Arthritic ankle replacement

If you’ve experienced lightning bolts striking your foot or pain so intense you feel you may never walk again, that's how people describe severe arthritis in their ankles.

It can literally stop you in your tracks.

But now, new technology is helping arthritis sufferers.

Years ago Jacqueline Devine, an arthritis sufferer, dislocated her ankle during a bad wreck. She lived in constant pain for two decades.

"It would feel like somebody hitting you with a ball bat all the time, in the ankle,” said Devine.

Severe arthritis set in and she could barely walk.

"I was getting to where I wanted to use a chair and wheel down the hall,” she added.

Orthopedic surgeon Dr. Brian Donley of Cleveland Clinic combined two breakthrough foot surgeries to fix her foot. A foot fusion and a total ankle replacement.

"These are two separate bones and we fused those now into one bone,” said Dr. Donley.

The foot fusion works in conjunction with the ankle replacement to give Jacqueline a stronger base.

"What we see here is the metal piece that replaced her ankle bone,” Dr. Donley added. “The metal piece that replaced her tibia bone here. And in between those two is a piece of plastic that's replaced her cartilage."

An ankle replacement is not for everyone. An ideal candidate is a non-smoker non-diabetic of reasonable weight who's 60 or older.

Twelve weeks after her surgery, Jacqueline said she was up walking on her own even tying her shoes. Something she hasn't been able to do without pain in years.

"I feel brand new,” she added.

Thanks to the surgical combo, she's kicked her ankle arthritis to the curb.

On an interesting note, before the doctor would perform the total ankle replacement on Jacqueline, he told her all her dental work needed to be up to date.

Major dental work can potentially affect the healing process of the ankle.

Bacteria from your mouth goes into your blood stream and could affect the new joint.

Research Summary

BACKGROUND: Arthritis is the leading cause of disability in the United States. It can occur at any age, and literally means "pain within a joint." As a result, arthritis is a term used broadly to refer to a number of different conditions. Although there is no cure for arthritis, there are many treatment options available. It is important to seek help early so that treatment can begin as soon as possible. With treatment, people with arthritis are able to manage pain, stay active, and live fulfilling lives, often without surgery.

TREATMENT: Depending on the type, location, and severity of the arthritis, there are many types of treatment available. There are non surgical options including pain relievers and anti-inflammatory medications to reduce swelling, shoe inserts (orthotics), such as pads or arch supports, custom-made shoe, such as a stiff-soled shoe with a rocker bottom, an ankle-foot orthosis (AFO), a brace or a cane, physical therapy and exercises, weight control or nutritional supplements, and medications, such as a steroid medication injected into the joint. There are also several surgical treatments such as arthroscopic debridement, arthrodesis (or fusion of the joints), and arthroplasty (replacement of the affected joint). (Source: http://orthoinfo.aaos.org)

WALKING AGAIN: The Salto Talaris Total Ankle Prosthesis is a member of Tornier`s Salto family of ankle arthroplasty systems which have been designed for the treatment of patients as an alternative to ankle fusion for patients with intractable ankle pain. The original Salto Total Ankle Prosthesis, a three part mobile-bearing implant, has been in use in Europe since 1997. The Salto Talaris Total Ankle Prosthesis was first implanted in the United States in December 2006 and has since established a leadership position in the total ankle prosthesis market. As with the entire Salto product line, the Salto Talaris was designed to simulate the anatomy and motion of the normal ankle, while also facilitating the surgical procedure and minimizing bone loss. The Salto Talaris is a precision-bearing design that is implanted utilizing instrumentation that has been designed to maximize the anatomic placement of device components. (Source: http://www.reuters.com)

"The ankle replacement works similar to a hip or a knee replacement, although the anatomy is different. The ankle replacement has to restore the exact anatomy that you remove in order to replace the ankle," Brian Donley, MD, an Orthopedic Surgeon at Cleveland Clinic told Ivanhoe. "An ankle replacement works by taking away the end of the tibia bone, which is the top of the ankle and taking away the top of the talus bone, which is the ankle bone and then replacing those with two metal parts."

Complications can include slow healing, as well as infection. Severe complications are rare, but they can result in amputation. The new models require that less bone be removed, so the bone to which the device is affixed is stronger. In addition, instruments used to guide surgeons in aligning the artificial joint have improved. (Source: http://www.nytimes.com)
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FOR MORE INFORMATION, PLEASE CONTACT:

Mary Vasil Email
Cleveland Clinic's Lutheran Hospital
(216) 363-5789
vasilm@ccf.org


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