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Total Ankle Replacement - Recovery issues & ongoing struggles
I had a TAR in July 2024. I am a female in mid 60's in very good health. I was told I would be an excellent candidate. I wanted the ankle replaced because of repeated traumatic injury over the years causing severe arthritis and restricting my activities including horseback riding and hiking and actually just plain walking.
I had problems with the anesthesia in the first surgery which landed me in rehab for a couple of weeks. The wound then got infected and they eventually determined that my body was rejecting the internal stitches so I had surgery again to correct that. Then, the wound would not heal and I was in a cast for eight weeks. Two weeks after cast removal I was in the walking boot and it twisted causing me to fall and break my tibia on the same side as the TAR, and my wrist on the opposite side. I was then in a cast for another eight weeks while the bone healed, I then began therapy and have been doing well, but six weeeks ago my surgeon commented that the bone density in my leg with the TAR was not great. He attributed it to lack of use and said it woud get better. Therapy has been extensive as they have tried to increase the mobility in my stiff ankle. I returned for a follow up visit to the surgeon after the six week period. He now believes the bone is fracturing under the implant. Three years ago I had a bone density scan and tested normal. None since then. The surgeon commented that he believes the bone suffered fractures due to bone density issue and ordered lab tests to rule out infection and/ or vitamin D deficiency, etc I am now back in the walking boot and no PT. The outlook is dismal. What, if anything should have been done differently, and what should be done going forward, or what can I expect please?
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So sorry that you are going through this. Have you had another dexa scan to determine if you you do have Osteoporosis?
I've had my TAR for a long time now and they are monitoring things. The doc said if I need surgery on it a standing CT scan would be needed. A year or so ago I had a nuclear medicine scan. I don’t know if these are appropriate for your situation. So sorry you have such a difficult situation. Avoiding infection is so important.
I should have said that I'm scheduled for lab work to rule out infection and Vitamin D deficiency, and yes, I will have a CT scan in a few weeks. But, it seems to me that the surgeon should have ordered this when he first noted the lack of bone density; not wait til there was a fracture. wth. 🙁
my lab work all came back normal so I have no Vitamin D deficiencies, infections, etc. I have read a lot about this type of fracture and it is not uncommon. I appreciate the sympathies but I'm hoping to find someone who has had a similar experience or even others who have had this surgery, and what their experience has been. My ankle is also very stiff because of the long recovery time in the cast, so I'm pretty sure the device will never function the way it's supposed to, but again, i don't know. My doctor does not say much. I feel like if he knew my leg bone was soft six weeks ago (which he did) and he now suspects osteopenia, that he should have been monitoring more closely and maybe caught the break earlier. I am pretty disappointed; I spent a lot of time researching and trying to select the best surgeon. My opinion with surgeons altogether lately as that there are very few who have the time to take a personal interest in their patients, we're all cattle going down the chute. :/