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Old 04-17-2009, 10:47 AM   #1
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TinaM1978 HB User
Osteochondral Ankle OATs surgery - five years later, wondering if surgery was mistake

Hi all-

I'm writing in with some thoughts/questions about a problem that is probably a mix of physical issues and my tendency towards depression and being angry at myself. Figured you all might understand or provide some guidance. Here's my story:

About ten years ago I went to an OS because I my ankle would spontaneously slip out of its joint and roll. I had a few nasty sprained ankles, but no chronic pain or restrictions on activity. OS advised after seeing my x-ray that I had an osteochondral fracture on my right ankle that would have to be surgically treated at some point in the future. I went on my merry way, did not do anything as I continued to have no symptoms other than the odd ankle role.

Five and a half years ago, I suffered a really nasty sprained ankle (the worst I had ever had) while playing soccer. I did not do PT for the ankle. When the pain did not go away after several weeks, I went to two OSs, both of whom advised that the pain was caused by an the osteochondral lesion. They recommended drilling. I saw a third doctor who recommended OATS. Because I wanted to get the whole thing over with (I was not able to do much physical activity other than walking or swimming), I did the OATS a few months after my soccer injury.

While my actual surgery went well, after I began walking again, I never felt that I fully recovered. I still had ankle pain (although not the same pain I had before surgery) and limited use of my ankle. I also had knee pain in the area where they had taken the grafts. About 8 months after the surgery I still had knee pain and problems with ankle ROM, but I was able to do some running and get back in the gym. I continued to do physical therapy, but, again, always had pain in my knee and limited ROM in my ankle. These symptoms were likely complicated by the fact that in the five years since my surgery I have gained about 40 lbs.

About a year ago, I started to have the same pain my ankle that I had before surgery, which completely freaked me out. I went to a get ankle specialist in NYC who is very familiar with the surgery. He took a special MRI that was able to confirm that the grafts had fully integrated, which was such a relief. He said that the pain that I have is caused by scar tissue and bone spurs, which could be helped by PT and fixed by arthroscopic surgery. I did more PT (more intense than last time, with lasers to reduce scar tissue), which helped with ROM. But I can't help but think that I rushed into OATs and that I did not do enough to conservatively manage my ankle. It seems to me know that the pain I had was likely not from the OCD (which I had had without symptom prior to trauma) but as lingering complications from my severe sprain.

Logically I know I need to move on. But I can't help but beat myself up about my decision to have OATs. I feel like I had a majorly invasive surgery for no reason. Sorry for the long post, but I just feel so bad about everything mentally.

 
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Old 05-14-2009, 10:54 PM   #2
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mstreet2379 HB User
Re: Osteochondral Ankle OATs surgery - five years later, wondering if surgery was mis

Quote:
Originally Posted by TinaM1978 View Post
Hi all-

I'm writing in with some thoughts/questions about a problem that is probably a mix of physical issues and my tendency towards depression and being angry at myself. Figured you all might understand or provide some guidance. Here's my story:

About ten years ago I went to an OS because I my ankle would spontaneously slip out of its joint and roll. I had a few nasty sprained ankles, but no chronic pain or restrictions on activity. OS advised after seeing my x-ray that I had an osteochondral fracture on my right ankle that would have to be surgically treated at some point in the future. I went on my merry way, did not do anything as I continued to have no symptoms other than the odd ankle role.

Five and a half years ago, I suffered a really nasty sprained ankle (the worst I had ever had) while playing soccer. I did not do PT for the ankle. When the pain did not go away after several weeks, I went to two OSs, both of whom advised that the pain was caused by an the osteochondral lesion. They recommended drilling. I saw a third doctor who recommended OATS. Because I wanted to get the whole thing over with (I was not able to do much physical activity other than walking or swimming), I did the OATS a few months after my soccer injury.

While my actual surgery went well, after I began walking again, I never felt that I fully recovered. I still had ankle pain (although not the same pain I had before surgery) and limited use of my ankle. I also had knee pain in the area where they had taken the grafts. About 8 months after the surgery I still had knee pain and problems with ankle ROM, but I was able to do some running and get back in the gym. I continued to do physical therapy, but, again, always had pain in my knee and limited ROM in my ankle. These symptoms were likely complicated by the fact that in the five years since my surgery I have gained about 40 lbs.

About a year ago, I started to have the same pain my ankle that I had before surgery, which completely freaked me out. I went to a get ankle specialist in NYC who is very familiar with the surgery. He took a special MRI that was able to confirm that the grafts had fully integrated, which was such a relief. He said that the pain that I have is caused by scar tissue and bone spurs, which could be helped by PT and fixed by arthroscopic surgery. I did more PT (more intense than last time, with lasers to reduce scar tissue), which helped with ROM. But I can't help but think that I rushed into OATs and that I did not do enough to conservatively manage my ankle. It seems to me know that the pain I had was likely not from the OCD (which I had had without symptom prior to trauma) but as lingering complications from my severe sprain.

Logically I know I need to move on. But I can't help but beat myself up about my decision to have OATs. I feel like I had a majorly invasive surgery for no reason. Sorry for the long post, but I just feel so bad about everything mentally.
First of all, you shouldn't be blaming YOU. Your O.S. should ALWAYS try less invasive means of medical treatment. YOU did not go to medical school and YOU are not suppose to know these things.... You are suppose to trust your O.S. and that's what it sounds like you did. Now with this said, perhaps your O.S. saw that the defect in your ankle was so prominant, it wouldn't have been worth trying an arthroscopy... may even be considered insurance fraud if it obviously wouldn't work. I had ankle arthroscopy done about 4 years ago and my doc at that time said it should last for a while and we may have to operate again.... about 3 1/2 yrs. later I went back stating that I thought we might need to try another treatment, so he said OK, took some scans and told me point blank, "Mandy, your ankle has progressed to a point that is beyond my surgical ability. You need to see a foot and ankle specialist for what's called the OATS procedure". What I would do if I were you is open up the lines of communication with your doc and ask him point blank, at what point is arthroscopy w/debridment removal effective and how did you perceive my injury to warrant the OATS procedure? You have the right to ask... and the right to know. He may have done what was actually was your best chance..... then again, maybe not. All you can do is ask. I wish you the best of luck!

 
Old 02-02-2011, 07:15 PM   #3
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chrisdv HB User
Re: Osteochondral Ankle OATs surgery - five years later, wondering if surgery was mis

Quote:
Originally Posted by TinaM1978 View Post
Hi all-

I'm writing in with some thoughts/questions about a problem that is probably a mix of physical issues and my tendency towards depression and being angry at myself. Figured you all might understand or provide some guidance. Here's my story:

About ten years ago I went to an OS because I my ankle would spontaneously slip out of its joint and roll. I had a few nasty sprained ankles, but no chronic pain or restrictions on activity. OS advised after seeing my x-ray that I had an osteochondral fracture on my right ankle that would have to be surgically treated at some point in the future. I went on my merry way, did not do anything as I continued to have no symptoms other than the odd ankle role.

Five and a half years ago, I suffered a really nasty sprained ankle (the worst I had ever had) while playing soccer. I did not do PT for the ankle. When the pain did not go away after several weeks, I went to two OSs, both of whom advised that the pain was caused by an the osteochondral lesion. They recommended drilling. I saw a third doctor who recommended OATS. Because I wanted to get the whole thing over with (I was not able to do much physical activity other than walking or swimming), I did the OATS a few months after my soccer injury.

While my actual surgery went well, after I began walking again, I never felt that I fully recovered. I still had ankle pain (although not the same pain I had before surgery) and limited use of my ankle. I also had knee pain in the area where they had taken the grafts. About 8 months after the surgery I still had knee pain and problems with ankle ROM, but I was able to do some running and get back in the gym. I continued to do physical therapy, but, again, always had pain in my knee and limited ROM in my ankle. These symptoms were likely complicated by the fact that in the five years since my surgery I have gained about 40 lbs.

About a year ago, I started to have the same pain my ankle that I had before surgery, which completely freaked me out. I went to a get ankle specialist in NYC who is very familiar with the surgery. He took a special MRI that was able to confirm that the grafts had fully integrated, which was such a relief. He said that the pain that I have is caused by scar tissue and bone spurs, which could be helped by PT and fixed by arthroscopic surgery. I did more PT (more intense than last time, with lasers to reduce scar tissue), which helped with ROM. But I can't help but think that I rushed into OATs and that I did not do enough to conservatively manage my ankle. It seems to me know that the pain I had was likely not from the OCD (which I had had without symptom prior to trauma) but as lingering complications from my severe sprain.

Logically I know I need to move on. But I can't help but beat myself up about my decision to have OATs. I feel like I had a majorly invasive surgery for no reason. Sorry for the long post, but I just feel so bad about everything mentally.

Hi Im Chris, and I have OCD in my ankle. I have seen 3 OS so far and two told me that i need to do a cartilage transplant and one says i could do arthroscopy. So im confused which procedure maybe rite for me. The lesion size from the MRI says about 8mm and there is also a large fragment of loose cartilage in the ankle. Im on pain killers now and walking with a crutch to alleviate the weight bearing. but it is still swollen everyday. CAn anyone offer some advice?

 
Old 02-07-2011, 11:27 AM   #4
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johnnymo HB Userjohnnymo HB User
Re: Osteochondral Ankle OATs surgery - five years later, wondering if surgery was mis

Hi all,

20 years ago I had Osteotomies done on both ankle for Osteochondritis and have lived with degenerative arthritis especially the past 3 years. I recently had Ankle Distraction Arthroplasty done, which is a procedure to help regrow cartilage. They scoped my joint and I have been in a fixator the past 3 months. I reccomend you both contact HSS (Hospital for Special Surgery) as they are the leaders out there. I will keep you posted. The goal is toreduce artheitic pain with this procedure. I have Dr. O'malley and Dr. Rozbruch as my surgeons. I highly recommend you look into them. All the best

John

 
Old 03-02-2011, 04:45 PM   #5
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akirka HB User
Re: Osteochondral Ankle OATs surgery - five years later, wondering if surgery was mis

Hey Tina,

I don't know what the details of your injury were but I also had OATS surgery 3 years ago as my first (and hopefully final) surgery. My lesion was very large and drilling and lesser procedures would not have helped - probably would have made it worse actually. Every surgery has scar tissue, nerve damage etc. so the fewer invasive procedures, the better. Maybe in your case you could have tried drilling, maybe not. For me, I'm extremely happy my doctor didn't put me through a series of surgeries and years of rehab. and then finally have to do OATS. 9 months out from OATS I finally started to feel normal but still had knee and ankle pain for another year. The biggest thing I've learned is that OATS is not a cure - running for example is not the best thing for this injury. My quality of life is significantly better after OATS - I can stand, walk, hike, ski etc... with no pain. If I jump around, run, do too many/ too long of high impact activities it hurts. That's just the nature of the beast. The graft is not the original - it is inferior to our pre-injury foot. It's gonna wear out faster than normal so I have learned to pull back on some of my activites. (I also gained the 40 lbs so I feel your pain ) Unfortunately, these injuries are for life - it took me a while to wrap my head around that. I'm hoping for major medical advances in the future that might 'fix' our feet for good. But I'm having tons of fun and am pain-free so OATS was very worth it. I think it's great to hear that 5 years out the graft is still good. Bummer that you probably do have scar tissue, etc.. but I hope it will be easy to clean out and you will be on your way again. Just be good to the foot and don't be too discouraged!!

Abby

 
Old 03-03-2011, 09:07 AM   #6
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dexatech HB Userdexatech HB Userdexatech HB Userdexatech HB Userdexatech HB Userdexatech HB User
Re: Osteochondral Ankle OATs surgery - five years later, wondering if surgery was mis

"Logically I know I need to move on. But I can't help but beat myself up about my decision to have OATs. I feel like I had a majorly invasive surgery for no reason. Sorry for the long post, but I just feel so bad about everything mentally. "

Anytime you have surgery done, it can be a roll of the dice. Everyone makes their best decision and that's what you go with. There is no guarantee. If yours had turned out great, you would be recommending it to everyone. Instead, you are on the other side.
It's noone's fault; just the way it is.

Which brings us to where you are now. It's hard to go forward when you're looking backward. I am not only speaking about your surgery but also life in general. You don't know and never will know what the other path would have led you down. It could have been better or it could have been worse. You'll never know and it doesn't matter.

Get your head on right and life will become much easier.

Good luck with whatever you do!

 
Old 03-12-2011, 05:11 PM   #7
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TW201 HB User
Re: Osteochondral Ankle OATs surgery - five years later, wondering if surgery was mis

Check out the DeNovo tissue transplant. Might work for you. Avoids a surgery to harvest from your knee and subsequent healing there. Also, tends to be cheaper than an allograft. Worked for my son after 2 failed previous surgeries.

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Last edited by hb-mod; 03-13-2011 at 12:23 AM. Reason: Please don't post unapproved website links, per Posting Policy. Thanks.

 
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