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  • Total Ankle Replacement (TAR) Options

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    Old 07-08-2008, 04:08 AM   #1
    Elmo151
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    Question Total Ankle Replacement (TAR) Options

    I am a 70 year old male in reasonable health. Following a badly broken ankle in feb '06 I was diagnosed with traumatic arthritis in my left ankle. I am now scheduled with an Agility TAR in early September at *** in NYC.

    I'm having second (and third and ... thoughts).

    Here is my logic.:
    the options are:
    1. do nothing and wait for a better ankle to be developed.
    2. fusion
    3. two component ankle (e.g., Agility)
    4. three component ankle (e.g., mobility, Hintegra)

    I look on fusion as a fall back position if a TAR is unsuccessful.

    My impression is that 3 component ankles are a generally better answer than 2
    component. The 2 component solution is used in the USA because the FDA is 5
    years
    behind the rest of the world.

    Are two component solutions still in use outside of the USA?
    In what circumstances would a 2 be recommended over a 3 if both were
    options?

    Last edited by Elmo151; 07-08-2008 at 04:09 AM.

     
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    Old 07-08-2008, 09:12 AM   #2
    happyfoot17
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    Re: Total Ankle Replacement (TAR) Options

    Hi,
    I would go for the three piece component (actually i did, the hintegra) the two piece components don't replicate the motion of the ankle well enough and wear faster, and are older technology and require more bone removal, so reducing your chances of being able to have a second entire replacement. The three part implants can often only need the poly insert changed which is a simple operation. I am 27 now, had mine for a year, love it, would say don't wait get it done asap, you won't regret it at all! Stay clear of fusion unless there is no other option as it impacts other joints and is a harder recovery.

    Just my opinions...but I did rather a lot of research before I got mine =)

    All the best

     
    Old 07-08-2008, 09:16 AM   #3
    happyfoot17
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    Re: Total Ankle Replacement (TAR) Options

    oh and 2 component implants are still used outside the USA, but in places where they also 'gave up' on ankle replacements as a viable option preiously like they did in the US, such as: the UK, Australia, New Zealand etc three piece components are almost exclusively used in contiental europe and eastern europe where the technology is furthest ahead and they didn't 'give up' on ankle replacement.

     
    Old 07-08-2008, 09:53 AM   #4
    janewhite1
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    Re: Total Ankle Replacement (TAR) Options

    If I were you, I wouldn't wait indefinitely on new technology. Waiting means years spent with limited mobility, which can lead to muscle atrophy, osteoporosis, even heart disease. If a joint needs replacing, now is better than later, and the recovery will be easier.

    Fusion has a longer recovery time and a poorer outcome than replacement. And at your age, the life span of the replacement joint is less of an issue than it would be, say, for Happyfoot here.

    If you did want a 3-component, what options do you have?

     
    Old 07-08-2008, 01:39 PM   #5
    Elmo151
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    Re: Total Ankle Replacement (TAR) Options

    Quote:
    Originally Posted by janewhite1 View Post


    If you did want a 3-component, what options do you have?
    my initial plan is to follow Happyfoot/Kira's steps to Switzerland. I hope to make initial contact this week and mail over my x-rays/ct scan soon. I think a quick vacation/trip to switzerland may be in order. I'll keep this thread up to date with my progress.
    As a secondary motive, I had to put my Bernese Mountain Dog down last September. A side trip to Bern might be a first step in finding Elmo's successor.
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    Last edited by Elmo151; 07-08-2008 at 01:40 PM.

     
    Old 07-20-2008, 12:44 PM   #6
    tess50
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    Re: Total Ankle Replacement (TAR) Options

    hi everyone,im tess i had a tar in november last year with the mobility depuy 3 piece replacement,i have never looked back,recovery was a bit long but it was winter time so i was happy to be in,on my computer etc kept busy,i could hardly work before had a stick and now i dont need a stick at all.by the way i was only 50,very young for the operation but what choice did i have,if i had to go through it all again,i would,without a doubt,i was very scared before but i read so much before about the replacement how it works etc.i live in england and i know i am one of the few people had it done as its new,but the quality of my life has improved,i dance and swim and walk a lot just i cant wear high heels,early days but thats nothing compared to my life.mobility depuy is fantastic 3 piece replacement and yes it makes your ankle move much better...tess.

     
    Old 07-20-2008, 03:30 PM   #7
    Elmo151
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    Re: Total Ankle Replacement (TAR) Options

    every success story adds to my confidence. THANK YOU FOR YOURS.

    My surgery is scheduled for late september in switzerland. I will post occasional updates here
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    Old 08-10-2008, 01:00 PM   #8
    kate139
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    Re: Total Ankle Replacement (TAR) Options

    Hi,

    I'm Kate; 57 yrs old. Previously extremely active; back country hiking/skiing, tennis, squash, running. January 2004 I was involved in a serious car accident involving a moose. I suffered severe fractures to both ankles as well as some other less serious injuries. After six surgeries to my left ankle, I underwent TAR (Hintegra prosthesis) July, 2008.

    According to my surgeon, the operation was a swimming success. He was able to regain more ROM that he had originally thought. Kudos to him and lucky me!!

    The morning after surgery, my dr. came to check on me. He was concerned about the lack of sensation in my big toe. Now, it has no feeling at all.

    Two weeks post op I have severe nerve pain on the inside of my ankle, radiating to the sole of my foot and shooting pains through and out the toes. I have been prescribed Lyrica, but it has not helped at all. I have found that if I rub the inside of my left knee and put a bit of pressure on it, the pain eases (does not go away though). My question is, did any of you suffer from nerve damage as a result of the surgery??

     
    Old 08-10-2008, 01:11 PM   #9
    Elmo151
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    Re: Total Ankle Replacement (TAR) Options

    kate==

    so sorry to hear about your problem. nerve damage is on the list of potential problems associated with TAR.

    have you seen a neurologist? I wouldn't trust as OS with a nerve problem.

    I wish you well. Please keep us informed.


    Elmo
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    Old 08-11-2008, 05:53 PM   #10
    happyfoot17
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    Re: Total Ankle Replacement (TAR) Options

    Hi Kate,

    Happy to hear the operation went well, except for the nerve damage. I always had a bit of nerve damage from my operations, I'm sure you did too. None of mine was anywhere near as severe as that though. I would talk to a nerve specialist, but I am sure that while concerning that it can be resolved.

    Hope it gets better soon

    Keep us posted and enjoy the new ankle =)
    Kira

     
    Old 08-12-2008, 11:18 AM   #11
    akirka
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    Re: Total Ankle Replacement (TAR) Options

    Hi Kate,

    I'm almost 7 months out from an OATS procedure. I had part of my talus replaced with a 2 grafts from my knee. The first couple days after surgery I had no feeling in my foot which the Dr. explained as residual numbness from the nerve block they gave me. However, after a few more days, I knew that I had some nerve damage as the whole top of my foot was numb. About the 2nd week my pinkie toe came back to life and it felt like a severe sunburn for awhile. At a 3 week cast change, I realized the side of my foot as well as the outside of my leg were numb. For the next few months my foot had burning nerve pain and weird sensations but not severe pain like yours. It took about 5 months, but I started getting back feeling in my foot and the burning pain subsided. At 6 mo. my foot is about 50% there - it tingles all the time, feels itchy, gets these little zaps like someone has pulled a single hair out, but is way more tolerable. I saw my OS and he feels over the next 6 mo. the nerves will repair back to normal. The side of my leg is still numb - never have had any sensation and I think it will stay that way. Take heart - you're only 2 weeks out - my hope for you is that your nerves will get better over time, but it may take months to a year. Hopefully they can reduce the nerve pain now while you're still healing! The heavy duty pain pills they gave me (Oxycotin) did tend to take away alot of the burning pain. Good luck - even with my nerve issues, I would do this surgery again. It has really improved my foot pain and function. Hopefully that will be your story!

    Abby

     
    Old 08-14-2008, 06:45 AM   #12
    kate139
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    Re: Total Ankle Replacement (TAR) Options

    Thanks to all of you for your support. My next post-op appt is August 26 at which time the cast will be removed and x-rays taken to determine the progress of the TAR.

    Over the past few days, the cast has become looser and I am able to flex the ankle a bit. Not sure if I am to do that or not, but boy does it feel good. The ease with which I can flex my ankle (limited of course within the cast) is remarkable compared to what the ankle was like before surgery. I am very, very hopeful that this surgery will allow me to participate in life rather than look from the sidelines.

    Nerve pain is easing somewhat; I am able to get a few hours of uninterrupted sleep each night. What a difference that makes.

    I'll keep you posted on the outcome of my next appointment.

    All the best
    Kate

     
    Old 09-26-2008, 09:56 PM   #13
    Elmo151
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    Smile Re: Total Ankle Replacement (TAR) Options

    I did it and am writing this from my hospital bed in switzerland 4 days post op.
    No Pain. Minimal swelling.
    Got my boot and physio yesterday and will leave the hospital after the weekend.
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    Last edited by moderator2; 09-27-2008 at 06:09 AM. Reason: posted disallowed website(s)

     
    Old 02-12-2010, 12:48 AM   #14
    limpy in limbo
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    Re: Total Ankle Replacement (TAR) Options

    I am 63, had a total ankl replacement 6 months ago. I may have had a injury that worsened with R. A and osteo. Find the best dr. who has the most experience with this ankle replacement. Mine has done over 600 and picks the right one for you to use. I am doing well he said, but do nto know why I have foot numbness and toes that are numb. He does nto either as they do not cut the nerves or tendons. It is pretty slick how it is done. I know a man who is in his 80"s and playing tennis and golf again after both ankle replacements. I am in Minn. but they come from all over to have this dr. do it. He is at the U of M.

     
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