Life after Osteochondral Surgery - new thread

[eko]

Greetings all! I decided to start a new thread, the old one was getting really long, so I am calling this one "Life After" so we can keep up with the progress and struggles we have along the way.

Here is my update for the week. I had mentioned that I was trying a new experiment with OTC orthotics after my DPM felt that I didn't need them. He get the "raspberry".

During the week when I work I noticed a big difference, my ankle was not as sore or as stiff at the end of the day, and the next morning, it was no big deal to hope out of bed. The weekend was to be a better test. This weekend I was a camping widow, but the weather was so gross, the only thing I did was some shopping. I noticed some of the soreness was back in the afternoon, but I was able to work through it faster and then next day it did not linger as long. Today I am off of work running errands and such, but wearing a different pair of shoes with the OTC orthotic in them. The experiment will continue, but I think they are helping. I have also noticed an increase in ROM with the stiffness minimized and I seem to be walking better and faster. There is something to be said for trusting your instincts, after all it is your ankle and foot, who knows them better?

I hope all of you are making progress!
~Ellen

[davidstone]

Would love to comment but I don't understand all the abbreviations/terms you've used? OTC, ROM, DPM etc

Any chance you could do a quick summary of your situation for new people reading this thread?

Out of interest, how much dorsal restriction in the joint did you have following the op (ie moving your foot fully up and fully down)? And what is it like now and over what timeframe did it improve? Did you have pain when doing the physio exercises and if so, which ones?

[eko]

Here the explanation for the acronyms used in my previous note.

OTC=Over the Counter
ROM= Range of Motion
DPM= Doctor of Podiatric Medicine (Podiatrist)

Summary:
Currently 5 months post-op from arthroscopic surgery for Osteochondral fracture of the talus, medial (inside) side of ankle. Lesion was 1cm x 7mm x 4mm deep. Eight loose bodies were removed from the joint, had picking a drilling of the defect. Was NWB for six weeks, moved to PWB and FWB over the next 4/5 weeks. Six weeks of physical therapy. Currently waiting out the 9 to 12 months to see how well it has healed.

David's questions: Dorsal movement after surgery was totally restricted for the first two weeks, after that I was allowed to flex the ankle up and down as far as I could comfortably. It was difficult in the beginning, gradually increasing. Found the ankle to be more stiff then painful. Currently back to the range of motion I had prior to surgery/injury, most of it gained during the first 3 weeks of PT. As for pain w/ PT exercises, I had the most problems with inversion of the foot (turning the foot in at the ankle) because of putting extra force of the outside of the ankle when walking to protect the injury on the inside (bad habit picked up before being diagnosed and having surgery).

Hope this makes sense. Let me know if you have any other questions, I am happy to share my experience.
~Ellen

[sevesteve]

Hello to all,

New to site. Had debridement/drilling on right ankle (lateral at talar dome) 11weeks ago. Twisted ankle many times over 35+ years of competitive/recreational sports. Seven years ago did a dandy sprain but went undiagnosed by DPM for first two years (treated as tendonitis with cortisone/orthotics), then general OPS did fragment removal/spur repair in early '03 (4 years after what I think was the major injury) but no cleaning/repair of fracture location. Results (pain with medium to high impact) from that surgery improved slightly, but not acceptable and went back to surgeon in Spring '06. OPS referred me to ankle/foot OPS specialist who immediately diagnosed condition (had I gone to this doc 7 years ago, who knows how different outcome might have been) and gave treatment options. Transplant not recommended due mostly to my age and lack of success rate being noticeably greater than debidement/drilling so went with that procedure.

Had 8 weeks NWB, and 3 weeks partial to full weight bearing since. PT for 3 weeks and first week and half, bone pain (that familiar deep aching pain) around defect area was worst than ever and I'm thinking I'm in the 25% no-benefit group. Last 10 days has improved to feeling as good as pre-op, but underlying bone ache/pain still there, especially when doing PT or when doing low-level walking, etc. Most consistent and noticeable pain now is each morning taking those first 30-50 steps, reminiscent of all those mornings after a rugged basketball outing.

Main reason for having surgery (I'm 46) was to be able to resume active lifestyle including basketball, some running and keeping up with two very active kids (13 and 10). Pain was minimal/nil from general walking/sedentary lifestyle, but not what I wanted so went for surgery being advised that odds for major improvement at my age and due to severity of injury were 50 to 75%.

Question..What type of pain did you experience upon returning to FWB (familiar bone pain symptomatic of OCD injury) and how long did it persist? Was there a time post surgery/during PT that you thought pain was worse than ever (even after really taxing it pre-surgery)? Trying not to get discouraged and am committed to full therapy and rehab regardless of surgery success, but also wondering if I need to accept that ankle will never be pain-free or even pain-reduced to extent hoped for to allow me to return to activities I love. Did your outcomes meet your expectations??

[eko]

I'll be honest, I am not sure that the surgery has met my expectations, but I am in fairness giving it 12 months to prove itself. The pain I had before has been replace with a different type of pain, hard to explain. It is not as severe, and at least I does feel the ankle grinding anymore. I am 42 years old with two sons, 10 and 12. I was told by my OS that if I walk three miles, I will feel it. He was not kidding. I find it frustrating and try not to let it stop me, but I am always prepared to treat my ankle afterwards. Again I have my good days and bad days. Hope this answers your question. -eko