Anyone had an ankle replacement or stem cell therapy?

[CherylGrrl]

Hello all,

I'm a formerly active early retiree who suffered a fall, broken ankle, and resulting osteoarthritis in the ankle joint due to loss of cartilage during the fall. I had a second surgery to "clean up" the joint but I'm not any better. I have pain all the time and can't walk more than 4 miles in a day -- not bad, but I'm used to skiing, sailing, and taking long hikes so this has completely changed my life. Less activity = weight gain, so this just makes it worse.

I take a lot of ibuprofen, which I would prefer not to do. I can't take any medication with opiates due to the side effect of extreme nausea, probably a good thing given the problems of opiate addiction.

I'm starting to read about ankle replacement, which is rarely done, and stem cell therapy to address the cartilage issue, which sounds pretty experimental. If anyone has any experience with these or other treatments of injury-induced arthritis in the ankle I would be very grateful to hear about it.

 

[kgtest]

Ay, my dad crashed his motorcycle and they just kept repairing his ankle. He has limited movement a year later, and as I understand in constant pain.

 

[Midpack]

I'm starting to read about ankle replacement, which is rarely done, and stem cell therapy to address the cartilage issue, which sounds pretty experimental. If anyone has any experience with these or other treatments of injury-induced arthritis in the ankle I would be very grateful to hear about it.

I PM'd as you know. But ankle replacement is not that rare where we live. The surgeon who did DW's ankle 16 months ago has done over a thousand total ankle replacements over the past 20+ years - with a 94% rate of success in the past 10 years. By his own admission, success rates were much lower 30 years ago.

Just one of several joint models.

In May 2009, the FDA approved the Scandinavian Total Ankle Replacement (STAR) system. At the time of approval, the design had been implanted in more than 15,200 patients worldwide, and more than 35 peer-reviewed clinical outcome papers had been published on the device’s efficacy. A study published in the July 2009 issue of Foot and Ankle International indicated that after 24 months, ankles treated with the STAR system rather than with ankle-fusion surgery had better function and equivalent pain relief, making ankle-replacement surgery a viable option for those with end-stage arthritis.

http://www.todaysgeriatricmedicine.com/archive/082510p16.shtml

Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958283/

SAN ANTONIO, TX. – March 2, 2012 – Arthritic hips and knees are replaced all the time—but did you know that arthritic ankles can also be replaced? In fact, ankle replacements in the U.S. more than doubled last year, thanks in part to technological advances in ankle implants (prostheses).

http://www.acfas.org/content.aspx?id=2971

There are several "models" - this is just the one we're familiar with:

 

[CherylGrrl]

Just found this statistic and interesting article:

Roughly 6,000 ankle replacements are performed a year in the United States, a fraction of the 700,000 knee and 300,000 hip replacements that the Centers for Disease Control and Prevention recorded last year.

Read more at Inside The OR: Ankle Replacement

 

[aaronc879]

I had no idea ankle replacement was a thing. Learn something new every day. Sounds like OP should talk with Midpack and maybe get a referral. Constant pain is not a good way to live if it can be prevented.

 

[Ronnieboy]

I have had neither, but I am a candidate for "cleaning out" my ankle. I don't know what started it, I think it was due to a slight injury from standing on a beveled mat so my foot was at an angle to my leg and weight.

I stand 8-10 hours a day so it wasn't/isn't so fun. Currently I am getting by with cortisone shots that have lasted on average of 9 months but it all depends on the MD getting the shot in the right part of the ankle (filling the sinus tarsi area). The PA's tend to be hit and miss but the MD can hit it everytime. I am told that when it lasts 3 months or less it is time to "clean out" the joint.
Based on your description it doesn't sound too helpful, so I am concerned about doing it. I have seen some info on the stem cell but it doesn't seem insurances tend to cover the experimental treatment and I am not yet willing to pay out of pocket until I see more promising results. If I could lose some weight that would be helpful too.

Good luck on your search and keep us updated on what you decide.

 

[RunningBum]

A ski friend of mine is getting ankle replacement this off-season. I probably won't see him again until next winter so I can't tell you anything about his experience. I'd never heard of it before, but apparently it's not extremely rare.

 

[AllDone]

It's pretty new. The five year success rate is nowhere near as good as knees and hips and the protocol for replacing a failed replacement is also pretty much up in the air. The recovery period is much more difficult than the larger joints too. I'm waiting for the surgeons to get some more practice myself, but right now I'm successfully controlling the pain with Aleve and Tylenol. I can walk a fair distance, but not on a daily basis so I get a lot of my exercise on a bike. Strengthening, stretching, and shoe choice has helped. When I can no longer control the pain, I'll get the replacement.

Stem cells are still very experimental. The last time that I looked, there was a phase 3 knee trial starting (3rd phase our of three). It looks promising, but the information that I have from people working in the field is that it's still some years off. There are various unscrupulous people, often chiropractors, who offer "stem cell therapy" now, but it's a scam. There are lots of phase 2 trials going on right now.

I also have mid-foot arthritis (where the foot bones connect to the ankle) and that is more easily treated with surgery by fusing the unnecessary and vestigial joint (you'll never hang by your feet from a branch again), but the long recovery is the same as the ankle replacement. However, I got an amazing amount of pain relief from changing the way that I lace my shoes! The price was right too.

 

[Midpack]

It's pretty new.

DW's surgeon has been doing ankle replacements for 30 years... From above:

Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s.