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DH has severe ankle arthritis and pain, any ideas?

Liz Wolf-Spada

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My husband is 70, still working as plant manager at a local school and within two weeks complaining of pain. An x-ray shows bone on bone rubbing due to arthritic deterioration at the ankle joint. Looking up on google I see surgery as one option. Has anyone had surgery for this? What other options are out there?
Thanks,
Liz
 
S

Steamboat Bill

Try conservative tx first
Rest, non-weightbearing, crutches, weelchair for 3-4 weeks (this works very well and is rarely done seriously)
Hot packs 2-3x per day
NSAIDS like Naprosyn 500mg EC
Cortisone injections into the joint
Physical therapy

Get a propert diagnosis
You need both a MRI and CT scan to look at the articular surface of the Talus and Tibia to see if there is damage or not (this does not grow back)

Surgery should be a last resort
1. Joint clean up procedure -cheilectopmy may help, but does not cure artiritis if the joint surface is damaged
2. Ankle joint fusion - this will be the only procedure guranteed to cure the pain as you are destroying the joint. This is a serious procedure and should only be done by a doctor that has done hundreds of these as a bad outcome or malaligned fusion is hard to correct.
3. Joint implants do not work for the ankle
 

vacationhopeful

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As my ex turns 60 today, I fully agree surgery should be the LAST resort.

He told me Thursday night, he needs to get his shoulder replaced. 6 weeks of passive PT, 6 months of active PT. Due to scuba bubbles. Will be getting a couple more MRIs to look for more dead bone, most likely in hips. Then would need a hip replacement.:eek: :eek: :eek:

He did the double knee replacements 5 years ago. Due to rock climbing and skiing. AND being over 100+lbs too heavy. Has been whining how he has blown/worn out the "pads" on the artificial knees for the last 6 months.

The only thing I can add on the ankle joint is, LOSE WEIGHT, as every couple of pounds lost (if this is even a minor issue) improves the outcome on any weight bearing joint problem.
 

beanb41

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As my ex turns 60 today, I fully agree surgery should be the LAST resort.

He told me Thursday night, he needs to get his shoulder replaced. 6 weeks of passive PT, 6 months of active PT. Due to scuba bubbles. Will be getting a couple more MRIs to look for more dead bone, most likely in hips. Then would need a hip replacement.:eek: :eek: :eek:

He did the double knee replacements 5 years ago. Due to rock climbing and skiing. AND being over 100+lbs too heavy. Has been whining how he has blown/worn out the "pads" on the artificial knees for the last 6 months.

The only thing I can add on the ankle joint is, LOSE WEIGHT, as every couple of pounds lost (if this is even a minor issue) improves the outcome on any weight bearing joint problem.
45 years of mispent youth and he is suffering just like the rest of us. If only we had listened to our younger fitter bodies when they cried out in pain and now they get us back when we cry out in pain. I feel for your better half and suffer with him with my plethora of anti inflammatories and pain killers.
 

lprstn

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Acupuncture....my grandma swears by it. She has arithtis and it has helpd. She also takes some kinda medication but I don't know the name of that either.
 

Passepartout

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Try glucosamine either with or without condroidin. The theory is that it helps regenerate the joint cushioning. I've been using it for maybe 15 years. As my rheumatologist says, try it, if you think it helps, keep it up. It can't hurt you.

I use that and a prescription anti-inflamatory and if I skip either, my joints tell me about it.

Jim Ricks
 
S

Steamboat Bill

It might be worth it to visit the Cleveland Clinic in OH. They have the best arthritic doctors in the nation.
This is not necessarily true (how do you determine who is the BEST doctor in the nation?) as great doctors sometimes get horrible results and average doctors usually get great results. Medicine is an art and science and sometimes bad outcomes happen even if everything was done by the book. Besides the OP lives in California and there are many great centers in LA, San Fran, and San Diego.

Treatment options for an arthritic ankle are pretty limited for a 70yo and many doctors will advise patients to live with it or prescribe some form of conservative treatment. Surgery is usually a last option for a less than majority of patients as the post op course is a challenge.

I would advise seeing someone in your area that actually specializes in ankles (hard to find) but you may need to call around. Many offices will say their doctor treats these conditions, but it is DIFFICULT to find someone that is really experienced in the FULL range of ankle conservative and surgical treatments.

Ask a few simple questions
1. How many "ankle" arthroscopes (knees don't count) has the doctor done in the past year?
2. How many ankle artroplasties (joint clean-up) have they done
3. How many ankle fusions have they done
4. How many ankle implants have they done (this is really rare)

I think you will find it hard to find someone that is an ankle expert.
 

Autoeng

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I'm sorry, I was referring to arthritis doctors in general not one specializing in ankles. I didn't read the full OP post.

I can comment on ankle arthritis as I have it from an auto accident where I had a calcaneus (heel) fracture and subtalar joint damage. Dr. George Quill in Louisville Kentucky (http://www.louisvilleorthopedic.com/doctor-quill.asp) is considered to be one of the best ankle ortho surgeons and is pioneering surgical treatment for ankle injuries. You do not want surgery if at all possible and he will tell you whether it is your best option or not. With myself he will not operate.

You can read some of his published papers here (http://www.louisvilleorthopedic.com/conditions5.asp?ctype=Foot).

This article on management of ankle arthritis would be of interest to you http://www.louisvilleorthopedic.com/documents/quill_manage.pdf

This article in particular deals with surgical options.
http://www.louisvilleorthopedic.com/documents/quill_current.pdf

Good luck.
 

mjs

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My husband is 70, still working as plant manager at a local school and within two weeks complaining of pain. An x-ray shows bone on bone rubbing due to arthritic deterioration at the ankle joint. Looking up on google I see surgery as one option. Has anyone had surgery for this? What other options are out there?
Thanks,
Liz
What did his doctor recommend?
 

Wonka

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Try glucosamine either with or without condroidin. The theory is that it helps regenerate the joint cushioning. I've been using it for maybe 15 years. As my rheumatologist says, try it, if you think it helps, keep it up. It can't hurt you.

I use that and a prescription anti-inflamatory and if I skip either, my joints tell me about it.

Jim Ricks
Not to be funny, my dog uses this! Although, it's probably cheaper for humans.

My wife uses another product, Mobic, daily. It also helps. But, not like the dramatic difference I saw in my dog.

She's 11-1/2 and was panting a lot and restless. I took her to the Vet. The Vet indicated that means they're in pain & discomfort.He prescribed ArthriSoothe which is 99% Glucosamine HCL (shellfish source), and Rimadyl. She was much better the next morning and continues to take them daily.
 
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Liz Wolf-Spada

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He has only been to urgent care and has an appt. with his regular doctor on the 16th. I am forwarding these responses to him. Thanks,
Liz
 
S

Steamboat Bill

He has only been to urgent care and has an appt. with his regular doctor on the 16th. I am forwarding these responses to him. Thanks,
Liz
I highly doubt any doctor will (want to) read any of these posts...no offense.

Doctors hate when patients bring in Internet reports.....especially non-peer reviewed journals.

However, my first post contains medically acceptable diagnostic and treatment options that you should verbally ask about.
 
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