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    Old 06-28-2010, 09:20 PM   #46
    techmom63
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    Re: Ankle Allograft VS fusion

    I'll update my story as well. I had an ankle allograft, also with Dr. William Bugbee at Scripps in San Diego, on Dec. 7th, 2009. I am now 6 months post-op. I live in Denver, so I flew to San Diego for my surgery, but did my early follow-up visits with an OS here in Denver who had done a fellowship with Dr. Bugbee a couple of years ago. I flew back to San Diego for my 3-month follow-up since that is the visit where decisions are made about returning to weight-bearing. My 6-month follow-up and xrays were done here in Denver once again, about 2 weeks ago.

    My insurance company agreed to pay for the procedure from the outset, saving me from having to appeal decisions or pay out-of-pocket. Like Melissa, I had minimal pain after surgery. I started physical therapy for range of motion (non-weight-bearing) at 6-weeks post op.

    I am making good progress. I began full-weight-bearing after my 3-month follow-up, and had little to no pain in the ankle joint itself. I did have some minor discomfort and swelling in the soft tissue areas around the ankle joint, especially if I overdid things. I was cleared to use an exercise bike or elliptical or swim for cardio, but no walking for exercise. Instructions were "weight bearing as tolerated".

    My 6-month x-rays show that the graft bones have healed to my bones, which is great news. I am still not allowed to walk for exercise, but am OK to do my daily activities. I have good range of motion; not perfect, but much more than I would have had if I had an ankle fusion. I have stiffness when I first start walking after sitting for a while, but my ankle usually loosens up within the first 15-20 feet, and then I feel fine. Still no pain in the ankle joint itself, which is amazing to me after 26 years of worsening arthritis pain prior to my surgery. Dr. Bugbee told me that the stiffness I have now should continue to get better as I continue to heal from the allograft surgery.

    Ankle allograft is probably not the right answer for everyone, and it is still considered an experimental procedure, but I felt like it was a chance worth taking before considering fusion. I have no regrets, and am happy with my results so far.

     
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    Old 06-28-2010, 09:28 PM   #47
    techmom63
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    Re: Ankle Allograft VS fusion

    Oops, forgot to mention two things. First, I am walking free at this point, no brace, etc. I usually wear tennis shoes for stability, but also walk around my house in bare feet, and every now and then, wear sturdy flip flops for a short trip to the grocery store. I'm pretty sure that Dr. Bugbee would not recommend that.

    Second, I don't take any pain meds at all, not even Advil. I have only needed to ice and elevate a handful of times over the last couple of months, and only when I was on my feet too much.

     
    Old 10-15-2010, 10:55 PM   #48
    dsr30
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    Re: Ankle Allograft VS fusion

    Quote:
    Originally Posted by girlwithbadankl View Post
    Hi all

    After a year of fighting the insurance company (anthem bc) and lossing appeals for the allograft all the way to the state review board, we borrowed $$ from our kids college fund to pay for the surgery ($25k). I couldn't take the pain anymore. I had my allograft surgery on nov 2009 by Dr Bugbee at Scripps in San diego. In addition my ankle was unstable due to torn anterior ligaments so he also did a ligament reconstruction, which was a covered procedure. Both were done at the same time. 2 nights at hospital.

    Post-op was fine really very little pain. I was in a huge cast. Luckily we live in the Bay Area so it's only a 90 minute flight home. I was non weight bearing for 3 mos. I flew back for the 2 week, 6 week, 3 and 6 mo follow ups. When I started walking there was really mo pain in the joint. There was soreness in my arch and heel and some swelling. I have pretty good range of motion.

    On a side note, when the hospital billed BC for the ligament reconstruction, they billed them for everything. At first I was upset because they may not cover if they find out other procedures were done. Turns out they paid the claim and I got an $18k refund! After all that agony. I was so excited.

    Bugbee said this is a long recovery. About a year. I am 7 mos post-op. I walk normal in flat shoes. I still wear a brace. It swells around ligament surgery so I still ice and elevate. No more pain meds except advil. I highly recommend the allograft because you have more options down the road as opposed to a fusion. My issue now is that the arthritis is in my mid and rear foot causing new pains. Will cross that road down the line.

    Triggs, not sure where you are but Bugbee will write letter to your INS co. I hope you can get a better surgery. The artificial joints are getting better. I do know Dr Meyerson in Baltimore is doing custom ankles. Talked to a gal there who had in done. I refused to fuse and I'm very happy.
    I just joined to forum to get some info, I see Dr. Meyerson Dec. 9 and wanted to talk to some people who have had an ankle allograft done. I destryed most of the cartilage in my ankle in a motorcycle wreck and my surgeon told me to expect ankle fusion within a year. I'm a 31yr old male and very active, Navy, paintball, running, etc. and refuse to consider a fusion. If anyone who has had an allograft done could message me, I'd like to exchange #'s so I can get some info. Thanks for any help that you give.

     
    Old 10-29-2010, 09:06 PM   #49
    dsr30
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    Re: Ankle Allograft VS fusion

    ...or emails or any form of contact...

     
    Old 10-31-2010, 12:06 PM   #50
    K_Lana
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    Re: Ankle Allograft VS fusion

    My last surgery was with Dr. Campbell who is also at Myerson's office. I've had the autograft. My knee did fine, but my ankle did not. I had too many OCD's and arthritis spots on my ankle. I just had distraction arthroplasty done (June-Sept) and am now in the early part of recovery. It was my only option other than fusion as I am not old enough for a replacement.

    I'm curious to hear what Myerson has to say. THey do the distractions there, so that is an option there.
    __________________
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    RSD

     
    Old 10-31-2010, 07:33 PM   #51
    dsr30
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    Re: Ankle Allograft VS fusion

    Thanks for replying.

    I think I'm way past the autograph procedure, I'm almost bone on bone right now. I'd come across the distraction procedure in my research but thought that it might not work for me because it only forms reparative cartilage and it doesn't hold up. I was very active before the accident and want to continue to be, not being able to run is my biggest fear. I'm thinking that an ankle transplant would allow me to do that. But time will tell, and so will Myerson and then my insurance company if it's viable.

    One of the PT's that I was going to refered me to another PT that she told me was really good and he told me that Meyerson is an ankle guru and if anyone could help it'd probably be him.

    I'm a lot more hopeful than I was before and looking forward to hearing some good news. I'm definitely going to do some more research about the distraction procedure.

    Thanks again for the reply, I'd like to know how your recovery goes, if you post here or my pm.

    Last edited by Administrator; 04-12-2011 at 10:04 AM.

     
    Old 11-01-2010, 05:09 AM   #52
    K_Lana
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    Re: Ankle Allograft VS fusion

    I went to Mercy hoping for a transplant too. I am pretty much bone on bone. My tibia and talus are shot. Both were starting to collapse. I also was a runner and I competed nationally in karate. So, I do know how hard it is to be active and then all of a sudden you aren't. You are younger than me, so maybe they will do the transplant. I'm 42 (41 at the time of the distraction) and I was told distraction was my only option. I was given a 66% chance (less after surgery) of it working. I won't know until next Sept. if it worked. DIstraction is extremely painful and a longer recovery than I expected. I had surgery in June and am still on crutches. I'm trying to be optimistic though because fusion was my only other option. THe fusion they do at Mercy though will not allow for a replacement later. Campbell didn't seem totally optimistic my ankle would be good for a replacement in 10 years either.

    I am very curious what Myerson says about the transplant. My dr. here (who did all my previous surgeries and trained with the dr.s at Mercy and Union) said the allografts have terrible failure rates and to be leary of them. I did find it interesting that Campbell never even brought it up because I know his group does them. Maybe only Myerson does, I don't know. But I asked again and again if distraction was my only option besides fusion and I was told yes.

    From what I've been told, running won't ever be in my future again and either will karate. I hate that. I know with even a replacement though that those activities will be out. I still often think about amputation because I could run again. But I have to give the distraction the full year....

    Keep me posted. I would like to know if they bring up the transplant with you or not. And if they do, why it would work for you and not for me, unless it all has to do with age.
    __________________
    Brostromx2 peroneal tendon repairx2 Peroneal subluxation PTT tendon repair microfracturex5 OATS Distraction arthroplasty ORIF talus & fibula subtalar fusion ankle replacement (failed) TT fusion
    RSD

     
    Old 11-01-2010, 11:40 AM   #53
    dsr30
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    Re: Ankle Allograft VS fusion

    I didn't know that healing process was that long and painful. My injury is pretty recent, June 18 and there isn't damage to the tibia and talus surfaces. It's interesting that the distraction was your only option. From what I read, the allografts seem to be doing well in the short time they've been performed, that was on Mercy's website and Dr. Myerson has done a few of them, he may be the only one who does them at Mercy.

    I wouldn't take what your Dr says as the final word on your activities. I've read of personal accounts of persons that had fusions and still are very active, one guy said that he runs 5k's and I remember an other that still rides motorcycles, so you never know, there might be a lifetime total ankle replacement that can handle anything thrown at it in the near future. The PT that told me about Myerson currently has a 35yr old patient who had an ankle replacement, I don't know anything about the patient or her circumstances, but I thought that that was pretty interesting.

    I know exactly how you feel about not being able to run or participate in karate, it is quite sobering, but new technology is always being developed...

    I will definitely let you know how my visit goes, and if you could post updates about your healing and progress, that'd be great too.

     
    Old 12-09-2010, 07:30 PM   #54
    dsr30
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    Re: Ankle Allograft VS fusion

    Hey Kris, I saw Myerson today and I was given two surgical options, the dreaded fusion and distraction. And two non-surgical options, a brace to immobilize the ankle or some kind of injection. I'm not a candidate for the allograft because of damage to the tibia cartilage. I had a CAT scan done and have to go back next week to see what they will suggest I do.

    How is your recovery going so far?

     
    Old 12-10-2010, 08:32 AM   #55
    K_Lana
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    Re: Ankle Allograft VS fusion

    Hey, I posted on the other thread. Recovery is slow, slower than what I had pictured it would be. I'm getting ready to go see a pain management dr. hopefully next week for some injections and or blocks to help with the RSD. As for the joint, it is sore for sure still, but Dr. Campbell said that for 8 mos post removal it would hurt as bad as or worse than before and then patients start to turn the corner. So, I still have awhile. They said that really for a year after removal, you won't really know.
    __________________
    Brostromx2 peroneal tendon repairx2 Peroneal subluxation PTT tendon repair microfracturex5 OATS Distraction arthroplasty ORIF talus & fibula subtalar fusion ankle replacement (failed) TT fusion
    RSD

     
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    dsr30 (12-10-2010)
    Old 12-10-2010, 11:26 AM   #56
    dsr30
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    Re: Ankle Allograft VS fusion

    Just read your reply. Wow, a year, that's a really long time, I wish the sucess rate was greater or that they would be able to tell you that the procedure will definately work. An entire year of waiting is torture, knowing that at the end of the year, you'd have a pretty good ankle would make things so much better mentally. I really hope that yours is sucessful. Keep me posted.

    Last edited by Administrator; 04-12-2011 at 10:02 AM.

     
    Old 02-14-2011, 12:56 PM   #57
    girlwithbadankl
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    Re: Ankle Allograft VS fusion

    Just an update on my situation. I had ankle allograft November 2009. I would call it a great success. Had it done by Dr. Bugbee at Scripps in San Diego, one of the few docs that know how to do it successfully. However, after I started to walk, my foot started giving me trouble. It got worse and worse. Turns out the talarnavicular joint was dislocated and basically walking on the outside of my foot. Always had instability in the ankle but now the foot was giving out - not related to ankle but was progressively happening since I was a kid. Because I had since changed insurance to Kaiser, I had to seek out new doctors to fix the foot. Waited 4 mos to see their top foot/ankle doc, Schuberth in SF. Well worth it but in so much pain by then. He was shocked at the trama to the foot but also said the ankle allograft looked spectacular and that was a smart move. Ultimately to save my foot I've had to have a mid-foot fusion. Not walking yet, but only 12 days post-op he moved my foot up and down and no pain so I'm optomistic. My piece of advice is always find the right doctor and be your own advocate. You may have to travel for the right care. Had I followed the advice of the first doctors I saw in my area and fused my ankle, I would now have both a fused ankle and fused foot now. They are also going much younger on the STAR replacements. I was told at 43 I was too young however I just met a 38 yr. old woman who just had one by SChuberth at Kaiser.

     
    Old 08-28-2011, 03:16 PM   #58
    lealouis
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    Re: Ankle Allograft VS fusion

    I just had ankle replacement surgery on 8/1/11 can anyone tell me. How they are doing.
    Someone thats had it for a couple years. And what to look forward to? I had the salto talris implant.Thank you Lea

     
    Old 12-13-2011, 05:47 PM   #59
    dsr30
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    Re: Ankle Allograft VS fusion

    I haven't been on here in about a year. Just a quick update, I had the hardware in my ankle removed about three months ago, by Dr. Nunley at Duke in NC. The procedure hasn't really helped, and I was being told about fusion again. Fusion is an absolute last resort for me. I was looking around and found a doctor in Fl (Mark Feldman) that was willing to do the total ankle, but he was out of network and required payment upfront and would then reimburse what the insurance paid. He actually recomends the replacements over fusions and has done them on patients as young as 15. The cost though, was $35k, so that wasn't happening. Anyway, I pushed for the replacement and got word that my insurance has approved the procedure and I just need to schedule a date!! I'm 32yrs btw.

    I'm not using or affiliated with this doctor but just came across this info and website and thought that I'd post the link: http://www.anklejoint.com/content/third-open-letter-my-110-total-ankle-replacement-patients

    Last edited by dsr30; 12-13-2011 at 08:26 PM.

     
    Old 01-25-2012, 07:50 PM   #60
    JimJJr
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    Re: Ankle Allograft VS fusion

    Quote:
    Originally Posted by girlwithbadankl View Post
    I have been on a long journey reading these posts and also finding how to treat my end-stage ankle arthritis. I'm 44 yrs. old with 3 young kids. Last year my ankle started hurting and now it's the size of an elephant and can't walk anymore. Debridement did not work. I'm really miffed because I appealed my case all the way to the state and my doctor who is a pioneer of the procedure, wrote a very compelling letter stating that a fusion would leave me crippled. The decision was to uphold Blue Cross's decision because an allograft would be no more successful than a fusion which I don't want to have due to other foot issues. So, I was wondering if anyone out there can compare/contrast their results of having an ankle allograft vs a fusion. If you've had a fusion, how has your life changed? Thanks.
    I just had the DeNovo Allograft, not Oats.. Click my name and follow along. I hope I can help. My Dr. at Mass General has ZERO interest in fusing me. I'm 42 with 3 children myself. She believes I am WAY TO YOUNG for that, and I think you are too.

     
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