, it had been torn off the bone when the ankle unlocked but as my luck would go it just kinda floated in place for that MRI so they had no idea why I was in such pain.
My surgery was also the use of cadaver bone and maybe you seen my other posts, if your son requires this surgery and they suggest cadaver bone / cartilage be warned, it was not covered by BCBS and I had to pay for the bone, it was near $7K and I am currently in my 2nd round of appeals with the insurance company.
Do your homework and make sure you find someone who has done this surgery and ask about their success rate, ask lots of questions, this is not a simple surgery or recovery.
I wish your son the best and if you have any other questions, please feel free to ask.
Thank you responding to my post and I'm very glad that you are recovering so well. In my son's case we don't know what caused his problem. Right after last year's figure skating championships he started having pain. By mid February, they casted him for 6 weeks with no improvement and then did Subcondral Drilling in April. He went back to skating last October but has been able to do only 20 minutes a day before it starts to hurt like bone on bone. Hasn't done any ballet. He can ballroom dance OK but the skating seems to hurt. He has a new figure skating boot coming that has a hinge built into it so he can flex his ankle instead of having it locked in the boot.
His OS has done about 25 Allograph Transplants on the Talus and says that not all have been successful but most have had some good results. I find it cruel that a 14 year old boy can't get BCBS to pay for an Allograph - this remains to be seen.
I did not have a complete allograft in my ankle, just a portion of the worn out talus floor was replaced with new bone and I had cartilage plugs put into the joint, along with spur removal and debridment of loose particals. The insurance company stated this treatment is experimental and not warranted when Fusion is as they consider successful. They paid for the actual surgery they did not pay for the transplant bone.
I would suggest you speak to the Ortho and ask if he has had insurance denials for this surgery. Call your insurance carrier and find out if it would be approved ( you will need the insurance codes) and if it is not approved, asking how can it be reviewed. I suggest that you start this process early so that your not in my position now.
The way I look at it, if they don't pay - yeah I have a home equity loan on my ankle but its a small price to pay to be pain free and have my freedom back.
Wishing your son the best
I had debridement and drilling in early October 2006 for front/outside talus osteochondral lesion (surgery included removal of loose fragment and spur removal). I also had surgery in 2003 for fragment removal and spur removal by a different OS (no drilling). I injured my ankle with severe sprain playing basketball in 1999 and have had pain since 2000.
After 16 weeks post-surgery, quite certain the results are not where I hoped, so today I had appointment with a foot/ankle OS at Cleveland Clinic who I am quite sure is top-notch. He recommended to begin "testing" it by doing the things I haven't done since last spring (basketball, running...other mid to high impact) to see how it responds now and over the next two months. He said improvement from drilling is often quite good but also can take up to six months or longer for full benefit to appear. Also, he said in my case, he would have followed the same order (debridement, drilling first), as it is less risky than drilling completely through the talus bone to ready for an implant. If pain is not where I'd like after two months of more taxing use, I'll be seeing him again.
For next procedure, should I need it, he is recommending use of a synthetic bone plug rather than autograft (either OATS or MOSAICPLASTY use tissues harvested from the knee). He indicated the use of these synthetic plugs is fairly new in US, but advantage is you don't jeopardize knee as can happen with autograft. The product he'd use is made by OBI. My reading done tonight is quite encouraging to me. I believe this product has been used extensively in Europe, and has just recently (in last year or two) been approved by FDA in US.
Doctor indicated success rate using OBI on talus is around 85%. If I need additioinal surgery, I'll certainly do more research but I believe this is a very good option...one which I was not aware of before today's appointment.
Last edited by moderator2; 01-30-2007 at 11:12 AM.
That is really interesting what you found. In September I had Mosaicplasty done using Cadaver Bone / Cartilage. I am doing well. My Doc also stated that he did not harvest from one's own existing joints like the knee or hip as in his study his patients ankles got better but the donor site that prior to surgery was fine was now problematic.
Even with this surgery I was told that I may not see the full benefit of it for up to a year, now at 4 months Post Op I do feel that my ankle is moving better, I just dont' have distance walking down yet, it will swell and pound but I don't have that bone to bone sensation anymore
I wish you the best and hope that if you do need this surgery you will be among those considered a success.
I am happy for you about your good news with healing. After 8 years of pain and limitations, I bet you are feeling pretty good right now!! I hope your progress continues and that in another 4 months (or less), you'll be back doing the things you haven't been able to for so long. Hearing about the spacing, bone and cartilage growth and all that is very cool...funny how we become "experts" about something that most people have absolutely no knowledge of.
My ankle is actually feeling better every day. Tonight I even did some light squats and other leg work and finished with jogging on a treadmill for 10 minutes, virtually pain free!! It's been at least a year since I could say that. I'm going to ease back into heavier activity to see how it holds up. Won't know until I try and 17 weeks post-op is sufficient time, from what two OS's have told me.
It was very reassuring for me to see the OS at the Cleveland Clinic and to hear him say to give it at least 2 more months and if wasn't where I wanted it, additional surgery would very likely help. The first 15 weeks post-op for me were very discouraging, and after completing PT I was fairly certain the drilling surgery had failed to relieve much pain. I think I have some newfound optimism...that's been a long time coming!
What activity level are you hoping to achieve once you are fully healed? Or is it a wait and see? That locking that you had pre-surgery sounds awful...much more painful than I ever experienced. I was relatively pain free until I stressed it, usually from some recreational activity, which I love. My hope is to get back to doing some/most of the things that I used to do...as you know, have to wait and see.
Good luck with your insurance issue. Don't know about your financial situation but I know in my case that if I had to take a big hit (that hurt) financially to have a greatly improved ankle, it would be a no brainer!! I'd mortage my house too if I needed to.
Let me know how you are progressing. Good luck and keep up with the positive attitude, now that you finally have some good news.
Sounds like your doing great and I am happy to hear that. At 17 weeks post op and your doing the treadmill and squats! That is great!!!!!
I only started squats on equipment about 2 weeks ago and the treadmill last week. I started PT in Nov and I am to continue thru Feb. I spent 17 weeks casted, 7 weeks in fiberglass and 10 weeks in the Boot and they think that is why I am having a hard time coming back from this. I also prior to surgery had limited ROM in my ankle and although this surgery would do nothing to improve that, PT and my Doc think I should score a 70 when its all said and done. Currently I score a 50 but that is huge considering I scored a 4 - only eight weeks from surgery!
I am taking a wait and see approach on my ankle. If I can walk painfree for distances, get back to work, take a stroll in the park with my dog, drive my stick shift car then I will be pleased, anything that comes in addtiion to those will be excellent.
If your considering this or the artifical plug surgery than start chatting with your insurance carrier. I learned today that they denied me again! (*&^%$#$@#! They said that they only allow $664 for this part and with my deductables and co-pays that is why I recieved $245.80 for the $6,800.00 claim. I am now filing a grievance with them... Onto appeal #2.
Still infuriates me to no end.
Take care and I wish you the best, continue your progress, keep smiling and keep me posted.