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  • Considering ankle arthroscopy

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    Old 06-25-2009, 11:55 AM   #1
    curtis79
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    Considering ankle arthroscopy

    Hello,

    I had a really bad sprain of my ankle 4 years ago. The ankle healed but continued to cause pain and conservative care didnít resolve it. I had an MRI that revealed a cyst in the talus bone. Iíve seen a podiatric surgeon. He said that I had some surgical options, but the decision would be based on how much the pain was affecting my daily life.

    He said that the initial surgical option would be to remove the cyst through arthroscopy. Then basically poke holes on the walls of the space where the cyst had been so that scar tissue forms and more or less seals it off. He said the pain was from blood moving in and out of the cyst when it gets compressed causing inflammation. If successful the pain would be reduced. He seemed optimistic that we could get at least some improvement. He did not feel that there was a high chance that this surgery would make things worse.

    I did see another surgeon for a second opinion and he agreed with the initial opinion.

    I am seriously considering the arthroscopy. I have managed my pain by modifying my activities. But it can get really sore especially when I am active and it wears me down sometimes. I would like to hear anyones opinions on the risks vs rewards of having this done.

    Any feedback would be greatly appreciated.

    Thanks,
    Curtis

     
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    Old 06-25-2009, 07:07 PM   #2
    emmie54
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    Re: Considering ankle arthroscopy

    Hi Curtis, and welcome to the board. I would suggest you get a third opinion from a board certified foot and ankle orthopaedic surgeon before you make your decision.

    I had an arthroscopy but it was to remove synovial tissue due to anterior impingement. It sounds like yours will be a bit more complicated. I would definitely get an opinion from an artho. Just my opinion!

    Best of luck to you. Maybe someone who has had a surgery a little more similar to yours will respond shortly.

    emmie

     
    Old 06-26-2009, 08:48 AM   #3
    curtis79
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    Re: Considering ankle arthroscopy

    Thanks Emmie,

    Both doctors that I saw were in the podietry department with my health plan. I assume they are both board certified. Isn't a podietric surgeon the correct specialist to be talking to?

    The surgery is moderately complicated since the cyst could be difficult to reach arthroscopically. That is because it is in the back area of the talus behind the maleosis. If he were unable to reach with the scope he would need to cut the bone and then put back together with a plate and screws.

    Of course, I would prefer just the scope if possible.

    Despite this, he said that the procedure has an 80% success rate. He said he has done a lot of these. People had anywhere from slight improvement to great improvement and he has not had any that got worse.

    At this point I am ready to try something because it hurts most of the time and it makes it difficult to be active and excercise. Even a little improvement would be a relief.

    Has anyone had a similar surgery that could share thier experience?

    Thanks

     
    Old 06-26-2009, 10:04 AM   #4
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    Re: Considering ankle arthroscopy

    While some podiatrist are also surgeons, I prefer an orthopaedist who typically has had more extensive surgical training. A foot and ankle ortho has had even more. If you do a search on this board for ortho vs. podiatrist you can review many other's opinons on this subject. Of course the decision is yours to make. There are some on here who have had great success using podiatrists. Most seem to prefer an ortho fior foot and ankle surgery.

    Best of luck to you. You will find lots of good information here as well as very supportive people, especially post-op when you need it most!

    emmie

     
    Old 06-26-2009, 10:10 AM   #5
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    Re: Considering ankle arthroscopy

    There are two types of surgeons who work on feet. Podiatric surgeons, who are not regular MD's but are podiatrists with extra training in surgery, and foot and ankle orthopedic surgeons, regular MD's, who did a residency in orthopedic surgery and have extra training in foot and ankle surgery.

    It sounds like this surgery might be the right move for you, especially if you are currently dealing with significant pain or limitation. However, anytime you go cutting bone, the recovery is going to take a while. I would recommend a third opinion, from an ortho, ideally one not associated with your surgeon.

     
    Old 06-26-2009, 03:34 PM   #6
    curtis79
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    Re: Considering ankle arthroscopy

    I might consider getting a copy of my MRI and going to someone outside my insurance (Kaiser) and just paying out of pocket.

    I see some posts from people who had similar cysts removed and havehad problems afterwards or needed further surgeries. However I would suspect that people who have successful surgeries don't always post on sites like this, because they are fine and are not in need of further advise.

    It's really hard to tell what the right decision is.

     
    Old 06-26-2009, 06:57 PM   #7
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    Re: Considering ankle arthroscopy

    Removal of a bone cyst is a relatively common procedure that usually turns out well. But still, I think your plan to seek a third opinion from an outside doctor is wise. Your surgery isn't particularly urgent, and you have nothing to lose except the relatively small cost of a consultation.

     
    Old 06-29-2009, 02:05 PM   #8
    curtis79
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    Re: Considering ankle arthroscopy

    Is it still a common procedure if he had to cut the bone and reattach with a plate?

    I would still like to hear from others who might have had this surgery.

    Thanks

     
    Old 07-06-2009, 12:49 PM   #9
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    Re: Considering ankle arthroscopy

    I began tracking my ankle pain in a journal. I am thinking that may help me make the decision.

    Most the time the pain is pretty mild. Its just when I work out. But on the other hand I don't want to have this keep me from staying in shape.

    Is there ANYONE who has had this type of procedure?

     
    Old 07-07-2009, 10:30 PM   #10
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    Re: Considering ankle arthroscopy

    I had a different arthroscopic ankle procedure last year--removal of a soft tissue lesion. It can't really be compared to your situation, my surgery was easier than yours would be. However, by 2 weeks after the surgery, it was clear to me that I had made the right choice, and not a day has gone by since when I'm not grateful I had it done.

    Before I did it, I actually consulted 6 doctors. The first two were not surgeons and had no idea what was wrong. (Didn't help that my MRI was falsely negative!). Numbers three and five believed I had a congenital malformation of my foot bones. Numbers four and six had more or less the correct diagnosis, and I eventually went under the knife of #6.

     
    Old 09-22-2009, 10:00 AM   #11
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    Re: Considering ankle arthroscopy

    Hi
    I'm new on this website. Here is what happened to me. In April after an MRI they found a have a cyst on my ankle. I spoke with my foot and ankle doctor and he said a need a surgery. He explained to the type of the surgery they can be: one is with removing the bone to get to the cyst and the other one which is simpler is to drill the bone to get to the cyst to clean it and then to fill up the hole with new bone. So I went for the simple one which was not very simple for me. I had to be in the cast for 3 weeks and in the boot for another 2 weeks. After 4 months I went to see my doctor for a checkup and the cyst came back already. Now the cyst is not that big but is there. My ankle doesn't hurt me that bad now but the cyst came back. My doctor told me more options and he even told me about an option to fuse my ankle and to remove my ankle. When I heard that I almost went down. I'm 37 years old and I never had any problems with my ankle before and to hear that I felt very bad. I told to my doctor that will never happen I will start to pray allot and take lots of ibuprofen until I will be ok. If you have any ideas please let me know. Thanks Ben
    I will be ok. If you have any ideas please let me know. Thanks Ben

     
    Old 12-22-2009, 08:05 AM   #12
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    Re: Considering ankle arthroscopy

    I have just completed the same surgery for the same problem. I had a bone cyst in the same area as well as having had broken pieces of cartilage that needed to be cleaned out. I am in recovery as we speak. On day 11 and still having pain from the surgery, can any of you tell me what I can expect as far as the recovery process goes. In real terms, how long before I can resume normal activities? I know that I can't bear weight on this foot for 6 weeks, and then I will need to do PT. What will I feel like in 6 weeks, and when can I get on a treadmill, bike, etc???/ Thanks for you input everyone!!!!

    Last edited by twinsmom2; 12-22-2009 at 08:08 AM. Reason: typo

     
    Old 12-22-2009, 12:02 PM   #13
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    Re: Considering ankle arthroscopy

    Hi,
    I just thought I'd post my experience with this b/c Twinsmom2 was asking about recovery time, etc. I had my scope on 3/18/2009. I had a cyst (OCD lesion) on the lateral/anterior aspect of my talus. It was small (4mm). My OS drilled mine. (I also have a tear in my PTT tendon that I will mange the rest of my life, I hope...don't want a tendon transfer). ANYWAY...

    It took me 2.5 weeks before I could bear weight. And I started with one crutch. It was really painful for the first 3-weeks. It took me about a month B4 I could take 45 steps....and then I slowly progressed from there. I had ankle swelling for a good 5 months. When I would walk, my ankle got very fatigued...but that subsided after 5 months. I still have issues with peroneal tendon, muscle tightness (not sure why...see PT tomorrow about that) and I still have issues with my PTT tendon. I'm still not back to anything close to normal...but I've also had 2 knee surgeries since the ankle surgery.

    Bottom line...it will take time for the pain to subside....it will take time to get back into your "normal" activities. You will get there though. I hope this post helps

     
    Old 12-22-2009, 03:13 PM   #14
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    Re: Considering ankle arthroscopy

    Thanks for the timeline "let me walk"...I am in the same boat as twinsmom2..I had surgery 11 days ago too! I got my stitches out today and the OS is happy with the swelling etc...Me I personally think it looks worse than when I went in as there was no swelling Guess surgery will do that for you..We are still thinking NWB for a total of about 6 weeks..depending on how I feel. I have a splint and or CAM boot to protect the ankle..I can take it off and do some passive ROM exercises now. I'm supposed to go back to work the first weekend in March..I work 12 hour shifts where I can be standing/walking the majority of the time..just depends on the night...Is this realistic at all???..This would be @ 12 weeks post-op.

     
    Old 12-23-2009, 07:12 PM   #15
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    Re: Considering ankle arthroscopy

    Momhmmx2...It's hard to say if it's realistic to be total weight bearing for a 12-hour shift just 12 weeks out of surgery. Where was your cyst (lateral, medial, posterior, anterior???) How big was it? What is your current fitness level and weight? I think all of those things play into your recovery and ability to weigh bear. For me, at 12 -weeks I was able to stand a lot (I remember that I was on a fishing trip at the time and standing for hours....but NOT 12 hours...more like 4 hours with moments where I could sit...and I wasn't moving around). My situation is different though b/c of my tendon. I wonder if you could get work restrictions from your doctor when going back to work.....a 12-hour shift on your feet is tough on anyone...let alone someone just recovering from ankle surgery. (My opinion only though.....). I hope this helps.
    Let Me Walk

     
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