Special Medical Moment: INBONE Total Ankle replacement, Part One

If you've ever twisted or sprained your ankle you know how painful it can be, but imagine breaking it and needing plates and screws put in just so you can walk.

That happens to millions of people across the country who often end up having surgery that leaves them with a limp.

Now, there’s new technology that's giving people back the spring in their step -- literally.

Not even in surgery yet, Virginia Zimmerman of Niles is telling her doctor she wants a purple cast.

Virginia broke her ankle eight years ago and has screws and a plate holding it together. She can walk, but it's very painful.

She hopes she's found the solution with Mishawaka podiatrist, Dr. Jeff Niespodziany.

Other doctors suggested fusion surgery, which often takes care of the pain.

“Well I refused. I don't want to have my ankle fused. I don't want to loose my foot,” says Virginia.

Fusing ankles can limit motion, so Dr. Niespodziany now performs what's called "INBONE Total Ankle System".

He's the only doctor in the area using the technology, which basically has two main pieces and can be custom fit to the patient, mimicking a real ankle.

“This type of implant is the third generation. It's been the most advantageous to ankle joint replacement and it’s pretty new,” says Dr. Niespodziany.

If all goes according to plan, Virginia will go home with a cast the day after surgery that she'll wear for six weeks.

“Right now, the ankle joint is moving but it's bone moving against bone and it causes constant inflammation and pain. It's going to replace the joint just like a knee or hip replacement would be. It's going to give her more mobility than she has now, but with the mobility she'll have no pain with it,” says Dr. Niespodziany.

Virginia hopes the added mobility will get her back to one of her favorites past times--tennis.

After kissing her husband, Mike, goodbye, it's on to the operating room.

Now fast asleep, Dr. Niespodziany's first order of business is getting the old screws out, and since it's been eight years, it takes some real muscle.

“Bone is made to grow into them. That's why it’s so hard to come out,” he says.

Then Dr. Niespodziany makes a small incision from roughly the lower third of Virginia's shin bone to just past the ankle.

“So now it’s just an issue of opening this up, avoiding the neurovascular bundles so you don't cut any nerves,” he says.

That done, it's time to put Virginia's foot into a device, which looks like something you have in your garage, but it's cutting edge technology. The way it aligns the foot is key to this surgery, a tedious process, but extremely important so Virginia doesn't walk with a limp.

“We're trying to set everything exactly up because these guide rods are going to determine exactly where we put the ankle joint implant in. That's what makes the engineering so exact,” says Dr. Niespodziany. “There's virtually no movement. The only thing that would move would be the entire frame and the foot would move with it.

It's taken roughly two hours to get to this point, but Dr. Niespodziany says this is the real science of this breakthrough surgery

“Lining this all up into the footplate is actually the most important, scientific element to it,” he says.

That done, it's time to make the hole into the lower part of the ankle joint to make room for the implants stem.

The system's saw guide also tells the doctor where to make his cuts

Three hours later, he’s ready for the implant.

“The ankle joint has been removed now, the bone’s gone and that right there is the portion where the ankle joint is going to be put into,” says Dr. Niespodziany. “It may be three, four hours of our time but it's 25 years for her.”

Click here to read Part Two of this story, where we'll take you back inside the OR and show you how the total ankle implant is put in, how the surgery went, and we'll catch up with Virginia for a first hand account of surgery and recovery.

If you'd like more information about the INBONE Total Ankle System, click here or contact Dr. Jeff Niespodziany at:

Unity Medical and Surgical Hospital
4455 Edison Lakes Parkway, Mishawaka, IN
574) 259-9668


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