Wow, just the sound of that is daunting. An ankle implant (also known as “ankle replacement”). I didn’t even know they existed until earlier this week.
But there I was, at my long-awaited meeting with a podiatrist on April 26, talking about having an ankle implant as one of the options to dealing with the degenerated condition of my left ankle. The doctor had looked over x-rays of my ankle from last year and came back to me and said, “How did you DO THAT to your ankle?!”
I proceeded to tell him about the fractured ankle I sustained in a serious car accident in 1975, followed by, in more recent years, the 20 marathons, 27 half-marathons and 10,000 or more miles I’ve run since 1996 (most of that in an eight-year stretch from 2003-2010). Apparently, the running (over time) aggravated an ankle condition that I did not know about. He seemed to have little sympathy, but I really was not seeking sympathy. I just want to be smart about it going forward, so that I can limit my arthritic pain and avoid having to walk with a cane.
Oh, and if I could run again, that would be ultra-cool. But it’s not likely. (I really miss running, by the way. I haven’t run a step since working in about five miles of jogging when I did the Mercer Island Half-Marathon in March. In the weeks since, I’ve focused more on long walks and workouts on my stationary bike. But I digress.)
Dr. Anthony Lo at the Minor & James Medical Clinic in Seattle mentioned getting an implant as the “most aggressive” approach on a scale between conservative and aggressive. Most conservative would be wearing a brace and getting a cortisone shot every so often. Conservative middle ground would be getting me ankle “scoped” — i.e., minor surgery to clean it of bone chips and other debris resulting in pain and swelling. Under this option, the scoping surgery might be necessary every three to five years.
A more aggressive middle ground, and an alternative option for me, would be ankle fusion surgery, where the two bones I have connected to my degenerating ankle joint would be fused together. This would allow walking and limit pain, but also possibly seriously limit ankle movement — a real problem with this option. There would be a rehab period, and perhaps a limp. Running may be possible, but problematic.
Now to the implant. The downside of it is that it is major surgery, could cost a bundle (though likely covered by health insurance), and it is risky. It would require wearing a cast for at least three months and a rehab period of about six months. Further surgery might be needed down the road. But the upside is that the arthritis and pain likely would be gone (or seriously reduced).
Could I run again with an implant? Dr. Lo, who does not do implants but knows quite a bit about them, said probably not. The pounding might be jarring and dangerous for the metal contraption that would be in my leg.
Here’s an article that advises fusion surgery or ankle replacement surgery: “What’s better: ankle arthrodesis or ankle replacement?” By the way, this article is a few years old; implant surgery has become a bit more common than when this was written. Here’s another site worth checking out: Myanklereplacement.com.
What about the conservative options? The downside of just wearing a brace and getting cortisone shots, or getting the ankle scoped, is that the arthritic pain will return at some point, Dr. Lo said. He added that, given the condition of my ankle, an implant may be needed at some point, no matter what. The pain may require it.
Doing nothing at all was not seen as a viable option for me.
So, I have lots to think about. First step is to make an appointment with a specialist who performs implants. Dr. Lo recommended two in the Seattle area, one in Everett and the other in Burien. Obviously, I need more information before I do anything. I am hoping tha one of these doctors can lead me to more info about the fusion surgery option.
My running days are largely over, but not my exercising. Not hardly. I am planning to do the Kirkland Half-Marathon Walk on Mother’s Day. Also, I am signed up for the Seattle Rock ‘n Roll Marathon in late June, which I will walk and jog. So any surgery would wait until after that.
P.S. For much of the past decade, I’d be running either the Vancouver (B.C.) Marathon or Eugene Marathon on this coming weekend. I have Ragnar Relay team friends doing one or the other this year. Good luck to Larissa Martin-Ralph, Rob Ralph, and Brad Nelson! Sorry if I missed anyone.
Till next time.