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Old 04-22-2009, 12:00 PM   #1
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Question Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Has anyone had experience with subchondral cysts in the tibia plafond? I got an MRI five years after OATS surgery on my ankle (15mm lesion in the medial talus) that noted such a cyst. I have no idea if it was present when my OATS was done - the doctor never mentioned another chondral injury -- I hope it was not or I will be ******!

Anyway, hoping this cyst is not a big deal, but it's a few weeks until I can see the doctor, so wanted to get any thoughts on this. I am planning to have arthroscopic surgery to clean up scar tissue and bone spurs in a few months, but I can't handle another invasive surgery to repair ankle cartilage.

 
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Old 04-22-2009, 02:40 PM   #2
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Hi Tina, I am just 5 weeks post oats so I don't know much as you do post recovery. But, I had two or three cysts on the talus dome prior to surgery. Those were removed. My doctor said through my recovery I might see cysts develop on MRIs and not too worry. I don't know much else but now I know to ask him. The MRI also showed an 18 mm lesion but it was actually 9mm, so I think sometimes it's hard to know what's really serious and what's not. Let us know what your dr says and best wishes.
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Old 04-22-2009, 02:54 PM   #3
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Thanks Liz. The doctor didn't say anything about it, so I am assuming (and hoping) that it's not a big deal.

Do you mind if I ask what doctor did your OATS?

Quote:
Originally Posted by anklehelp View Post
Hi Tina, I am just 5 weeks post oats so I don't know much as you do post recovery. But, I had two or three cysts on the talus dome prior to surgery. Those were removed. My doctor said through my recovery I might see cysts develop on MRIs and not too worry. I don't know much else but now I know to ask him. The MRI also showed an 18 mm lesion but it was actually 9mm, so I think sometimes it's hard to know what's really serious and what's not. Let us know what your dr says and best wishes.

 
Old 04-22-2009, 08:08 PM   #4
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

I don't mind telling, I just don't know if I'll get kicked out of here if I disclose that. It's so private on here! He's a great and very experienced dr in NY. I have a feeling you know who I am referring to.
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Old 04-22-2009, 09:09 PM   #5
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

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Originally Posted by anklehelp View Post
I don't mind telling, I just don't know if I'll get kicked out of here if I disclose that. It's so private on here! He's a great and very experienced dr in NY. I have a feeling you know who I am referring to.
So strange - did not realize we could not discuss doctors! Yes, I probably do (he was not my original surgeon, since I had OATS in another area of the country).

 
Old 04-22-2009, 09:21 PM   #6
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

tina, I've had PTTD and Peroneal surgeries and last year had an arthroscopy to clean out scar tissue. My MRI revealed some subchondral cysts that my OS said he would just keep an eye on them to make sure they didn't "break free". Not sure what that meant but since he wasn't worried, I really didn't want something else to worry about so didn't ask.

 
Old 04-23-2009, 11:53 AM   #7
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Hey guys!

I've posted my Dr.'s names here before with no problem. They just don't want internet links to his website etc... but the name is fine. Tina, I wonder when you had your intial talus injury if you also had an injury to your tibia too? There's one person (Kimberp) on here that has had OATS and I think she also had a lesion to her tibia. So how was the success of your OATS the last 5 years? Have you basically been pain-free and this surgery is for newer issues or have you had some degree of pain throughout? I'm wondering because I had OATS 15 months ago and my foot feels great and basically pain-free. I hope it stays like that for a long time! I hope your MRI is no big deal - I agree with Liz that even the scans aren't perfect. I had a lot of cysts in my talus but the MRI didn't show a giant cartalige tear they found in there. Then I think Kris on this site had an MRI that showed cystic lesions after her OATS surgery but they said it would always look like that and it was nothing new to worry about. Let us know what your Dr. says!

Abby

 
Old 04-23-2009, 07:05 PM   #8
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Hey Tina, I see Abby says we can post drs names. I saw Dr. Kennedy, hope that helps. I think he's great.
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Old 04-23-2009, 09:27 PM   #9
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

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Originally Posted by akirka View Post
Hey guys!

So how was the success of your OATS the last 5 years? Have you basically been pain-free and this surgery is for newer issues or have you had some degree of pain throughout? I'm wondering because I had OATS 15 months ago and my foot feels great and basically pain-free. I hope it stays like that for a long time! I hope your MRI is no big deal - I agree with Liz that even the scans aren't perfect. I had a lot of cysts in my talus but the MRI didn't show a giant cartalige tear they found in there. Then I think Kris on this site had an MRI that showed cystic lesions after her OATS surgery but they said it would always look like that and it was nothing new to worry about. Let us know what your Dr. says!

Abby
Wish I could be more positive, but my experience has not been great. Until a year ago, my ankle pain was better, though I still had a limited range of motion and pain when I dorsi and plantar flex. But I started to have more pain a year ago. I'm hoping it is just the scar tissue and bone spurs. So the jury is still out. An MRI taken a year ago said that my grafts were completely incorporated, with some unevenness on the repair cartilage (which I believe is pretty normal).

My main problem however has been that I have had pain in my knee since the surgery (which I never had problems with prior to surgery). Despite numerous PT sessions, I have frequent pain in my knee when weight bearing (particularly when doing stairs). It's really frustrating. When I am being honest with myself, I regret having the surgery, although who knows how my ankle would be if I did not have surgery.

 
Old 04-24-2009, 12:50 PM   #10
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Tina,

Sorry you haven't had the best experience. So far I would say that it was very worth it for me. I also have knee pain that I never had before surgery but it's pretty insignificant compared to my ankle pain. Going downhill is the worst for me too - esp. downhill skiing!! I'm hoping better fitness and weight-loss will help my knee some more. I really hope for you that after cleaning out the spurs/scar tissue you will feel much better. With all the variety of experiences on this board you can see why there are so many opinions about OATS out there. I'm sure you made the best decision for you at the time and you're right, your ankle without OATS might have been ready for fusion by now. Too bad we don't have a crystal ball at our disposal!

Thanks for the feedback

Abby

 
Old 04-24-2009, 04:05 PM   #11
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

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Originally Posted by akirka View Post
Tina,

Sorry you haven't had the best experience. So far I would say that it was very worth it for me. I also have knee pain that I never had before surgery but it's pretty insignificant compared to my ankle pain. Going downhill is the worst for me too - esp. downhill skiing!! I'm hoping better fitness and weight-loss will help my knee some more. I really hope for you that after cleaning out the spurs/scar tissue you will feel much better. With all the variety of experiences on this board you can see why there are so many opinions about OATS out there. I'm sure you made the best decision for you at the time and you're right, your ankle without OATS might have been ready for fusion by now. Too bad we don't have a crystal ball at our disposal!

Thanks for the feedback

Abby
I should also add that I definitely have good days (like today). I exercised yesterday - 30 minutes elliptical and a lot of weights, which would have caused me significant pain pre-surgery. Today I felt totallly fine - no pain in my ankle at all.

 
Old 08-02-2010, 11:42 PM   #12
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Hi Liz,
I don't know if you are still on here, but I would love an update if you have one.
I am about to have surgery with the same doctor and am curious to talk to someone who has been through it all. How does it feel now? are you back to all activities?
Thanks,
HH

 
Old 08-06-2010, 12:56 PM   #13
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

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Originally Posted by HHtriathlete View Post
Hi Liz,
I don't know if you are still on here, but I would love an update if you have one.
I am about to have surgery with the same doctor and am curious to talk to someone who has been through it all. How does it feel now? are you back to all activities?
Thanks,
HH
Hi HHTriathlete -

Sorry for taking a while to get back to you...
First of all, when is your surgery? I had my surgery in March '09. So that makes me...a year and five months post op. I'm feeling a lot better than I did a year ago. It's strange, but even a year and a 1/2 post op I still feel that I'm healing. It has been a rough recovery, I'm not gonna lie and I STILL stretch my ankle every day, and do balance and other ankle exercises about three times a week just to keep my joint stable.
I can't say that my ankle feels 100%, but maybe 90%. I do kickboxing, cycling, weightlifting (including squats & lunges). I don't run for exercise but when I run after my dog for example, or other things, my ankle feels fine. I just choose not run for fear of damaging my cartilage again.
Overall, I am happy with the outcome of the surgery. I'm painfree and active. Areas I need improvement are: My ROM never fully came back, so it's hard for me to squat deeply (which is bad for your knees anyway so maybe that's a plus, haha), my ankle still feels somewhat "stiff" especially after not moving it for a while, and my calf is about an inch smaller than the other! I think this is because I don't have my FULL range of motion.
Anyway...hope this answers some of your questions...let me know how it goes. Dr. K is great.
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Old 08-09-2010, 08:41 AM   #14
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Hi again, Liz,

Thanks so much for the reply. It is great to hear you are back to doing all that activity and it feels so good!
I have one more question, if you don't mind.
Did you seriously consider drilling instead of OATS?
I just got back from a 3rd doctor and was convinced that maybe drilling is the answer for now over OATS - I was convinced otherwise after my 2nd opinion. i am so confused and conflicted. How did you make that decision?

If anyone else has any advice on this topic, I'll listen to anything right now.

Thanks,
Hilary

 
Old 08-09-2010, 11:51 AM   #15
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Re: Subchondral Cyst in Ankle (Tibia Plafond) 5 years after OATs surgery

Hi Hilary,

So I wanted to get drilling instead of OATS, much better surgery to try to recover from! I saw a handful of doctors and 3 suggested OATS for me, one suggested drilling and another said to do nothing and wait until it got worse. I did a lot of research and from what I read, drilling - also known as microfracture is most successful on smaller OCD lesions. I believe most doctors do not recommend drilling if your lesion is greater than 10mm (1cm). My lesion was 9mm, so I was right next to the "cut-off." As I mentioned earlier the majority of MDs I saw suggested OATS in my case, so that combined with the research I did convinced me OATS was a better option for me.
Definitely get all the expert opinions you can for YOUR injury and YOUR best options. If your lesion is not that big, drilling might be something you want to try FIRST.
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Last edited by anklehelp; 08-09-2010 at 11:52 AM.

 
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