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Old 06-28-2009, 07:20 PM   #1
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klbarbara HB User
20mm OCL in my talus

Hi my name is Jane.
I had a 200mm OCL in my talus and had micro-drilling surgery on March 5, 2009.
The reason they did microdrilling surgery in place of OATS is b/c I dance professionally and they wanted to save my knee, and they figured that b/c I'm young and active, my bone would heal pretty quickly.

I stayed on crutches for 2 months and then walked with crutches for another 3 weeks after that.
Since then, I've used a cane and have had a lot of pain. It's been ~15 weeks since surgery and I'm worried that it's not healing correctly. The doctor does not want to do another MRI or CATSCAN, he says that it won't be useful. Did you guys get scans after your surgery? I'm wondering if anyone knows what I should be experiencing with regards to pain and what I should be expecting in the next phase of recovering? When should I expect to walk without making this thing worse?

Basically, I'm anxious to get back to dancing, but I'm also worried about pushing myself too fast and hard in the recovery process. Thanks in advance for any thoughts or insight here.

 
Old 06-29-2009, 04:54 AM   #2
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

[QUOTE=barbaralankamp;4024158]Hi my name is Jane.
I had a 200mm OCL in my talus and had micro-drilling surgery on March 5, 2009.
The reason they did microdrilling surgery in place of OATS is b/c I dance professionally and they wanted to save my knee, and they figured that b/c I'm young and active, my bone would heal pretty quickly.

I stayed on crutches for 2 months and then walked with crutches for another 3 weeks after that.
Since then, I've used a cane and have had a lot of pain. It's been ~15 weeks since surgery and I'm worried that it's not healing correctly. The doctor does not want to do another MRI or CATSCAN, he says that it won't be useful. Did you guys get scans after your surgery? I'm wondering if anyone knows what I should be experiencing with regards to pain and what I should be expecting in the next phase of recovering? When should I expect to walk without making this thing worse?

Basically, I'm anxious to get back to dancing, but I'm also worried about pushing myself too fast and hard in the recovery process. Thanks in advance for any thoughts or insight here.[/QUOTE]
Jane,

I had ankle arthroscopy/debridement surgery 6 weeks ago. I just asked my doc today about future MRIs, scans, etc. I'm trying to get a grasp on what my future treatment looks like. The answer I got was if there is pain, we'll do MRIs, etc. to see what is going on. So, I recommend you push your doctor on the pain issue.... not necessarily just to have an MRI, CATSCAN done, but to get some answers about the pain you are experiencing.

Don't be discouraged!! I'm sure others who are further down the road of recovery will be able to give you some more insight!

Hang in there,
Goksu

 
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Old 06-30-2009, 10:55 AM   #3
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Thank you so much for your answers, Goshu and Nicki!
I am so greatful to hear from others who are going through the same thing as I am. I think I will have to speak to my doc because I am experiencing the same kind of pain (only more intense) that I was feeling before the whole surgery.
I see my PT on Thursday. hopefully he will be able to give me some guidance as he is more approachable then my doc, and I am a bit shy.
thanks again!

Jane

 
Old 07-01-2009, 03:40 AM   #4
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Jane,
I had the microfracture drilling August of 08'. I too had pain after and faithfully did all my pt for 3 months and the pain got worse. I had an MRI done and a cortizone injection, which didn't work. In January 09' my doc requested another MRI due to the failure of the cortizone and of course the pain. It revealed the ocd lesion was much bigger than before. I was than left with having to have the oats procedure done. I too have bad knees due to years of gymnastics and cheerleading as a teenager. So my doc opted to use cadaver plugs. This could be an option for you. I had the oats done in March 09' the plugs integrated perfectly and the osteotomy also healed well. My doc said that it was a good thing we opted for the oats procedure because the lesion was much bigger than the MRI showed once he got in there to look.

I would definetly demand another MRI. The drilling may not have worked and you might need the oats using the cadaver plugs. From my experience you will know more once you start walking weather the pain is the ocd lesion or just being off of the ankle for a bit. Good luck and keep us posted!

 
Old 07-02-2009, 07:44 PM   #5
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

Thanks so much for your advice,

I am kind of starting to realize that there is a pretty good chance it didn't work. How long did you have to wait until you got the second surgery?
Yes, the doc was thinking about the cadver plugs the first time we discussed the surgery, but thought that it might be too risky because sometimes they don't take to the body.

So glad that yours worked!

It's hard to wait so long. it's been 4 months and still so much pain. pain that is exactly the same kind of pain that I had prior to the surgery, only stronger and worse. The doctor said that I need to wait a few more months before an MRI would show clarity of whether it healed or not. Was this your case as well?

Did your pain ease or subside over time?

thanks so much!

Jane

 
Old 07-20-2009, 12:24 PM   #6
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Re: Osteochondral Surgery/debridement/drilling medial talar dome (post surgery)

I had the debridment and drilling done via arthroscopy in 2004 or 2005. I was walking within 1 week after this procedure and felt 100% within 1 month. My OS's jaw hit the floor in absolute disbeleif when I told him how absolutly wonderfully I was doing. He said that typically it takes many months before patients notice any improvement from the surgery and couldn't understand why it seemed to be such a miracle procedure for me. He's right in suggesting that further scans wouldn't do any good at this point. If I were in your shoes knowing what I know, I would try to be patient and wait it out a bit longer. In late 2007 my ankle starting hurting again, going out, catching etc. I thought I needed another arthroscopy/debridment removal... so when I went back to him again, his jaw hit the floor. He informed me that the condition had progressed far beyond his surgical ability and I needed to see a foot and ankle specialist. So, the following week I was seeing a new doctor who informed me that to rectify the problem I'd need the OATS procedure. Tired of the chronic pain, I eagerly scheduled the surgery and did much research on it, but no research will ever prepare you for what you will actually endure from the OATS procedure. I'm nearly 3 months out from the surgery and still have pain (grant it, I fell 1 month ago and the osteotomy slipped, so I'll be going in for another surgery in about 2 weeks or so...), extremely limited mobility, stiffness etc. etc. and in all honest to God truth, I don't think my ankle will ever be 100% again. Now that I'm in this situation, I feel as though I could have endured the pain/catching/ankle going out etc.... at least another year or so before doing the OATS procedure. So, I'd give yourself a good 9-12 months after the initial surgery before considering anything else. If you end up going into the OATS procedure I'd kiss dancing goodbye for at least 1 year, if ever again. I know some people say that after OATS, they can run again and it's all good, but the surgery is a very complex surgery and the outcome will be different for everyone. My OS does not seem to think I'll be able to run or play volleyball anymore... and I'm only 26 years old.

 
Old 07-21-2009, 11:14 AM   #7
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Re: 200mm OCL in my talus

Hey Jane,

a 20mm or 2cm defect is really big - mine was 18mm and I had 2 specialists say that it was too large for drilling. But the nature of everyone's problems are different and so maybe the drilling will work for you. I agree with mstreet to give it time - up to a year to see how it fares. It takes ankles a long time to heal for sure and you don't want to rush it. And you don't want to rush into OATS. When the OS first recommended it it for my foot I contemplated it for over a year. I really spent time evaluating my quality of life, my pain level, my ability to take a good 9 months to recover. When I finally did have the procedure done, I was very happy to take the risk. And I'm one of the OATS people who says I can 'run', but I really shouldn't say that. My activity level is no where near where it used to be and I still baby my foot. My 'runs' are small, slow little jogs on soft ground. I can't run miles everyday like I used to. The most amazing difference OATS made for me was that the stabbing pain I had disappeared and I am now able to wear shoes comfortably, walk and stand for hours without pain. I've learned to be very happy with that level of activity.

Mstreet - don't be discouraged at all. 3 months out my whole leg was in terrible pain and was as stiff as a log. By 6 months it was completely different - good different! You're right though - your ankle will never be 100%but don't rule out fun but low impact activites you'll be able to do. I think you'll be very happy the catching/pain is gone!

Abby

Last edited by Administrator; 12-02-2009 at 05:31 AM.

 
Old 07-22-2009, 03:07 AM   #8
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SkatersDad HB User
Re: 200mm OCL in my talus

Jane,
Sorry to hear about your problems. What do you think caused the damage and what do you mean by 200ml OCL 200 seems very large for a Talus Bone.
Are you in ballet? Do you think this may have been caused by leaps? Did you tap? My son is a dancer and ice skater, had 9mm donor cadaver plug 2 years ago after a failed drilling about 3 years ago.
Dennis

 
Old 07-23-2009, 08:08 AM   #9
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Re: 200mm OCL in my talus

Hi Jane
I had about the same thing, 20mm piece of boone broken from talus, they removed it, drill and microfracture. I had the surgery mid February and looks like I was lucky or maybe was my high pain tolerance... I didn't have much pain... I was nwb for 6 weeks. Now I'm walking normal, my ankle is nearly 80% of the strenght had before, and more important, NO pain.
If I was you, I would press the doctor about the pain... too much pain means something is not right.

Good luck
Sparks

 
Old 07-24-2009, 08:42 AM   #10
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klbarbara HB User
Re: 200mm OCL in my talus

Wow! thank you all so much for your responses!!!!

Sorry for the delay here, we have dial up internet and it often times out before I can get the message composed

W/re to the size.....200mm did sound huge when the doc told me. However he said that my lesion was 2cm by 1.5 cm. I think I will ask him again when I see him next to clarify, but I do suspect it was the biggie. On the CT scan it looked like someone had taken an enormous bite out of my talus. He told me that he was going to have to do the OATS procedure because of the size, (that he had rarely seen one that large) but after speaking to several other specialists they decided to do a sort of "experimental" trail to see if the drilling could work. they did this because I am 25 and quite healthy. (Skaters' Dad - I am trained in ballet and used to tap....now I do contemporary dance. however I also run long distance, used to be a gymnast and love sports all together) I think that the condition was exacerbated because I have a bow in one of my legs, which means that all of the weight goes directly into the spot where the lesion is. I am working with a rehab/pilates specialist who is helping me correct my leg alignment and it is helping a lot. I think that if I need to get the OATS surgery, I won't do it and opt for more alternative therapy techniques like the pilates until stem cell research advances enough. No way is someone cutting into my knee. I think that my injury was likely caused by pounding on it via my bow leg for years and years so I think I need to do some mega correction on the bow leg.

I can walk around the house without pain but at the end of the day it gets a little sore and if I walk to much it gets a little scary-sore. i hope this is progress?????

thanks again guys!
it is great to have this kind of support.

Jane

 
Old 07-24-2009, 01:29 PM   #11
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Re: 200mm OCL in my talus

Hi Jane
Not trying to be negative... but...
If the OATS is needed, better have it, even if is with donor bone. Steam cell can be years away, pilates might work in helping with the alignment of the leg, but is not gonna heal the OCD... Instead you risk further damage to the Talus which is really not gonna be good.
I remember reading someone's story who had the Talus damaged beyond repair and had to be completly removed, I don't remember if was here in boards or somewhere else.
If I have to get to OATS, I will do it without thinking for a second, and if the donor option is not available, I'd rather have a hole in the knee then a missing talus in a few years.

And yes, that is progress... when starts to hurt, rest it... I still put cold gel packs on it sometimes, it helps.

Sparks

Last edited by Sparksa; 07-24-2009 at 01:34 PM.

 
Old 07-24-2009, 07:34 PM   #12
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Re: 200mm OCL in my talus

Jane: I agree with Sparksa, if you need it, get it. My doc says too many people have the drilling only & end up needing OATS down the road. By then they have more severe damage & can even get ankle arthritis. If left untreated you may need a total ankle replacement or fusion. I'm not an athlete, just a person who likes to walk & my injury came from walking across my living room floor & "turning my ankle". I didn't know for 4 months what I had done & by then it was major damage. I had the OATS with 2 Trucor plugs put in ankle (no graft from knee). They are stainless steel. I'd ask your doc about this option. Good luck.

Last edited by 2ScrewedUp; 07-24-2009 at 07:35 PM.

 
Old 07-25-2009, 08:26 AM   #13
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Re: 200mm OCL in my talus

Hi Jane,
The soreness you feel after walking on your ankle at the end of the day, is classic cartilage pain. I've read it in so many books, talked to many professionals about it and have experienced it myself. It looks like you have a 20mm lesion or 2 cm lesion. I don't think the area of cartilage on the talus could be humanly possible to even be 200mm big! That would make it 20cm or just under 10 inches WOW!
I know the sound of having the OATS procedure sounds scary. To be honest, it's a barbaric surgery... but so is any orthopedic surgery. I sounded like you when I found out I needed it! I saw five doctors and three out of five told me the drilling would not be a good option because it's typically done on really small lesions, anywhere under 8mm or so. And that's pushing it. I read research articles stating the same thing. I saw the best doctor in the country for osteochondral lesions on the talus and he told me the same thing. In fact, he told me these types of lesions are common in basketball players and dancers. He has published research on that too. So after all that I knew the OATS procedure was my best option. My pain was actually quite tolerable, so I was shocked I would need such an invasive procedure, but I didn't want it to get to the point where I needed an ankle replacement or fusion...I'm only 30! I too am waiting for medicine to advance. I can't wait to see stem cells regenerating cartilage! But it might be ten years or so before we start seeing that happen, so in the mean time, take care of yourself.
I am glad I had the OATs procedure. I am four months post op and my knee is doing great, and just stopped swelling and feeling funny. My ankle is getting stronger and better everyday, and the pain I had prior to surgery is gone! I am back at the gym now, doing the stationary bike, elliptical and weights. I don't think I'll ever be a runner, but I do plan to go on light jogs once every rare while. I'm really happy so far, and extremely grateful for advanced medicine! So, don't be afraid to choose this option if it sounds like the smartest move! The key to success is finding an experienced doctor in OATs procedures and of course, more importantly, trusting in God.
Good luck to you!!!
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-Liz

 
Old 07-25-2009, 09:56 AM   #14
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Re: 200mm OCL in my talus

Great post Liz - you said it best! I had 1 foot doc. & 2 ortho. doc. opinions & they all agreed on the OATS for me as my lesion was rather large & mine occurred in the non-athlete way (rolling ankle while walking in house ). I did extensive research like Liz & had a lengthy talk w/my foot doc whom I love/trust his opinion. He agreed w/the procedure & said he'd support me 100%. My main concern was surgeon saying he'd have to shave off or go thru the ankle bone due to lesion location (posteror medial talus). I got lucky in finding a surgeon who had OCD lesions of Talus listed on his resume as a special interest. He did his fellowship on this. The surgery went better than expected though he found a dime-size bone fragment in my ankle. I did have 2 permanent screws put in, but I've been very pleased w/doc.'s care & my follow-up x-rays look good. I'm 8 wks post-op. The best advice I can give? Research anything/everything on OATS, Talus, Osteotomies, surgery, get 2-3 ortho. surgeon opinions (ask their experience w/OATS & Talus lesions, ask their stats on surgery success, see if you can talk to a former patient)

Last edited by Administrator; 12-01-2009 at 09:01 PM.

 
Old 07-26-2009, 07:15 AM   #15
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Re: 200mm OCL in my talus

Jane,
I had the oats and then proceeded to have a year long fight with my insurance co. I had to prove the oats was a viable option and scientifically proven to work. In my year of reserch I found alot of info on lesion size. It seemed like whenever the lesion crosses over to the cm numbers it is too large for just drilling. I was once told the talus is about an inch and a half in size. If you draw out the 2cm x1.5 cm on a paper and then draw an 1.5 inch circle, you will be unpleasantly surprised how big your lesion is. Now with that horrible thing said, keep in mind the oats is not easy or guaranteed. But also proven is with out it the lesion will continue to grow making it even worse for treatment. So unfortunatly there is not easy decision for you. The success rate are in all of our favor. If you look at the people on the board who have ongoing trouble, alot of it does not have to do with the actual oats. You being young and healthy is just more in your favor. (I'm old and decrepit ). I wish you luck and healing.
2screwedup and Anklehelp nice to hear things are going well. Happy healing!

Last edited by Administrator; 12-01-2009 at 09:01 PM.

 
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