Treatment for arthritis of the Subtalar joint in the ankle

Posted by lovetennis @lovetennis, Jul 24, 2018

I was diagnosed with moderate arthritis of the subtallular ankle joint. Dr. says no research has been done indicating help for arthritis in this joint. He said that this joint is very complicated. The only recourse is to adjust my orthotics. He does not believe that any injections will help including cortizone, PRP, or stem cell. He said way down the road, a fusion might be considered. I will never have a fusion or any surgery done on my ankles or feet. I do not want to wait for my condition to get that bad to have anything done. Is there anyone out there with this condition? Is there any research or trials to test treatment for this particular joint? Is there anyone who can advise me on what to do about arthritis in the ankle?

@JustinMcClanahan

I had my left ankle fused in December of 2014 if you have any specific questions about fusion. I had end-stage arthritis with severe bone deformity from years of internal bleeding due to my genetic bleeding disorder called hemophilia. I was told a large factor in whether or not a replacement or fusion is best for you is based on how active you are. I was told it is the opposite of what you think, the more active you are the better a fusion is because it creates a stable joint that can take more weight and activity, whereas a replacement is a bit more limiting due to the fact that the components are so small and susceptible to failure. I can say, the recovery from an ankle fusion was long and arduous, but the end result has been a complete elimination of years of severe chronic pain and I find it to not limit almost nothing I do – except for running, which I no longer did anyways. Feel free to ask other questions about fusion, I'd be happy to answer them.

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I am quite mobile now. Pain only comes after several hours of walking. My doctor said I am a candidate for replacement or fusion. The only thing I am concern about is the time limits of the replacement ankle (10- to 15 yrs.) I am leaning towards replacements only because the ankle would be free to move.

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@gallagher17

How long did you get the surgery? How is the rehap doing? Did they offer you the replacement surgery? Thanks

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@gallagher17, are you asking me about how long ago did I get the ankle fusion? It was December 2014. Ankle replacements were not offered at that time because of my young age and expected activity level. I was told that you are able to be more active on a fusion than a replacement, but things progress quickly so the replacements may be more durable now. Long, hard recovery. But, I am pain free and I am able to do what I was doing before the surgery. I wasn't running anymore anyways because of end-stage arthritis in my right ankle and a right total knee replacement in 2006.

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I would love to hear what others have found helpful in regards to this as well. I fell and sustained a compound fracture of my ankle almost two years ago, underwent an external fixation, then had it fixed with plates and screws, developed severe bone on bone arthritis and eventually underwent a fusion 6 months ago. However I now have severe arthritis in my subtalar joint with cysts and bone spurs and am bound to my knee scooter again. Has anyone else gone through anything similar and if so what has helped you?

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@JustinMcClanahan I was wondering if you might be able to help me. Back story. June 4 th 2018 I shattered my calcaneus. June 13th underwent surgery where a plate and 15 screws were used to put my calcaneus back together. Recovery took forever or seemed to. September I was finally able to start walking again ( slowly putting weight on it through several weeks.) finally returned to work end of October ( medical field on my feet 14 + hours a day ) from then to present I’ve had an extremely difficult time walking and extreme edema where 30-40 compression socks had to be used. November I was diagnosed with severe arthritis of the subtalar joint. Medication and braces were used. End of January we found out the subtalar joint had collapsed. My surgeon briefly talked about a subtalar fusion in November. In January he feels that’s my only option. I’m bone on bone and have lost all side to side motion already. By the end of the day I can barely walk. I realize my life has and will change. I guess I’m curious as to if it’s worth it? I’m 35 years old have already changed my activity levels drastically as I can’t even walk without a limp much less try to run or hike. How long was your recovery period? How much pain do you have now? My biggest concern I guess is I’m a mother of two children 11and 5. I know this has taken its toll on my family as well as myself. Is it possible to be able to recover without a limp and continue to work 14-16 hour days with my patients? Can I return to a somewhat normal life without constant pain from morning to night? Do you know of any other alternative options? With what I’ve researched I have not been able to find anything about someone in my age group. Any suggestions on where to look to find information ?

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@miflowers

@JustinMcClanahan I was wondering if you might be able to help me. Back story. June 4 th 2018 I shattered my calcaneus. June 13th underwent surgery where a plate and 15 screws were used to put my calcaneus back together. Recovery took forever or seemed to. September I was finally able to start walking again ( slowly putting weight on it through several weeks.) finally returned to work end of October ( medical field on my feet 14 + hours a day ) from then to present I’ve had an extremely difficult time walking and extreme edema where 30-40 compression socks had to be used. November I was diagnosed with severe arthritis of the subtalar joint. Medication and braces were used. End of January we found out the subtalar joint had collapsed. My surgeon briefly talked about a subtalar fusion in November. In January he feels that’s my only option. I’m bone on bone and have lost all side to side motion already. By the end of the day I can barely walk. I realize my life has and will change. I guess I’m curious as to if it’s worth it? I’m 35 years old have already changed my activity levels drastically as I can’t even walk without a limp much less try to run or hike. How long was your recovery period? How much pain do you have now? My biggest concern I guess is I’m a mother of two children 11and 5. I know this has taken its toll on my family as well as myself. Is it possible to be able to recover without a limp and continue to work 14-16 hour days with my patients? Can I return to a somewhat normal life without constant pain from morning to night? Do you know of any other alternative options? With what I’ve researched I have not been able to find anything about someone in my age group. Any suggestions on where to look to find information ?

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I am now on 14 weeks of recovery from a fusion ankle(3 screws). I am walking normally with boot and have no pain. I have an appt. Feb.14 with my doctor and an xray. I believe I will given the O.K. to remove strapped on boot and to walk again.

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@gallagher17

I am now on 14 weeks of recovery from a fusion ankle(3 screws). I am walking normally with boot and have no pain. I have an appt. Feb.14 with my doctor and an xray. I believe I will given the O.K. to remove strapped on boot and to walk again.

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Glad to hear things went well and you are walking without pain – it give mes hope for my future.

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I too have questions regarding this condition. I fractured my fibula in 2017 with ORIF repair (which would have been a simple recovery) but then fell with my knee scooter 3 months later and re-injured the ankle joint, however the docs at Mayo did not do anything other than tell me to take ice and take anti-inflammatories and to come back in 6 months if it was not better. 6 months later I was still unable to fully weightbear and received a diagnosis of moderate subtalar arthritis from the ortho surgeon at Mayo who fixed my fracture and was told that I will probably need future surgery, but was not given any plan for present treatment of my condition. At the time of that visit, he did not even touch my ankle for examination or look at it – he only looked at the x-rays on the screen.

7 months of PT have somewhat improved my ankle mobility and partial weightbearing but has not allowed me to fully weightbear or walk normally without pain. 4 months after the last Mayo visit, my ankle is still painful with every step, and I cannot walk without using crutches or a walker to take some weight off of the ankle. I also have numbness in my toes, and part of my foot, ankle, and calf, along with pain in the big toe with toeing off. I had to go to a second doctor to get actual evaluation of my ankle condition and am now awaiting a nerve conduction study for further information.

I am wondering what to do next to get myself the proper treatment so that I can someday walk again without constant pain… although I am somewhat older than others in this discussion, I am not old enough to accept being crippled and don't want to be a burden on my newlywed daughter the rest of my life. I am also wondering if there are any clinical trials or research regarding this and what treatment there may be for me now before looking into surgeries.

Any thoughts or advice regarding braces or other treatment are welcome – I am feeling very lost and discouraged right now. My husband recently died and I lost my health insurance with his death, so further surgeries may have to wait until I can qualify for Medicare.

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@windyt I'm so sorry to hear all you,be gone through Your Dr is he a Orthopedic or a Podiatrist? When I fractured my arch I went to Podiatrist after looking at ,x-ray and touched area he put me in a cast ,told me to stay of it so had a loan if power chair after a couple of weeks he took cast of but put a boat on it again loaner With your problems hope everything will turn out Please keep us posted

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@lioness

@windyt I'm so sorry to hear all you,be gone through Your Dr is he a Orthopedic or a Podiatrist? When I fractured my arch I went to Podiatrist after looking at ,x-ray and touched area he put me in a cast ,told me to stay of it so had a loan if power chair after a couple of weeks he took cast of but put a boat on it again loaner With your problems hope everything will turn out Please keep us posted

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@lioness Thanks for your reply. The Mayo doc who did the surgery on my ankle was an orthopedic surgeon but as I noted, he did not address my concerns at the last visit in November, so I went to see a podiatrist in January and she is the one running more tests to try and find out why I am unable to walk. I am now awaiting scheduling for a nerve conduction study, but am having increasing pain in the inside of the ankle and calf with attempting to walk with my crutches or walker. I had to stop Physical Therapy now also since Uncle Sam now wants the money I have been using for PT every month, so that may have something to do with my lack of progress as well. At this point don't know if I should go back into my boot or continue to try to walk as I am with an ankle brace and sneakers…

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@windyt

I too have questions regarding this condition. I fractured my fibula in 2017 with ORIF repair (which would have been a simple recovery) but then fell with my knee scooter 3 months later and re-injured the ankle joint, however the docs at Mayo did not do anything other than tell me to take ice and take anti-inflammatories and to come back in 6 months if it was not better. 6 months later I was still unable to fully weightbear and received a diagnosis of moderate subtalar arthritis from the ortho surgeon at Mayo who fixed my fracture and was told that I will probably need future surgery, but was not given any plan for present treatment of my condition. At the time of that visit, he did not even touch my ankle for examination or look at it – he only looked at the x-rays on the screen.

7 months of PT have somewhat improved my ankle mobility and partial weightbearing but has not allowed me to fully weightbear or walk normally without pain. 4 months after the last Mayo visit, my ankle is still painful with every step, and I cannot walk without using crutches or a walker to take some weight off of the ankle. I also have numbness in my toes, and part of my foot, ankle, and calf, along with pain in the big toe with toeing off. I had to go to a second doctor to get actual evaluation of my ankle condition and am now awaiting a nerve conduction study for further information.

I am wondering what to do next to get myself the proper treatment so that I can someday walk again without constant pain… although I am somewhat older than others in this discussion, I am not old enough to accept being crippled and don't want to be a burden on my newlywed daughter the rest of my life. I am also wondering if there are any clinical trials or research regarding this and what treatment there may be for me now before looking into surgeries.

Any thoughts or advice regarding braces or other treatment are welcome – I am feeling very lost and discouraged right now. My husband recently died and I lost my health insurance with his death, so further surgeries may have to wait until I can qualify for Medicare.

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@windyt You are in a very tough position if you do not have health insurance. Your husband's did not continue after he passed away? There are often provisions for survivors.
I presume then that you want to wait, how soon will you qualify for Medicare? I would as soon as possible seek a second opinion. It does not seem right that you are living with so much pain, I can't imagine that there is nothing that can be done, although that does happen at times.
For now it sounds as if you are doing all that you can. I hope your efforts will be fruitful. Why did the physician at Mayo say future surgery? If it's on the horizon is there a reason to not do it now?
JK

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I just got fusion surgery from Mayo Clinic, Rochester, MN. After four months I am walking with Hoka shoes; tennis shoes that have a thick solee. My ankle is sore at the end of the day, but the next day my condition improves. Get an at Mayo and let them give you an accurate diagnosis. Warrn.

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@contentandwell

@windyt You are in a very tough position if you do not have health insurance. Your husband's did not continue after he passed away? There are often provisions for survivors.
I presume then that you want to wait, how soon will you qualify for Medicare? I would as soon as possible seek a second opinion. It does not seem right that you are living with so much pain, I can't imagine that there is nothing that can be done, although that does happen at times.
For now it sounds as if you are doing all that you can. I hope your efforts will be fruitful. Why did the physician at Mayo say future surgery? If it's on the horizon is there a reason to not do it now?
JK

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@wendyt So sorry for your problems. All I can tell you is what I have related that my Podiatrist put me in a cast first then a boat but told me to stay of it then I did P.T. Later on yrs later I had a bunionectomy and was told same thing . Walk on heel when I had to. I wish you well hope you find the right Dr.

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