Supramalleolar osteotomy is an alternative to ankle fusion for some people. It has the advantage of retaining joint motion, unlike fusion surgery. I had this procedure performed 4 weeks ago, along with a general clean out of all the arthritic junk in my ankle and reconstruction of the lax ligament that led me to develop the arthritis in the first place.
As I understand it, fusion is currently the gold standard treatment, mostly because it is excellent for pain relief and has relatively few immediate complications. Over time, however, many people develop arthritis in adjacent parts of the foot and ankle because of the way they compensate for the restricted movement of the ankle post-fusion. At 50 years old and with a very active life-style (hiking, biking, strength training, yoga) I feared the limitations of a fused ankle and what seemed like the inevitable development of additional arthritis. I was lucky enough to find a surgeon who knew of alternatives to joint fusion.
Not everyone is a candidate for an osteotomy. In my case, there was still healthy cartilage in part of the joint. The procedure involves cutting a wedge out of the tibia to open up the joint space and redistribute weight onto the remaining healthy part of the joint. According to my doctor and studies that I read, this procedure can provide long-term pain relief and retains joint motion. It may or may not be the last procedure I need, but at a minimum, it buys time for there to be advances in the treatment of ankle arthritis, especially for total ankle replacement to improve.
I'm only a month into the process and am still non-weight bearing ( in a boot), so I can't say how it all will turn out. Still, I wanted to let people know that there are surgical alternatives to fusion in some cases.
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Supramalleolar osteotomy is an alternative to ankle fusion for some people. It has the advantage of retaining joint motion, unlike fusion surgery. I had this procedure performed 4 weeks ago, along with a general clean out of all the arthritic junk in my ankle and reconstruction of the lax ligament that led me to develop the arthritis in the first place.
As I understand it, fusion is currently the gold standard treatment, mostly because it is excellent for pain relief and has relatively few immediate complications. Over time, however, many people develop arthritis in adjacent parts of the foot and ankle because of the way they compensate for the restricted movement of the ankle post-fusion. At 50 years old and with a very active life-style (hiking, biking, strength training, yoga) I feared the limitations of a fused ankle and what seemed like the inevitable development of additional arthritis. I was lucky enough to find a surgeon who knew of alternatives to joint fusion.
Not everyone is a candidate for an osteotomy. In my case, there was still healthy cartilage in part of the joint. The procedure involves cutting a wedge out of the tibia to open up the joint space and redistribute weight onto the remaining healthy part of the joint. According to my doctor and studies that I read, this procedure can provide long-term pain relief and retains joint motion. It may or may not be the last procedure I need, but at a minimum, it buys time for there to be advances in the treatment of ankle arthritis, especially for total ankle replacement to improve.
I'm only a month into the process and am still non-weight bearing ( in a boot), so I can't say how it all will turn out. Still, I wanted to let people know that there are surgical alternatives to fusion in some cases.
July 3, 2009 - 3:10pmThis Comment
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