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    Old 11-04-2006, 08:04 AM   #1
    carol1225
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    Question Mosiacplasty of Ankle

    Hello,
    I am new to this board and wanted to know if anyone else has had Mosaicplasty or OATs done in the ankle due to an Osteochondral Defect. I am six weeks post op. I would like to know how long before you could move your ankle? I still have alot of swelling but when I try to move the foot, it feels like the stitch area is bursting open, stitches were removed yesterday. I do have some weeping of the wound area but nothing significant. I am permitted to apply pressure when in the boot but becasue I can't get my foot to stay in the down flat position, its hard to use it. Any advice? Thanks!

     
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    Old 11-04-2006, 01:55 PM   #2
    eko
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    Re: Mosiacplasty of Ankle

    I have not had the procedure you have had, but am glad you posted. I hope that you will continue to post regarding your recovery. I have arthroscopic surgery earlier this year for an OCD, so I am waiting to see how it turns out. OATS is one of the alternative plans if what I had done fails (knock on wood).

    I don't have much advice, but I am surprise that you are having difficulty moving your ankle after six weeks. I guess that I would keep trying, moving it little by little, every opportunity you get. If you don't see some improvement by your next Dr.s visit, (hopefully it isn't of for another 6 weeks), ask about physical therapy.

    I wish you well, and post your progress.
    ~eko
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    Old 11-05-2006, 12:47 AM   #3
    jprinz99
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    Re: Mosiacplasty of Ankle

    While I didn't have OATS/mosiacplasty for my OCD's, I did have open and arthroscopic. I was having trouble getting my foot to move in certain directions. Turned out that one of the reasons was excessive scar tissue forming quickly. (fortunately I got an infection, etc so I had to be seen soon after surgery). You might want to call the office and let them know what is going on as my OS said that in any Talus repair/injury this is sometimes a result. I also formed excesive scar growth at the suture sites in addition to the joint area - guess it might just be my body "healing"

    I ended up having to have scar breakdown therapy at PT (amongst other things for other issues). It worked for me, but was not the most pleasant thing in the world to have done. Good luck and let us know about your recovery. I am interested as I am probably looking at this next (one area is not healing/regrowing tissue as hoped)

    Jane

     
    Old 11-05-2006, 07:04 AM   #4
    carol1225
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    Re: Mosiacplasty of Ankle

    Thank you both for responding.
    I hope you both do well and do not require this surgery, it has proven to be brutal. I have DJD as well as OCD.
    I had arthoscopic surgery the same time as OATs, to clean up the joint, remove spurs, reshape bones. The doc said on Friday its like at this stage my ankle is fractured, they had to break normal bone to get to the talus and then they cut the talus to put in the bone graft and then drilled it for cartlidge tranplants. He thought it looked great other than some excessive scabbing of the wound area. I can start PT this coming week and am anxious to do so, I want to walk again, I am loosing patience.
    A word of adivce to anyone who is having Mosaicplasty / OATs using Cadavier bone / Cartlidge... Check your insurance company - I have BCBS and they refused to pay for Mosiacplasty as its "experimental" they wanted me to do fusion, I said no way.... I ended up having to charge the cost of the bone to my credit card.... I am curently appealing it and while it was a chunk of money, I feel it was my best option to walk normal again.
    Thank you both again!

     
    Old 11-06-2006, 04:56 PM   #5
    akirka
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    Re: Mosiacplasty of Ankle

    Hi Carol,

    Now I'm getting really nervous after reading your board. I am waiting to see a specialist who is recommending an OAT procedure on my OCD of the talus. I also have BC/BS and in Idaho they said that they consider the procedure to be medically necessary if done on the ankle and knee, however experimental if done on the elbow or shoulder. I'm not sure how it varies state to state... how frustrating is that! I guess I can get the procedure reviewed by BC/BS before the operation. I hope you win the appeal!

    So, my ankle feels good if I don't do any activities. I have full range of motion, no swelling, but if I try to do any activity like hiking, walking, aerobics, it starts to kill me. So, what made you decide to go ahead with the procedure? It sounds so brutal what they did to your joint. I've read though that the outcome is good to excellent in most people. It must just take a long time to heal!

    Thinking good thoughts for you!

    Abby

     
    Old 11-07-2006, 12:48 PM   #6
    carol1225
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    Re: Mosiacplasty of Ankle

    Hi Abby,
    I had this done because my other options were distraction or fusion. My ankle was locking up, turned bruised and swollen and I had bones grinding and the pain.. Whew...was it painful, pins and needles, stabbing pain, burning pain, throbbing pain, it never stopped.... never let up, each day was an adventure on how it would behave.
    This came on suddenly in June and progressively got worse day by day, it was an MRI that revealed that I had OCD. The floor of my talus was bad and flattened, actually when he read me my issues it was like a shopping list...
    BCBS did pay for the actual surgery - they DID NOT pay for the bone, that is what I had to pay and FYI a talus bone costs $6,850.00 CASH..... I have a home equity loan on my ankle! I call it my $7K ankle!
    I can only suggest that you do your homework and know what this is all about, I had two pages of questions that I reveiwed with my OS before agreeing to the surgery. It is funny though that while I agreed and was informed I can tell you it was easier hearing about it than it has been living it.

    If I can help you anyway - please let me know. I didn't mean to scare you just wanted to make sure no-one was caught at the 12th hour like I was scrambling to figure out how to pay for a bone when surgery is the next day.

    I wish you the best of luck and wish you weren't in this postion to need this surgery.
    Carol

     
    Old 11-08-2006, 04:15 PM   #7
    akirka
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    Re: Mosiacplasty of Ankle

    Thanks Carol!

    Now I understand your insurance problem. I think this Dr. is wanting to take the graft from my own knee so I guess I can say my own body parts are free for the taking ....

    Well, you definitely sound like you have experienced more problems than I have with your ankle. It's such a hard decision for me. If I chose to be a couch potato and let go of my athletic life, I could basically have a normal foot. So do I risk the surgery? I guess I better start writing questions down now for my appt on the 16th.

    I went and ran a mile last night to try and convince myself I don't need to do anything. Of course, my foot is sore today! What did you do to injure your ankle? How long ago? I'm just curious .... I injured mine in July 2005 on a backpacking trip but didn't find out what was wrong until May 2006.

    Well better go. Thanks for your advise!

    Abby

     
    Old 11-16-2006, 12:21 PM   #8
    carol1225
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    Re: Mosiacplasty of Ankle

    Hi Abby
    Just wondering how you made out today at your follow up appointment. Wanted to make sure you do your research on using your own body for the donor, my surgeon informed me in the beginning that he did not use the knee or hip becasue of falure of the donor site over time. I've seen several articles on the web about this as well. If you do decide this surgery is your best option please do your research. All around this is very rough to go thru and recover from.
    I've started PT last week, I am frustrated that I am not seeing faster progress but I see that I can move my ankle a tiny tiny bit, I can also put 10% weight on the foot at this time for brief, breif periods... PT says this is totally normal for the surgeries I encountered.
    I wish you the best and just wanted to make sure you do your research all the way around.... If you able to run a mile and only have sore ankles you ought to rethink this surgery and seek a second, third or even fourth opinion.
    Let me know how you made out.
    Carol

     
    Old 11-20-2006, 03:40 PM   #9
    akirka
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    Re: Mosiacplasty of Ankle

    Hey Carol,

    Thanks for your note. I had my appt. on Thursday and it was very interesting. The assistant Phy. told me he also has a lesion on his talus. He has chosen to live with it which makes me question having any surgery. However, he stated that his is very small (mine is 1.2 cm wide and almost 1 cm deep which I guess is large) and less bothersome than mine. He can do sports and just at certain times it might bug him. Mine has annoying pain on a daily basis, I can only wear certain shoes, and I can't really do any impact sports. It's still not nearly as bad as your which makes me hesitate for sure! However, I don't want to be a couch potato for the rest of my life!

    Definitely I know that it's going to be a long recovery. The Dr. said that he has to cut the lower leg bone, like in your case, about 50% of the time. Hopefully I can be in the 50% that doesn't have to do that! He said that he has about an 85% success rate which is pretty good. I will look up the donor site issues for sure. This Dr. says he hasn't had any problems beyond a month or two of soreness from the donor site.

    I hope you continue to improve rapidly! I had hand surgery 3 years ago and was immobilized for 3 months up to my finger tips and I remember how frustrating that was!! My hand was like a wet noodle when I first went to PT and took a good year to feel really normal again. Sorry you feel frustrated!!

    Thanks for your advise. I'm going to think a little longer before making a decision. It's good to talk to someone who understands!

    Take care and let me know how you're doing.

    Abby

     
    Old 11-20-2006, 06:33 PM   #10
    carol1225
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    Re: Mosiacplasty of Ankle

    Hi Abby
    It sounds like you have a good doctor who is willing to be open about this surgery, that is good. My Doc did have to cut my bone in half to gain access to the Talus, then he cut the talus to do the bone graft to reshape my talus which was flattened due to wear. I have 3" screws holding things together now, they will remain forever. The surgery is brutal no doubut, the recovery discouraging as its so long with little progress, I watch the people at PT and they have knee injuries and are biking fast... shoulder injuries are lifting weights and I am sitting in a chair trying to get my foot to sit flat on the ground and pull it close to me... Talk about frustrating.... However I do see now I can get it to line up with the other foot, not a huge milestone to others but to me, it was big!
    I know how you feel, its a scary thing to decide on and I wish I knew someone who had gone thru this to ask questions etc., so anytime you have a question or need to talk, please feel free, I'll help anyway that I can.
    Have a great holiday and take care of that ankle!
    Carol

     
    Old 11-23-2006, 10:22 PM   #11
    dawnlmiller8
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    Re: Mosiacplasty of Ankle

    Hi,

    I had the mosaicplasty procedure on October 9 and, in my case, the OS did need to cut the tibula in order to gain access to the injury. I had grafts taken from my knee and put into my ankle and am seeing significant improvements in my knee as each week passes. My doctor did warn me that some patients have pain in the donor site, but this typically lessens over time. Also, with the size of your defect, you may want to ask your doctor about cadaver cartilage. My OS noted that this is standard protocol when the defect measures greater than 1 cm X 1 cm.

    Overall, the recovery process is trying and definitely shows you what you are made of. As an independent person, the hardest thing has been relying on everyone around me for everything; however, know that the pain will not last forever and your longtime health will benefit from it. In my case, the first two weeks after surgery were the worst. I was in a heavy plaster cast and could not get comfortable. After the first week, I was able to control the pain more easily with pain meds, but it was still very uncomfortable. I went into a fiberglass cast during my third week which improved the pain significantly. I'm now in an Aircast walking boot and am slowly putting weight back on my leg. I would think that if they don't need to break the lower leg bone (in my case, this resulted in a plate and seven screws), you would be able to walk sooner and more easily.

    You're smart to do your research on this and I hope that everything with your surgery goes well

     
    Old 11-27-2006, 02:23 PM   #12
    ActionMaxen
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    Re: Mosiacplasty of Ankle

    Hey,

    I could very well be having Mosaicplasty of the talus done in the not-too-distant future. Did you have to stay in hospital over night? Or was it done on an outpatient basis?

    Thanks.

     
    Old 11-28-2006, 01:30 PM   #13
    carol1225
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    Re: Mosiacplasty of Ankle

    Hey Max
    My situation was not "typical" I was three days, two nights in the hospital but the first night I was admitted as my surgery got bumped due to an emergency that took preference over my elected surgery. The next day it occured and they ended up admitting me as the surgery was twice as long as they anticipated as they corrected alot more with my ankle than the X-rays and MRI's showed. I would suggest that you ask alot of questions and ask about the pain management in the hospital and once home. This is a very painful surgery, I had a nerve block done and when I woke the next day I thought wow, this was a breeze, a few hours later... I was screaming in pain when the block wore off... The hospital controlled the pain well... Once home I found what they prescribed did not dull the pain only made my head fuzzy and since I was alone, I decided to stop taking the pain medicine the second day... not the brightest thing I am sure, but I managed to do fine without out, lots of ice and keep it elevated.
    I wish you the best of luck and do your homework on this surgery. All I can say it sounded easy listening to the surgeon tell me what to expect when I was "well" than it has been living it.... but its all for painfree walking, things people take for granted, you will never take for granted again.
    Keep in touch, let me know how your doing. Are you using cadavier bone?
    Carol

     
    Old 11-29-2006, 04:01 PM   #14
    akirka
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    Re: Mosiacplasty of Ankle

    Hi guys,

    Well I still haven't decided what to do yet. I'm in the info gathering stage. It looks like the standard hospitalization is 2 nights for this surgery. I think they keep you at least one night because of what Carol has stated. They give you a nerve block which takes several hours to wear off. Then they try to regulate the pain that you may have overnight and the next day. I may ask about the cadaver cartilage directly to my doctor. I have read though that your own cartilage heals much faster than donor. I'm not sure why???

    I've been doing extra stressful things on my foot this week to see if I can 'live' with the pain. I'm going skiing this weekend. It's one of the few things that doesn't bother me much because it's gliding, not stepping!

    I hope, Carol and Dawn that you start to make large leaps of improvement!

    Talk to you later

    Abby

     
    Old 11-30-2006, 12:00 PM   #15
    carol1225
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    Re: Mosiacplasty of Ankle

    Hey Abby
    I am impressed that you are able to still maintain a high level of activity. and I am really happy to see your gathering information, some of it will scare you beyond words but you have to decide whats in your best interest. If your able to do all your activities with little pain, maybe you want to rethink it. I am not sure what Dawn's condition was that resulted in her having this surgery but I can say I waited 12 yrs... I wanted to see if I could live with the pain and I did.... There were days I tell ya that I was crying saying ok... I'll have it fused.... then the next day it would be fine and I'd say no way... It was this summer when I was unable to walk even two steps without it taking my breath away that I realized the time had come and I had to do something, I really feared it was going to be fusion and I won't have that done, so when this was offered to me, I said Ok.... I really didnt' have a choice at that point, I couldn't even walk.
    Anyhow you know you can ask me anything and I'll help you anyway that I can, keep me posted on what you decide and how your weekend skiing goes... You impress me... skiing with a bad ankle... I gave that up 12 yrs ago... along with a list of things that is staggering to say the least!
    You take care
    Carol

     
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