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Old 10-29-2008, 04:51 AM   #1
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having "leisons" of the talus dome repaired

Hi Everyone...

I am 58 years old and a little overweight. I had 3 falls in 2003 that resulted in "sprains" to which the hospital sent me home with an "air cast" after x-rays revealed that nothing was broken. (Sprains are the most underdiagnosed injury going but insurance companies don't want to shell out for MRI's..go figure...further down the road they have to shell out for an operation to correct the damage). Anyway, I kept having pain in my left ankle which at times would "lock" up and stop me dead in my tracks when I would be just walking normally, then, I would limp for days or weeks and then back to normal walking for awhile. The ankle would also "click" and I could feel that something was really not right.

This went on for a year or so and I went to a local Orthopaedic Dr. and he gave me a shot of cortisone and I went home. The ankle was okay for awhile and then it would start locking up again. I went to the same Dr. again each time it happened and he gave me two more shots...the 4th time I went to him he sent me for an xray and a MRI. He asked me how long have I had this "hole" in my ankle? I said "What?" and he then told me I had a 9mm leison of the talus bone in the ankle. I asked him what I should do and he said that I could get periodic shots of cortisone or consider having surgery to repair it. I asked him about the surgery and when he got to the drilling part, I said we would just get the shot and keep a check on it.

To make a long story short, in 2007 (after putting up with the locking up, the limping, the shots, etc) I went to him again when the limping increased and my ankle (medial side) was sore and tender to the touch) and he had another MRI done. He said that the "hole" had now grown from 9mm to 1.4 cm. and that I also had posterior tibial tendonitis..I said "great". First he sent me to a well known surgeon who only does "feet and ankles"... on our first meeting he agreed with my local dr. that I had the posterior tibial tendonitis and that I should be fitted with an orthotic device for my left shoe to realign my foot and heal the tendonitis first. So I did that. I had the orthotic made by a truly talented young man who assured me that we could get the tendonitis healed but I had to be patient..literally. I got the orthotic in april and it was around the end of August before my tendonitis was healed enough to go back to the surgeon to discuss the surgery to correct the leison in the talar dome.

The surgeon agreed that it was time to do the surgery and that if I didn't have it done, even with the 60-70% success rate of the surgery, I could be a candidate for ankle replacement in the future. Well, I certainly didn't want to go through an ankle replacement so I agreed on the Debridement/drilling of the talar dome surgery. On Sept. 25 I had the surgery, everything went well and I went in as an outpatient and came home the same day. I was told no weight bearing AT ALL on the left ankle/foot for 4-6 weeks. Prior to surgery I tried using crutches but found I could not use them without ocassionally putting my left foot down no matter what I did so I "rented" a Roll-A-Bout" knee scooter which was wonderful! I don't know what I would have done without it. Believe me getting from the bed to the bathroom was much easier with this knee scooter. It's for anyone who has had ankle surgery or any foot surgery.

I went to my first post op check up on 10/7 and the surgeon said everything looked good but to continue to not put any weight on the foot and he would see me on 10/28. I just went to that post op appt. and now he says that I can start putting some weight on the left ankle/foot and that he wanted me to go to PT 2x a week for 4 weeks. I left the office with a rx for a "walker". I didn't try to "stand" when I was in the dr.'s office and he did not encourage me to do so. He just left me with the "be patient and take it slow" talk and said he would see me on Dec. 2nd. I got home and stood by my counter in the kitchen and "tried" to stand on both feet...well, the "electric shock of pain" that went up my foot to my leg and body was unbelievable...I cannot imagine going to PT.

I feel very depressed right now and at this point I'm wondering if surgery was the right thing to do... I know I walked with a limp before but at least I could walk... so, anyone out there with a word of encouragement that has gone thru this recovery ..please write.
Patricia

Last edited by Administrator; 07-11-2009 at 01:58 PM.

 
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Old 10-29-2008, 09:19 AM   #2
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Hey Patricia,

You might want to look at some of the OATS threads that are on this site. OATS is a procedure when drilling is not sufficient to correct these lesions. There are 4 of us right now that are going through the recovery from this. I had an 18mm 'hole' in my talus from an ankle sprain. It wasn't diagnosed correctly for a year and then was treated conservatively for 3 years. My lesion was too large for drilling and so I had a bone graft from my knee to repace the bone/cartilage in my foot. Just with drilling there are risks of it not working, but the odds are more positive in our favor for it to be successful. I have to say that my stabbing, stop dead in my tracks pain is totally gone since the surgery. But this surgery and even drilling is done to improve function, unfortunately your foot will never be 'cured'. I am 9 months out from surgery and have just hit the point where I am allowed to try higher impact activities. I wasn't allowed to walk on my foot for 12 weeks. And I did use the Roller-Aid for a month of that and it was awesome!! So what I'm trying to say is don't be discouraged!! These operations have a long recovery period but in the grand scheme of things, it's really not that long. It just seems like it! You are only one month out and your foot is still very fresh from surgery. Take it very slow and don't try and push it. It'll probably take you 6 months before your foot starts to feel like normal but don't get depressed. Ankles just take a long time to recover but I bet it will be worth it! Fell free to ask any questions. Sorry I don't have any direct advice about drilling.

Abby

 
Old 10-29-2008, 03:27 PM   #3
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Patricia,

I am sorry to hear you are going through what you are going through but I can certainly relate. I am recovering now from the OATS procedure Abby just wrote about (I am another one of the four) but I did have the drilling first, which failed for me.

My story is similar to yours ... many ankle sprains from playing soccer from age 4 to age 22 when I found I had a large lesion on my talus. Back in 1990 they of course didn't know what to do with them and I was living with it with the same pains and locking you are until last year when I went skiing and made a 'stable' lesion 'unstable'.

They suggested debridement & drilling as an option given my lesion is 9mm x 9mm x 6mm deep and gave me a 70% chance of it working. I had drilling last October and was 6 weeks NWB followed by 6 months of PT, when we found I was in more pain than before surgery and gained no range of motion. OATS was then my only option which I had 12 weeks ago (bone plugs from knee put into talus) and I'm currently recovering and in PT for that.

Before my OATS surgery, my OS thought that perhaps the integrity of the scar tissue that regrew from the drilling was of poor quality, only to find out during my OATS procedure that it was good quality, but covered in blood vessels which made it inflammed (I was told 'beet red'), causing the pain I was experiencing. It also only filled in 75 percent which left what wasn't inflammed, crumbling pieces.

If I had it to do all over again, I'd of course skip the drilling and go right for the OATS procedure, but that wasn't an option. Drilling does work for some people so I do understand why the do it first, but unfortunately I don't have any good news about my personal drilling experience.

I completely understand your frustration, depression and feeling you are never going to walk again as I've gone through all the same emotions over the last 16 months.

If you have anymore questions we are here to listen and answer what we can. We certainly aren't doctors but have become rather schooled on this topic.

Kim

Last edited by kimberp; 10-29-2008 at 03:28 PM. Reason: typo

 
Old 10-29-2008, 06:32 PM   #4
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

I'm 5 weeks out from OATS. I also, like Kim, had drilling first that failed. I had ligament issues and tendon issues to go along with my mess. My drilling worked for awhile, well, at least the pain was gone for a bit. I don't think it ever went away. I was good for maybe a year and then it went downhill fast. I did push my recovery way to much last time around. This time I'm going to try and take things slower.
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Old 10-30-2008, 07:00 AM   #5
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

I really appreciate the replies to this post. Yesterday when I got home from the dr.'s appt...where he said I could "start" putting weight on the ankle/foot I was so upset because of the terrible pain I had upon putting just the weight of trying to stand with I'd say 80% of the weight on my good foot (right)....I have had 3 children, surgery for abdominal incision hysterectomy but nothing compares to the pain I had when trying to put weight on this left foot. I don't start PT until Tuesday (today is Thursday) and I just wanted to know how you all began your journey to walking again... I can't believe the "electrical" like shock pain that comes up from my toes and heel... I never felt this kind of pain before. Is this normal? Any at home exercises any of you can give me to help me be able to put any weight on this foot would be greatly appreciated. I am starting to "write my abc's" in the air with my left foot (toes) and I am using an elastic bandage to use as a way in which to do those "towel" exercises where you put the towel or elastic banage under the ball of your foot and hold in both hands the ends of the towel or bandage and then dorsi flex and plantar flex the foot... so I hope that I am not doing anything wrong. Let me know what other things I can do. I am so afraid of not being able to walk without assistance I could cry

Patricia

 
Old 10-30-2008, 08:45 AM   #6
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Patricia,

I would wait on the home exercises and see what your OS told your PT to work on. I was only allowed to move my foot up and down after my drilling for a couple of months so I am not sure you should be doing ABCs already. (If your OS said that was ok than I'd continue, but if not I'd wait for your PT appt.)

As for beginning to put weight on your foot, I too had after the drilling and now, the 'pins and needles' feeling and the shooting pains at first, but they do get better. I started weight bearing by just putting my foot down when brushing my teeth, doing dishes, etc. and gradually put more and more on. The feeling you are feeling will go away as your foot gets more used to it so don't worry, it's normal.

PT will have great ways of helping you put more weight on it and they are great at distracting you with other things to make it more bearable (i.e. throwing a ball so you concentrate on catching the ball and not the weight on your foot) You are awhile away from that one but you get the idea.

Kim

 
Old 10-30-2008, 10:02 PM   #7
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Kim
I am so appreciative of all the people here on this board that have responded to my post... and, I'm so glad you shared your experience with me. I am going to hold off of doing more than just the balancing on two feet while I brush my teeth ..I'll wait to see what the PT says on Tuesday. I certainly don't want to rush things and have the "drilling" not work. I just hope I'm in the small percentage of people for whom it does work. I do thank you for your advice and I believe you are right...I'm just impatient. Looking forward to hearing from others and I will continue to post important updates. I hope through all of this I can possibly help someone else like you all have helped me so far.
Patricia

 
Old 10-31-2008, 05:18 AM   #8
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Patricia,
I agree with Kim. Don't do anything that your OS hasn't specifically told you to do. I know that contributed to my failure.
I also don't know if I mentioned it, but it was a good 4 mos before I could even walk without a limp. I remember thinking the first day I was allowed off of crutches that walking would be so easy, and it wasn't. It was much more painful than I ever thought it would be. It'll get better in time. Don't push it though.
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Brostrom x2, peroneal tendon repair x2, Peroneal subluxation, PTT tendon repair, microfracture x5, OATS, Distraction arthroplasty, ORIF talus & fibula, subtalar fusion, ankle replacement (failed)
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Old 10-31-2008, 09:30 AM   #9
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Patricia,

I am glad to help. This board has certainly helped me and always made me feel like I wasn't alone in what I was going through. What we have is rare and it's nice to talk with people that have the same thing and that are at the same point and even a few steps ahead to educate us on what to expect, vent when we need to, and support us when we are down.

We're here if you have any questions!

Happy Halloween!
Kim

 
Old 10-31-2008, 12:31 PM   #10
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

I also have a lesion on the medial side of my talus. In June 2007 I underwent debridement and microfracture surgery, with an 85% chance of success. Prior to surgery, my lesion was 4x6mm. My most recent MRI indicated the lesion is now 8x8mm. According to my new dr. (the one who did the surgery moved away), the increased size "could" be due to the surgery itself. So, I'm in a wait and see mode. My dr. will only do OATS if the lesion grows to 1cm. I am (was?!) a competitive runner, so this whole thing is a huge bummer.

I can say the pain now is better than it was prior to surgery, so I am hopeful that I'm in the 85% for which it works. It's not perfect, but better. I do LOTS of ankle work, and I am able to run again.

One thing I can say to you is that I progressed to full weight bearing very gradually. If I recall correctly, I was on crutches 10-12 weeks. At about 6-8 weeks, I was instructed to bear approx. 25% of my weight, at 8-10 weeks it increased to 50%, and then FWB after that. PT REALLY helped a ton. At first, I couldn't walk w/o a limp, but after 3 or 4 PT sessions, I was walking normally again. I should add that I was in a boot for about 8-9 weeks prior to the surgery, so my ankle was quite stiff.

Just be patient, and progress to FWB slowly. I came back too fast, and I'm sure it adversely impacted my complete healing.

 
Old 11-22-2008, 09:26 AM   #11
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Hi!

I had the microfractures done in Dec 2007. When I went to PT for the first time, they told me to put on a sneaker. I wasn't able to, evne with all the way open. I did end up fine, for a while, I never 'grew' enough cartilage, so need to go back.

I was told that that pain was 'normal', and it did get better, after about 3 months post surgery I felt pretty darn good.

 
Old 12-05-2008, 04:53 PM   #12
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Patricia,
How are you doing? You have not posted in a while so I was wondering.
I had my ankle drilled in June 2007 and by Sept I knew there was something wrong. Not trying to get you down, but my Doc didn't take it serious and I did not get a new MRI till Jan. Turns out there was alot more damage done. I hope your doing better. If not BE INSISTANT don't let it go. That electic shock is not normal in my opinion.
Diane

 
Old 12-15-2008, 06:49 AM   #13
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Hi...well I'm in about my 7th week of PT and so far everything is going well. I was total non-weightbearing for 6 weeks which was terrible... I did manage to get around using a knee scooter (Roll A Bout) and found out they manufacture them right near my town..was very reasonable to rent...and much better than crutches. Then I went to a walker when I jointed PT and after about a week or so with it I got a cane and now, after all of that I am finally able to get around with just taking the cane as a security thing... My toes still swell if I am up too long on the ankle but the surgeon said (Dec. 2nd) that it was not unusual after 2 months post surgery to have the foot swell a bit. I have no more electric shock feelings when I stand and I think the ankle is better. I know it's too soon to be sure, but I am at least over the pain and am hopeful that the problem is solved. Joint is still somewhat stiff in the a.m. but at least I'm walking which, after the non-weight bearing 6 wks., I was seriously doubtful that I would walk again. I appreciate your input and I definitely will let my dr. know if I start feeling any kind of pain in the ankle or start hearing that "clicking" again when flexing the foot. Thanks again for responding.

 
Old 03-07-2009, 09:09 PM   #14
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

[QUOTE=PatriciaBeet;3776287]Hi Everyone...



Hi Patricia,
I can certainly relate to your suffering!
I also had same surgery 20 years ago and was unsuccessful with first surgery.
About 1 year later I've had another surgery basically same as first time
more drilling and scar tissue removal, it got significantly better with therapy and exercise and I would say 70%-80% back to normal.

But I could never run as I would like but can ride bike or hiking, work out without pain, when it's cloudy day it gets sensitive and painful time to time also never regained my flexibilty.

Lately it's bothering me again so I had MRI done and looks like I'm going to have a another one there's lots scar issue build up, minor bone deformity,
Talus dome looks pretty good though.

Anyway don't give up hope it will get better but you have to put lots of effort yourself.
Hope this helps.
Bob

Last edited by Administrator; 07-11-2009 at 02:00 PM.

 
Old 03-09-2009, 03:45 PM   #15
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Patriciabeet,
I too can relate. I had the drilling and debredment about 9 months ago, Aug. 08. I also had alot of trouble walking after, I was put in a cam walker (boot) 2 weeks post op and that was soooooooooo painful. I had to bend it to a 90 degree angle from a 30. Then when I started pt I wasn't walking yet and it was very painful just doin range of motion. And when I started walking i kept the boot on and used the crutch so I could ease into it. I still have trouble walking. Can't put full weight on it and i walk with a limp. After the post MRI revealed the lesion had not healed and was larger than before I am now preparing for the OATS procedure, more surgery. I wish you the best of luck with recovery and hope that you have sucess with the first procedure and don't require further surgery.

 
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