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Fixing, fusing, or replacing an ankle

Published: Oct. 20, 2020 at 8:16 AM EDT
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For people with ankle arthritis, every step can be a struggle. When medication and bracing don’t bring relief, patients may look for surgical options. Who should consider fusion and which patients are good candidates for total ankle replacement?

Tina Burd, a long-time fitness instructor, teaches spin to serious athletes. But for most of her adult life, Burd has had crippling pain in her left ankle.

“Because there’s no cartilage in the ankle joint, basically, I was bone-on-bone,” explained Burd.

She’s worn braces and boots, done therapy and visited countless orthopedic doctors.

“I’ll be honest, I seriously asked a couple doctors and contemplated amputation,” said Burd.

Lew Schon, MD, is not only an accomplished keyboard player, but an orthopedic specialist at the Institute of Foot and Ankle Surgery, Mercy, using skilled hands to perform delicate foot and ankle surgeries.

When medication and injections fail to relieve pain, patients can either fuse the ankle joint, or replace it. For patients with a history of infection or bone disease, fusing or welding together the two bones that make the joint, might be the best option.

“Get rid of the joint, stop the motion. Stop the pain,” shared Dr. Schon.

But fusing prevents the back and forth flexing motion, so Burd resisted. Five years ago, Dr. Schon replaced the joint.

“The ankle replacement allows us to remove the diseased cartilage and bone, realign the ankle and replace the surfaces with metal and plastic,” said Dr. Schon.

With the replacement Burd can do everything she wants to do, except run. She and her pup choose to walk instead.

Because of the risk of joint replacement parts wearing out, replacement has often been reserved for healthy patients in their sixties or seventies. But with the replacement system in Burd’s ankle, the plastic parts can be changed if they wear down, without the need to remove the entire replacement.

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