I'm new here and I'm impressed by the number of threads regarding ankle OATS. I had OATS 8 weeks ago, and I'm very worried cause my ankle mobility hasn't improved since my fourth week. With the leg straight, the ankle bends almost like the good one (except my big toe, which has ~20% less flexibility).
But when I start to bend the knee, the mobility of the ankle decreases significantly...with the knee at 60 degree angle, the foot has more than 30 degrees less than the good one.
And the pain in my knee is excruciating when i bend it over 90 degrees, keep it there for a while and than trying to straighten it back (unsuported).
Can anybody help me by sharing his/her experience regarding the recovery evolution....Please!...I dont have a PT (yet), and my surgeon is very far and not very comunicative, and any help would be grealy appreciated!
Did you have an autograph from the knee? Is that why it is so stiff? There is a thread right below this about "what after cast removal" it has two different scenarios with the OATS. It is a long road that is for sure. I am still very stiff and that sounds like what you are experiencing. I had my OATS on May 18 and still get super stiff. There is nothing much to do for it other than constant movement. You don't have to do impact just alot of movement. I also really like heat which is a bit contradictory. If you can spend time working it in a hot tub, then of course ice when you are swollen. There also sometimes is an issue with scar tissue which can make you feel real stiff. You need to massage your scars for that one, it can be a bit painful but in the long run it helps. check out the other thread for some experiences
Best wishes to a good recovery
Thank you Dizzizzi for quick reply!
Of course I had autograft from my knee ( OATS means exactly this). I'm not worried very much by the acute pain in my knee, but for my lack of improvement in ankle mobility for the last 4 weeks....although I work very hard (2-3 hours daily of walking in a pool and other exercises).
So, I was wondering if the limited and dificult to improve ankle mobility is normal for the second month....and when should I expect for better results. I have wore cast just for two days, and starting with week 7 I started to walk with only one crutch quite easily. I was looking for exact description of ankle mobility evolution, especialy from people over 40, cause I'm 47 now.
You should do a search for older OATS conversations in this section - there were 4 of us going through it at the same time, myself included, and we were all around 40 at the time.
If it helps, I am 3 years post OATS, my knee is great (never had any pain, just some stiffness for the first few months) and my two plugs incorporated wonderfully. My biggest challenge now, 5 surgeries later is degenerative arthritis affecting that joint and my subtalar joint and scar tissue. Sounds like you are doing the right thing though and are moving it early - good for you.
I'd say I started to feel better about 6 months after but took a good year to know if it worked.
well it seems like you are doing quite well if you are pool walking that long already. I have been through OATS in both ankles and the first was an autograph from the knee and my last one was an allograph which was taken from a cadaviar. So there are actually several different kinds of OATS. The thing to remember with this surgery is that it an extensive rebuild of a very important weight bearing bone. Although at this point it may seem like it has been a very long time it is actually just a short while into the recovery that is a very long process. It will take up to a year for your transferred piece to get revasculated and incorporated. The part that is healed for you at this point is the osteotomy (the sawed open part) once that part is healed it is generally safe to start weight bearing again. However I strongly caution over doing it at this point. Please take it easy if possible. Remember to ice and elevate still. There have been too many instances of set backs in the 4 years that I have been on this site with the other OATers. I agree with Kim on the at least 6 months...I go even further and say 8 months... Please take care, this is just not a broken bone healing. Best wishes to you!
Thanks again both of you for taking time to answer to my thread.
You are so right: I'm already encountering problems and set backs because I sped up too much with my unsupervised recovery: my knee has swallen, loss 30 degrees of mobility and hurts lot more in the last 3 days: A week ago I traveled to and from the pool (two days in a row)on my feet with only one crutch...I was feeling great, no pain at all. Half a mile walk, after 7 weeks of iceing on my bed. And I think I stretch too much at the pool! It seems that I have to slow down for a while!
My question still remains, though: did you achieve full ankle mobility after few weeks or not???
You are also right: there are a lot of posts on OATS, but after reading about 100 of them and not finding a clue about actual recovery progresses and exercises, I gave up and decided to make a thread myself. So, any precise post about that would be greatly appreciated. Remember that I can't rely on a good PT and my doctor is far away!!!
PS Sorry Dizzizzi, I didn't realize that alograft starts with an A, also! I just supposed that describing my painfull knee was enough!
Both Dizzi and I did answer your question... No, we didn't get full mobility back until 8 months to 1 year out. You are still way too early in recovery to expect normal ROM... And while I suspect this isn't the answer you want to hear, unfortunately it's the truth.
Thank you Kimberp!
I very much prefer this answer! I was worried sick for not having any improvements in ankle mobility for the last 4 weeks. Now, I think I over exercise and I have some trouble with the swollen knee and a little bit of pain in the ankle. Sorry for insisting on precise answers...I have no professional help around me. I read carefully your answers.... lead me to understand that you regain your full mobility (without pain) in 6 to 8 months. I was wondering just if you ( or Dizzi) had full ankle mobility (with pain) in your second or third month.....? Cause my ankle is so stiff for the last 4 weeks as if my implants are too big from that point of mobility onwards. And if it is normal to have so acute pain in the knee on stretching after bending at about 90 degree angle or more.
I really hope that I made myself clear thistime!
Keep in mind you can do damage to your new plugs by doing too much too soon so if you are in pain, back off a little. I never experienced any pain in my knee, except for the day after the surgery maybe so I suspect you might be pushing too hard.
In my case it took a year to get all the mobility back that I was going to get back, but I can't say I was ever pain free. After a surgery like this it will never be like a normal uninjured ankle so while you hope that the pain is minimal, I wouldn't set your expectations at no pain at all - you might end up disappointed.
Dizzy can share her experience but mine, to this day is certainly not pain free and I am 3 years later.
My first OATS was done in 2008 February. I have gained almost full mobility with some complications. Very different from this second one. I will explain... I have had a bit of issues with the first one since surgery. It clicks horribly loud (like some one snapping their fingers) and because I had been aligned crooked all my life and now it was aligned differently now the tibia started to split into two. So needless to say I am not sure if I could say there is not mobility issues. I do remember starting a new job in November of 2008 and having to REALLY try hard not to limp and let them see I was unhealthy in any way. I also remember I felt I was not ready to go back to full time work again. Now 3 years later. I am very mobile with the 08 one. I still have the clicking and the splitting has stayed stable. I have pain issues in the split part which is about half way up my leg. the clicking can be cleared up with minor surgery which I am choosing not to do because it is something I feel I can live with rather than risk another surgery. Sometimes with cold or rainy weather the osteotomy site will hurt which is normal from what I understand with having screws and the cut site. Since I had a huge OCD in the other ankle I believe that pain over rode any of these minor things. Oh yes...only knee issues on the weather days.
Now the next one on May 18 of 2011 so I am 4 moths and one week post surgery. I have not gained even close to full mobility. I wish I could give you numbers but I am not in any form of theropy and don't know how to measure. The first leg will bend all the way forward pointing my toes out. This new oats will only go about half that. If toes pointing toward ceiling with legs stretched out is 90 degrees then I can go almost 45 degrees. I will say that I have much less pain at this time than I did with the other one. I am not sure if it because both of them are working better than they have since I was 10 when the defects were first discoverd, or whatever but I am really enjoying my ability at this point. I am now 47 so for over 30 years I had issues.
I referred you to the thread "what after cast removal OCD" by carlos. It should be a bit lower down. It has him and me talking for quite a few weeks and pretty detailed progress reprts. I will gladly give you a better time line but I think this post is long enough so I will start a new one.
Here is timeline but done from memory (not always accurate comes with the 47 he he)
I had the OATs may 18 Weds. they also did a debridement clean up from the old arthroscopic surgery if had in 07 and a tendon transfer and lenghtening. They used a cadaviar tendon and talus. the OCD was about 20 x18 mm.
I stayed in hosp for 12 hours after surgery. I had a nerve block behind knee and a very large gauze and ace bandage wrap up to knee.
2 weeks out - went to surgery consultant (not doc) he took off the wrap and all the staples out. This was when I found out about tendon transfer. I had wondered why it hurt on back of calf. they gave me a cast up to knee at this visit.
4 weeks out - Saw doc. he was pleased with outcome of surgery he was able to do what he called bone mapping what ever he removes from the old talus he is able to do an exact match to replace with the new bone. He said this was important because the shoulder of the talus is shaped a certain way and it would give a better smoother bend (unlike the first with the click). They removed the cast. He let me go without a new cast. (different from first one, was casted till 8 weeks) I was told NO weight bearing what so ever till he says so and to come back in 3 weeks. To do only ROM exercises.
7 weeks out. Osteotomy looked 90% healed gave me the OK to start weight bearing IN BOOT on crutches starting at the 8 week mark... also will start physical theropy in week nine.
during seventh week started to put foot down with boot and crutches
during eight week started to work toward getting rid of crutch still in boot. by end of week off crutches in boot.
week 9 started to go into shoe. used a cane started theropy where they did alot of scar massage and I rode a bike and worked on more ROM
week 10 went back to doc x rays osteotomy looks healed. I can do more in theropy but No impact and not even pool until week 12.
weeks 11 and 12 continued theropy. did alot of strenght building because of calf muscle and even hip muscle were greaty atrophied. did alot of balance like trying to stand on one leg more than 15 seconds did the shuttle or leg press alot and they still did massage.
week 12 went to doc he released me and did not give me any more theropy. Said I was fine but to call if any trouble.
Really would have liked more theropy. I don't have anything a home and I don't have money for a gym membership. So I have just been living life normally... I have not gone back to work cause I stand all day and know it will be something I cant do. However last week I painted my bathroom and I have continued with most normal life activities. Have not tried walking more than the grocery store or in and out of school I attend. I would like to ride a bike.
Hope this all helps. Remember it is just one persons experience. and as you can see two legs two different experiences just on my body alone.
Best wishes for mobility!
Thank you both for your assistance, I can assure you all this is very helpfull to me! Dizzi you gave me a remarcable clear picture of your evolution...it is great and I'm in your debt!
I clearly understand that every person and every leg is different, but I truly think that some similarities must exist. From your posts I see that ankle mobility is a long term issue and that you two had no problems in your knees, whatsoever. Good for you!...because mine is simply killing me this days! So, I'm thinking of starting a thread asking if there is somebody with knee pain after OATS.
Best of luck!
Hi all, Fellow oats patient here. Im 10 weeks post op with 2 allograft plugs inserted into my right ankle. I had a huge defect on the talus. I was non weight bearing in a cast for 6 weeks. From the 7th week i started therapy and my ROM was ok and gradually got better with the exercises. I can say at 10 weeks out I have 85% back ROM on ankle. It is still stiff and swollen but also working on building back the strength in the entire leg. I have been walking in the boot for the past 2 weeks and doin well so far. Also pool work and massages. Im just concerned on how my ankle would adjust to walking without the boot. Im supposed to stop walking in the boot at the 12th week which would be next friday then I go into a brace. I have not been in the office so Im hoping I can go back by the 13th week. Hope you guys are also progressing well.
Thanks for valuable information! Dont you have any pain in your knee (or you had alograft?) Can you be more specific about your ROM...what movements you can not do? Tell me please if your improvements were continuous....because I have a serious set back this week and I'm very scared!
Hi Armand, I had allograft so my knee is fine. My improvements were continuous im in Therapy 3 times a week with a very good therapist. I can twirl my ankle perfectly clockwise and move it back and forward. However I cant move it that far back because the tendons are still a bit tight. but I have seen the progress each week. Are you in therapy? I wont worry too much about the set back, these things you just have to give it time.