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Foot & Ankle Problems Message Board
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Old 07-18-2013, 11:34 AM   #1
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skiersteve3 HB User
OCD of the Talus/ATFL Repair

Hey guys, new to the message boards here and accidentally put this post in the wrong section, anyway here is a copy of the post with a little more update on my current status...

Quickly a bit about me. I'm a 27 year old active male. 6'0" tall and 175 pounds. I'm an avid skier, kayaker, and rafter. But i also enjoy playing basketball, golf, soccer, mtn. biking, and some running (i've run 2 marathons).

So about a year and a half ago I started having aching pain in my left ankle after long days at work (12+ hours on my feet). At first i figured i must of tweaked my ankle and that it would go away with time. Some days i would be fine, some days i wouldn't. And ocassionally, if i moved it just right, I would get a brief sharp shooting pain through my leg. Finally after six months of toughing it out and noticing my ankle was starting to swell after a full day at work, i decided to see an OS.

My initial visit with the OS seemly went well. He diagonised me with a complete tear of my AFTL, something i linked back to likely happening nearly 6 years ago with a horrific ankle sprain i suffered playing basketball. Being such the case that i had dealt with this injury for years and we were in the midst of ski season (January), i told the doc i'd take care of it sometime during the summer. At some point between then and the surgery the doctor wanted my to get an MRI of my ankle to clarify the issue.

Well, two weeks later i tore my ACL skiing (same leg by the way). Being that I needed an MRI of my knee immediately folllow that injury i also ended up getting one of my ankle. Low and behold i had a fairly good sized OCD on my talus (i can't remember the exact size but if anyone is interested i can find the info). By far this was the real issue with my ankle (i've come to find out 30-40% of people have torn their ATFL). That's when i hit this message board and started reading the doom and gloom that is an OCD of the talur dome.

At little over bummed about the news and not really knowing what to do i took care of my ACL first (just over 4 months out and doing great) while i researched my options for repair of the OCD. I really hoped to have the Denovo NT prodecure done and won't be surprised if that or something like that becomes the future of the the injury repair. Unfortunately I couldn't find anyone in the Salt Lake City to do the repair and i couldn't afford to go out of pocket in another state. OATS seemed way too intense for an intitial repair. So I found a great Doc in Salt Lake and went for the standard debridement and drilling procedure (Drew Van Boreum).

Anyway, I had the surgery yesterday and all went well according to the doc. Slept well last night and am yet to take any of the pain pills he prescribed. The doc wants me two weeks completely none weight bearing before i will be switched to a walking boat (yes only two weeks). For those of you interested in my recovery I will post updates here throughout. Feel free to ask any questions you have as well.

-Steve

 
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Old 07-18-2013, 07:27 PM   #2
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ScaldedDogCO HB User
Re: OCD of the Talus / ATFL Repair

Good for you, Steve. I think the MF surgery can work, though I didn't have great luck with it. That was 9 and 7 years ago, though. I built up a ton of scar tissue both times, though I don't know think that's typical. I say that because I'm 1 week post op from DeNovo surgery, and the doc had to remove "a ton of scar tissue". I'm mid-50's, so probably don't heal as well as a youngin' like you. :-) OTOH, being older enabled me to afford DeNovo, so it's a mixed bag...

Good luck!

Mark

 
Old 07-18-2013, 07:47 PM   #3
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skiersteve3 HB User
Re: OCD of the Talus / ATFL Repair

Thanks Mark. I believe my OS only has me NWB for two weeks in part do to a new thinking that this reduces and helps break down the initial scar tissue. Apparently the majority of his patients have seen great results (told me he has had to redrill once in ten years). Regardless I really really wanted Denovo. At the very least i would like this to work for the next 5-10 years and hope something better is in place by then if this fails (sorry but the board stories kind make me think that way). Anyway, I'll follow your updates if you post them, best of luck!

 
Old 07-23-2013, 10:19 AM   #4
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skiersteve3 HB User
Re: OCD of the Talus/ATFL Repair

So just quickly...today is exactly one week since the surgery. First full day after surgery had little to no pain as mentioned, but days two, three, and four that all changed (no terrible pain just tough to sleep with pain). I dabbled into my pain pills primarily at night and had to keep my foot elevated to keep the pain and swelling down (something i did not do too well at the first full day after surgery because it didn't hurt). Also it feels that the majority of my pain is coming from the incision point for the ATFL repair, not the OCD scope, debride, drill location. That being said, it is somewhat tough to tell as i still haven't seem my foot.

I see the doc this Monday (CAN'T WAIT) and likely will start PT soon after. I'm still a bit skeptical about getting on my feet in one week (w/ walking boot of course), but this was/is the plan at the moment, regardless i took three weeks off of work (i work on my feet). Also back off the pain meds for the past few days so that's good. I'll post something next week after my appointment.

 
Old 07-30-2013, 08:52 AM   #5
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skiersteve3 HB User
Re: OCD of the Talus/ATFL Repair

Went to the doctor on Monday, this was the first time that I actually got to talk to the doctor about my procedure ( he just spoke w/ my parents post op). Anyway, the doc showed me pictures of my ankle from with in....there was obvious signs of inflamation and of course the OCD. He seemed more confident than ever i would be happy to have done this procedure after actually seeing the inside of my ankle first hand. Looked to be about 1.5 cm x 1 cm lesion, however i'm not sure how deep (again i can find out if some of you are interested). At any rate he called it a medium sized lesion.

After that, he cut the splint off and my ankle was able to see the light of day for the first time in two weeks. I was very surprised by the amount of swelling in the ankle still, it was huge. However, i did slip and fall a bit on Sunday and did notice additional bruising in my toes that morning. I think i inflammed the AFTL repair site a bit, but it really didn't hurt so i'm not too concerned i did any damage to the OCD (my real concern). Of course i mentioned this to the doctor and he also wasn't concerned at all by the way. Now that i have a walking boot on (which i'll cover later) i'll be able to monitor the swelling/bruising situation more closely.

The incision for the AFTL repair was bigger than i would have expected ~2.5" (and very inflammed), the OCD was just the tiny scope holes. I think and have thought the majority of pain that i'm having is coming from the ligament repair, but we'll see how that goes as i continue to get back on my feet (i haven't taken a pain pill since about the fifth day post op). Having said that, the doctor put me in a walking boot and told me to let pain be my guide to how much i'm on my feet.

Soooooo.....i started taking me first pwb steps right away. So far i've had absolutely no pain but I'm not going to rush into anything. I'm still planning on using my crutches for the next five or six days before i try some fwb. Ideally i'll go back to work next week, but i'm definitely going to take more time off if i don't feel ready. The doctor wants to see me again in four weeks at which point i'll be moving to a lace up brace and start a pt program. I think i'll stay in the boot a little longer though (one to two weeks), just to be on the safe side. To be out of a cast/boot and in an ankle brace sixs weeks post op just seems crazy to me when i ready these boards!!!! But follow the doctors orders right? Anyway, look for an update regarding my fwb status in a week or so.

-Steve

 
Old 08-05-2013, 11:09 AM   #6
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skiersteve3 HB User
Re: OCD of the Talus/ATFL Repair

quickly three week update post op...

Began partial weight bearing in the big boot last monday (although i was allowed to go full weight bearing at any time). Went to full weight bearing on Friday. Amazingly enough i've experieced little to no pain in the foot/ankle so far, ocassional small sharp pains from the AFTL repair site, but seemingly nothing from the OCD location (still way way way way too early to really say much obviously).

Anyway, tonight will be my first shift back at work in three weeks, hopefully all goes well. I'm also planning to slowly start doing a very small amount on startionary biking in the coming week along with a few other non weight bearing leg exercises (i'm still rehabing an ACL reconstruction from five months ago). As my doctor has told me from the get go, i'm going to let pain be my guide and stop doing something immeditately.

I'm only taking the boot off to shower or to ice my ankle, the rest of the time it is always on. Being able to ice my ankle directly has really helped with the swelling. Although my ankle looks far from normal it has gone down quite a bit in the last week, even with me being up and on it a fair amount. I really hope this works!!!!

-Steve

 
Old 08-05-2013, 08:39 PM   #7
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ScaldedDogCO HB User
Re: OCD of the Talus/ATFL Repair

Sounds like you're doing great, Steve! I'm impressed that you're on it so early.

Mark

 
Old 09-08-2013, 07:01 PM   #8
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GinaB1717rtOCD HB User
Re: OCD of the Talus/ATFL Repair

Hi guys,
Hope all goes well with your DeNovo recoveries! Just thought I'd tell my story, since it seems relevant.
I slipped on ice and broke my fibula Jan 2012. That got fixed with a steel plate and screws, no problem. I was 48 and that was my first broken bone ever! After 7 months or so, I suspected that something else was wrong, as my ankle was not recovering very well. An MRI showed an OCD on my talus (about 6mm) that had been festering since my fall. So, one year after the fibula fracture, I had microfracture surgery (Dr. J Miller, Phila area). It was arthroscopic. Once he got into my ankle, my talus lesion was worse than he had predicted and he had to implant cadaver bone graft, as well as DeNovo cartilage. All went well, I never took a single pain pill (virtually NO pain at all!) The doctor had promised at least 85% chance of success, and I had no worries about a complete recovery.
Then around 6 months after the mf/DeNovo surgery, I realized my ankle was no longer improving. I felt like my PT exercises were doing more harm than good. I was not able to walk very far without limping. A new MRI showed that my talar dome was totally collapsed and the OCD was now 12x16mm, and definitely growing worse fast.
Since then, I have spent the last month or two gathering other OS opinions and trying to decide my next step. I'm dismayed that the best experts I can find are giving me different recommendations, so I don't know what my best option is! Total ankle replacement, fusion, OATS. All are horrible in their own way, but I have to choose soon.
Don't mean to be pessimistic, and I do wish you the best. I just wanted to let you know my true story, so far.

 
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