Ankle Replacement Surgery

I tend to receive a lot of junk RA and health-related mail in my email inbox, which I usually skim over and then send right to the "Trash" folder. A couple days ago, however, I was surprised to see an email that I wanted to actually read in its entirety and investigate further. The subject--ankle replacement surgery--could very well impact my own ankle and life.

Severe RA pain in ankles

Angela's Annoying Ankle Saga (or whatever you want to call it) has been a maddening, never-ending story since April 2005, when both ankles suddenly became swollen and unbearably painful while I was on a trip visiting my sister in Spain. After high doses of prednisone, round-the-clock icing, wrapping/bandaging, and rest helped my left ankle shrink back to normal (more or less), the right one decided to stubbornly remain swollen and debilitatingly painful. Why? Who knows. I certainly wish I did.

I've written about my frustrations with my "bad" right ankle and the two failed arthroscopic ankle surgeries (synovectomies) on it several times over the years, yet sadly the "ankle story" remains the same--it's an apparently unsolvable (and untreatable?) mystery. But, maybe, just maybe, this little press release that found its way to my email address the other day could be a new sliver of hope?

Ankle replacement for RA

The email was from Loyola University Medical Center (a.k.a. Loyola Medicine) and tells the story of patient Nancy MacFarland who had successful ankle replacement surgery after several other treatments didn't help alleviate her pain.

You can read the press release here: Ankle Replacement Surgery Enables Loyola Patient to Walk Again Without Pain

"This story about Mrs. MacFarland and her severely painful, arthritic ankle sounds hopeful for others who suffer from ankle pain with little to no relief (like me). However, the mention of "bone-on-bone" arthritis makes me wonder if her pain was caused by osteoarthritis and not rheumatoid. And if so, then how would this surgery apply to me? Could it also help? Are RA patients good candidates for ankle replacements instead of ankle fusions?"1

Like the press release mentions about the ineffectiveness of corticosteroid injections, all of the steroid shots I've had over the years have never helped my ankle--even when I had one guided by ultrasound (fluoroscopically-guided injection). I've also tried several types of braces and wraps and tapes yet nothing works. Expensive, custom-made orthotic inserts for my shoes also didn't help.

After seeing rheumatologists, many orthopedic foot and ankle specialists (some out of state), a podiatrist, and several physical therapists during the last 10+ years, I have basically admitted defeat--well, at least for right now. I feel stuck and abandoned and unsure of what to do. However, I still hope and wish and pray so much that something can be finally discovered to help my ankle. Maybe this little email that almost got sent to my "Trash" folder will help lead me down a real road to recovery and healing. I hope so.

In the past, no doctor would agree to fusing my ankle because I'm "too young" and it's technically a "healthy" joint; no damage shows up on any of my MRI and X-ray scans all of these years. Great, no damage! But why can't we get this stubborn thing calmed down and under control? The option of ankle replacement surgery never seriously crossed my mind before because I've been so adamantly told "no" to having it fused by every ankle surgeon I've seen. I can't believe that I'm expected to just put up with this constant debilitating pain for the rest of my life. The idea of another surgery is frightening, but I want so much to get my mobility back that I'm willing to go under the knife again if it will actually help.

Ankle fusion vs ankle replacement for RA

What do you think? Have you had your ankle fused or replaced? Should I give Loyola a call? Should I give my ankle surgeon (who has seemingly given up on me now) a call? I've put so much time and effort and emotion into trying to find out the truth of what's going on with this joint and how to treat it that I don't know who or what to trust anymore. The only thing that remains clear and constant, day and night, is the pain. The pain is real.

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