Pins & plates removal from ankle

I've had a screw in the bone of my hand for about two decades now. I can feel the head of the screw if I rub the spot. Every time I get asked about having metal in my body (eg, MRI), they tell me that screw in that location is not an issue. And I've never had a problem going through TSA at the airport. Therefore, I'm just leaving it there forever.

On the other hand, my husband has a cage in his spine that may now be impinging upon a newly-herniated disk, or may be causing the vertebra next to the spine to erode, or something -- they are at the beginning of figuring out why he just had a spectacularly debilitating pain episode in his back. So it is entirely possible that he will have revision surgery to go in and modify or remove the metal.

So my question is: why are you contemplating the surgery? Are you in pain or having issues with walking? Or does knowing the metal is there bug you (which is a legit concern, if you find it is preying on your mind)? Because it's a question of the trade-offs. Every surgery involves some level of risk (for example, infections). I'm sure you thought all this through in regard to the TKA.

For what it's worth, I believe this sort of thing is called revision surgery. I have found that it's very hard to get useful information about any form of revision surgery, for a variety of reasons. One of them, though, is that everyone's revision surgery is even more different from each other than everyone's original surgery. So probably this will boil down to doing an initial consultation with a surgeon who has specific experience with going back into an ankle to remove hardware, getting x-rays (and maybe something that looks at the soft tissue, like an MRI), and not making a decision until that point. Without that, neither you nor your doctor really knows how big a deal this will be, and what the odds are of success (meaning: your definition of success, which needs to rule the situation), time in the hospital, recovery time, need for rehab (which could be meaningful, or could not be needed at all), etc.

Keep in mind that insurance might not cover this if it isn't causing a physical problem or pain, so cost might be something to think about, too. Your primary care doctor may have some insight into that, and the surgeon you consult definitely would.

I'm guessing that how big a deal it would be to get the screw out of my hand, for example, would depend at least in part on how much the bone has grown into and over it, and what would be done about the hole in the bone it would leave behind. Just a guess, never having thought about it.

I doubt if your age or mild overweight would be a factor. Osteoporosis might, though, as might any drugs you might be on. It would seem that a successful knee replacement is a very good sign that none of that would matter.

Yes. I broke my ankle in 2011. A really bad fracture with lots of pins, screws, and a plate. Some hardware stuck out and would get caught on bedding. Or I'd bump into something which would cause a lot of pain. I had surgery for hallux rigidus 2 years ago and opted to have most of the hardware removed from my ankle at the same time since it was causing issues. Even pain when the weather changed. The surgeon left some internal hardware. Very glad that I listened to his recommendation to get most of that removed. My ankle feels so much better when the weather changes and I can wear certain shoes again.

Thanks for your comments. I had bunioneictomies (same as hallux rigidus I think) on both big toes. The results have been great. The surgeon did say I could have the hardware removed. I guess I just haven't found the need.

Anyway removal of metal after surgery is a legit thing and a surgeon would be in position to advise.

Joe

I shattered my left ankle in December 2004. I tripped over my dog and when I landed my foot was actually pointed backwards. It had wrenched both sides of my ankle into. After 4 months in a cast with no weight bearing allowed, it became badly infected; MRSA. Up until September of 2011 I had suffered through 4 additional debridement surgeries due to ongoing infection. Finally a surgeon suggested taking all the hardware out as it was infected too. I was so scared it would be to weak but after a few days of walking very carefully; I found out that it was stronger than I had thought possible. I still have bouts of recurring osteomyelitis as the infection had gone into the bone, but they are mild and I know what to look for and can treat before it gets out of hand. Long story short, get the hardware out if at all possible. Our bodies were never intended to have foreign hardware in them. PS: I've recently had a total hip replacement and I'm petrified of that getting infected. Don't think you can remove all of that and still walk; but ankle hardware; get rid of it.