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Foot & Ankle Problems Message Board
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Old 03-19-2009, 07:30 AM   #1
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Join Date: Feb 2009
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avboy HB User
worried about aggressive post-op recovery plan

hi everyone,
its good to know that there are so many out there who share the same bum-ankle problems as i do.

I had an ankle arthroscopy done on 25 February 2009 to remove bone spurs and perform some subchondral drilling to help repair a OCD (5mm X 5mm) located on the talus bone of my right ankle.

1 week post-op and already my OS has advised that i start doing some "tip-toe" walking with light heel touches to prevent the joint from getting stiff. i did get some electric jolts from this but its almost all gone now.

2 weeks out stitches were removed and asked to start "heel down" walking with 2 crutches as support. (PWB about 10~20% of weight)

as of today, i am 3 weeks post-op. OS prescribed Hyalgan injections to be administered weekly for the next 3 weeks to help the cartilage heal even better as Hyalgan lubricates the joint and is exactly what the joint and cartilage likes. Further to that, he advised that i should start PWB (50% of body weight) with one crutch and hopefully by about 4 weeks out i'll be able to get rid of my dependence on crutches and walk with an ankle aircast only.

During this 3 weeks, i have been working with my physio therapist on a continuous basis (PT sessions every other days). she is an excellent PT and has been very re-assuring in telling me that the joint needs to be stretched and that range of movement exercises are ok as long as i am aware of the pain and do not go beyond 2 of 10 on the pain scale. She explained that if i continue to rest the ankle joint and not use it the body might start depositing bone cells instead of cartilage cells (chondrocytes) onto the drilled area forming bone spurs. she gave an example of false joints (pseudarthrosis) where people have reported cartilage like formation on non-union bone fractures due to excessive movement during recovery in a cast. I googled this and it makes sense. Has anyone heard of such a theory before?

The center i go to is a well-known sports medicine center in kuala lumpur,Malaysia and have successfully regenerated knee cartilage using stem-cells harvested from the body. During these 3 weeks while attending my PT session, i have had a chance to interact with some patients who did their surgeries a year ago and are absolutely happy with the results that they obtained and hence reinforces the confidence that i will be able to recover as well.

but after reading the threads here, my recommended post-op recovery plan from microfracture seems very aggresive compared to what is practiced in the US and i am worried that it would jeopardise my full recovery and proper formation of healty cartilage. The OS i see is a foot, ankle specialist from the same establishment. I was wondering if anyone else has been given such an aggressive post-op recovery timeline from microfracture of the ankle? should i take actions into my own hands and stay off the foot for the next 6 weeks as is practised in the US or should i go with my OS/PT advise and proceed with their recommendations. haven't been able to find much information on ankle microfracture recovery plans except for here. Any information or help is greatly appreciated.

Thanks

Last edited by Administrator; 07-11-2009 at 02:12 PM.

 
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Old 03-19-2009, 11:43 AM   #2
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Join Date: May 2008
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jflash3 HB User
Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Avboy i had microfracture/debridement of my talor dome back in Dec/06 and i was only non-weight braring for around week. I don't understand these long non-weight bearing periods for micro-fracture surgery to the talus. After the week i was walking with the aid of crutches and in therapy already. Your timeline sounds fine. I had to have an allograft done in apr 08 cause the micro-frac/debridement didn't work due to the large size of my lesion, and even after this surgery which is a major surgery compared to the micro-fracture i was only non-weight bearing for around 8 weeks. Then i progressed to a cam boot with crutches for a week, then just crutches for maybe another week or 2, and after that walking with no aids. I was not walking normally by no means, but i was walking with full weight bearing at around 11 weeks. I see one of the best ankle specialist in chicago at northwestern so i don't think his timeline is off by very much when it comes to this stuff. Good luck to you ,hope this helps. Jflash

 
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