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Old 07-16-2010, 07:40 PM   #1
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Drilling a sucess, freak tendon tear, need surgery again

Drilling of my 18 mm ocd worked. Finally out of boot. All going well until standing on drilled foot , practicing proprioception when heard a loud pop, strange sensation behind lat malloleus. MRI- partially torn sup peroneal retinaculum allowing tendons to subluxate. Peroneus b. has partial tear. Longus partially avulsed. Partial tear syndesmosis. Tenosynovitis. Back in boot- not much pain unless I try to walk. OS says its unlikely, but not impossible for peroneals to get better without surgery. Doubtful conservative treatment will work, since I just got out of 3mos casting/boot and they tore from standing still.
They were bothering me before ocd drilling, worse now. Very discouraged. Going to get second and third opinions in Baltimore few weeks.
Not sure how soon to do surgery- psychologically, not ready for another three mos of crutches, casts,
Surgeon such a cowboy- tells me no restriction of activity , stay in boot if pain, don't do anything w causes lateral motion. That brevis will tear more if it continues to subluxate and snap. How does that add up to no restriction?

Many of you have had multiple surgeries- any back to back? Any advice?

 
Old 07-17-2010, 09:15 AM   #2
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Re: Drilling a sucess, freak tendon tear, need surgery again

Hi Hallie2,
I so feel your pain!!!! Had my first surgery to repair the peroneal tendons and the posterior tibial tendons in May 2007. Was doing great and then reinjured the peroneal tendons in summer 2007. Had my second surgery October 2007. Was back to normal, doing what I wanted, when I wanted, pain free when in summer of 2009 reinjured the peroneal tendons. Had my third and hopefullly my last surgery January 26, 2010. Was finally pain free, then started PT. Don't know what happened but by the end of my third PT session, I couldn't walk. My doc thinks something happened within the ankle joint. Have had 2 cortisone shots, am on 800 mg ibuprofen pretty much around the clock , using voltaren gel twice a day, icing, wearing my brace and still in pain. Some days are worse than others. Don't know what else he'll suggest we try. Hang in there, I know it's rough.

 
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Old 07-17-2010, 09:50 AM   #3
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Re: Drilling a sucess, freak tendon tear, need surgery again

Wow, you've really been through the mill. Was your original tear acute or degenerative? OS or podiatrist?

 
Old 07-17-2010, 11:41 AM   #4
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Re: Drilling a sucess, freak tendon tear, need surgery again

I have no idea how I initially hurt my ankle. I broke that foot just by standing up 6 months prior to my ankle problem but my doc said it was a freak thing and had nothing to do with my tendon problem. I went over 2 years trying different treatments etc. hoping to avoid the surgery but it finally got to the point where it was keeping me up at night and basically interfering with my life. I used a podiatrist and he is great. I work in healthcare and know several OSs but felt a podiatrist was experienced in just foot and ankle problems and that's alll they deal with so I took that route.

 
Old 07-17-2010, 11:46 AM   #5
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Re: Drilling a sucess, freak tendon tear, need surgery again

One more thing. I don't know how your doc can say no restrictions. I was no weight bearing for weeks, then partial weight bearing for a couple of weeks then in a boot for a month. I think you're smart getting another opinion.

 
Old 07-17-2010, 12:29 PM   #6
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Re: Drilling a sucess, freak tendon tear, need surgery again

Probably because he expects me not to be an idiot and overdo it and also because I literally just finished 2 mos nwb then 1 month boot. The tendons were bad going into the drilling, but if they were going to improve, they had a leisurely 3 mos off to get better. So I can ride exercise bike or walk, in boot or brace, depending on pain. Very little pain, more a feeling of instability and achiness. Regardless, it does seem like I ought to do whatever possible to keep them from getting worse. Think I'll have surgery asap-

 
Old 07-17-2010, 10:03 PM   #7
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Re: Drilling a sucess, freak tendon tear, need surgery again

I've has 3 ankle surgeries and bilateral tailors bunions corrected. 2 of the ankle surgeries and the bunion surgery have been in the last 3 years (with a broken thumb and a skull fracture tossed in too). In December I had a Brostrom done to repair the lateral ligaments. When given the okay to start doing more around April I got very sore in the peroneal tendon area and developed a pop. After 2 months of fighting with it, MRI showed tendonosis, tenosynovitis, and a tear in the peroneal brevis. After a lengthy discussion my surgeon and I agreed that I could have no restrictions with the understanding that if I got more sore I would wear my boot until it settled down again. My surgeon is amazing and understands my active lifestyle and that after 10 months of being restricted (injury was in Aug 2009) tying me down isn't the best. Sure, the tendon could heal, it could not. We'll have that discussion in October or November when I check in with him. Until then, I ice, massage with Freeze It, and brace when active or sore.

In your case, with thee subluxation, I'm not certain I would trust "no restrictions." The popping I have is scar tissue. Definitely get another opinion. I use an OS with a foot and ankle fellowship.

 
Old 07-18-2010, 04:58 AM   #8
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Re: Drilling a sucess, freak tendon tear, need surgery again

Thanks, sounds more hopeful. My os is foot and ankle as well, very competent- going by the literature, my OCD was larger than what reliably heals w drilling, and it was a revision from a drilling 5 yes before. He fixed it, w was fantastic. But he's very casual, doesn't give me much guidance. The popping started before the surgery, it was subtle, and I didn't know at the time what it was. It was the peroneals, and the very loud pop was something tearing, retinaculum, peroneal tendon? He does say that if peroneal continues to rob against fibula, tears could get more severe, then surgery is no longer elective. My sense has always been that because I'm so physically strong, and don't feel much pain, orthopods miss injuries in the ankle. I'm prettyuxh doing the same as you, activity with brace, boot if feel pain or unstable, ice ice ice. My sense is that the ankle structure- tendons and ligaments- are degenerating, and that I'll need reconstructive surgery to continue my active life. There are 2 superstars- Myerson and Schon- nearby.I see Schon in two weeks( he did my surgery 5 yes ago) Myerson takes three mos. My surgeon, the cowboy, is only 5 yes out of foot and ankle fellowship, and I'm guessing I want someone with many, many reconstructions under his belt to tackle this. I had a closed head injury a few yes ago, may explain my hardheadedness

 
Old 07-18-2010, 07:42 AM   #9
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Re: Drilling a sucess, freak tendon tear, need surgery again

What is Freeze It?

 
Old 07-18-2010, 02:27 PM   #10
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Re: Drilling a sucess, freak tendon tear, need surgery again

Freeze It is like Icy Hot only way, way better. It can also be found as BioFreeze. Comes as a gel, roll-on, and spray. Personally, I like the gel because I massage it in. You can find it at a drug store in the same section as the Icy Hot. I usually find it on a lower shelf. Works great on neck and back soreness from sitting around after surgery too.

 
Old 07-19-2010, 06:56 AM   #11
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Re: Drilling a sucess, freak tendon tear, need surgery again

Hallie2,
Sorry to hear your looking at surgery again. I can't imagine just getting finished nwb and having to go back right into it again. 13 month between my two surgeries was to close for me.

Like skyhighifly suggested biofreeze works or icy hot works well for minor aches. I know you have horses if you keep things like HPQR or Theraflex around those I have found work better and are cheaper than other products.



I wish you the best of luck.

 
Old 07-19-2010, 03:34 PM   #12
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Re: Drilling a sucess, freak tendon tear, need surgery again

thanks. I did hear back from my surgeon-after I complained about pain on walking- that I should take it easy, rather that no restriction of activity. The good news was that the ocd is healing well-if that had failed, I'd be a wreck. I knew the lateral ankle was in bad shape, but I kinda assumed after 3 mos in cast/crutchs/boot it would heal.
Have an appt in Baltimore in two weeks, until then, the slow and easy life.
I hope they can do something meaningful for all the torn ligaments and tendons.

 
Old 07-19-2010, 04:37 PM   #13
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Re: Drilling a sucess, freak tendon tear, need surgery again

Hallie2
Sorry for all you are going through- Schon fixed both of my ankles, personally I think he is one of the best. I have been toying with PTT tendonitis but have a few other issues to take care of before I go back to him. Good luck with your visit.

 
Old 07-19-2010, 06:13 PM   #14
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Re: Drilling a sucess, freak tendon tear, need surgery again

thanks Maggie. Everyone is so supportive here, it's such a great resource. Lew did the first ocd repair in 2005, and the only reason I didn't go to him for the revision was because I thought it would be easier to see someone closer. And this surgeon did a good job, but, seems to me a reconstructive surgery is dicier, and I want someone more experienced.
I don't know what to expect, there are old tears of cfl, atfl (from riding accident 15 yrs ago) and now the subluxing and torn peroneals.

 
Old 07-19-2010, 06:23 PM   #15
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Re: Drilling a sucess, freak tendon tear, need surgery again

Hallie2
Are you far from Baltimore? That's funny, I had my second surgery with him in '05, for the second peroneal, then all was kind of quiet till july "09 whenhe did a small surgery on my fascia (attached to my tibia). I have not had too much that is complicated, but from what I hear from everyone he is the best.Good luck- take it easy for the next ten days and let us know how the appt. goes.

 
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