subtalar fusion - should I have it?

shbirch

Hi, I wonder if anyone can offer any advise. I had an accident 24 years ago and broke my ankle after around 8 surgeries over the years to rebuild the ankle degenerated and collapsed. I was told I had osteoarthritis. 3 years ago they tried an ankle realignment to buy me time before facing ankle fusion. it did not work so I had an ankle fusion. 3 years later I have just been diagnosed with further arthritis in my subtalar joint. They are reluctant to offer me the second fusion due to my age (40). and want me to have a cortizone injection first to try and delay the invevitable fusion. I have tried the podiatrist and have inserts for my shoes and a lace up ankle brace (neither seem to do any good) the pain is horrible. My knee joints are also beginning to become painful. I am not really convinced about having the cortizone injections as it feels like I am just delaying the inevitable and they can be very painful from what I remember in my teens, without much benefit. Do you think i should just push for the fusion? or are there other options I should explore first? I know it sounds drastic but I often wish the ankle had just been amputated at the time of the accident. I am tired of all the surgical procedures but would bo through a second fusion if there was hope of some pain relief. I am sure there are others out there that have had similar dilema's can anyone offer any advice?

[Deleted User]

Welcome to Arthritis Care Forums, shbirch, from the moderation team.

As moderators we are here to help with any problems you may have using the message boards so feel free to send us a message if you need to.

I am very sorry to hear that you are facing the possibility of having ankle fusion at 40. There have been people on here who have had to make similar decisions. Hopefully one of them will be along soon to give you the benefit of their experience.

You might find it useful to download the leaflet here:

https://www.arthritiscare.org.uk/treatments-aids-and-equipment/surgery-and-arthritis

If it helps to talk it over with someone the helpline number is:

0808 800 4050

I look forward to seeing you posting on the boards.

Best wishes

Ellen

stickywicket

Hi and welcome from me too.

It is an unfortunate fact that OA can set in at the site of a former bone trauma and, once it arrives, it can settle in and make itself at home. With around 8 lots of surgery you seem to have done your level best to eject it and I'm sorry these attempts have proved unsuccessful.

My own ankles fused themselves over the years (I have RA) so I know how painful they can be and can understand your sterling efforts to get back to something approaching normality. It is true that one 'out of kilter' joint can beget others as our gait worsens to accommodate the pain. Plus, of course, our feet support the whole of the rest of our weight.

Cortisone injections, when they work (which is a bit unpredictable), usually last up to a maximum of three months by my reckoning. Some find them painful: others less so.

We are all different, with different hopes, wishes and backgrounds. I think a good chat with your surgeon would be your best option as he is best placed to answer your questions. From my experience of doctors and surgeons (And I've had a lot :roll: ) if we ask questions they will answer: if we don't ask they presume we don't want to know. In your situation I'd want to know what a successful operation would offer in terms of pain relief and for how long. It seems as if your ankle has, so far, continued to deteriorate despite all the operations. I wonder if this particular operation would be different or would just give more temporary relief until one of the other many (26 in all) bones in the foot packed in. Of course your surgeon is no Mystic Meg but he should have plenty of experience of the different outcomes depending on how much was wrong to start off with.

You write of orthotic insoles and an ankle brace. Have you never been offered surgical shoes / boots? These might help.