Need to decide if I should have triple on rt foot

[Frank Corsi]

Hi, new to this blog. I am 68 years old and have suffered with severe flat feet all my life. I was first recommended to have the triple arthrodesis  on both my feet 12 years ago and was scared off after reading comments on a blog like this one. My new orthopedist has tried a Richie boot to help with pain and improve stability and activities. Not getting the results hoped for and my right foot has deteriorated to the point where the doctor feels my only option is this procedure for my right foot. My age and the amount of arthritis precludes an ankle reconstruction. 

I will be trying a new brace for my right foot,  which is much more restricting to provide stability and alignment. It will extend up to just below the knee. The surgeon indicated this might give me enough relief to put off surgery or time to make a decision.

Have read through a good deal of the postings on this blog; concerned that the successful fusion, recovery and time to regain full function seems daunting. 

I would appreciate any insights any of you can offer about this procedure and if you feel your experience and outcome make it worthwhile. Thank you.

[DENNIS HULL]

  I was 73 at time, in good shape and had broken my navicular bone in 3 pieces. Had triple fusion and was a rough surgery. Had a knee walker which was awesome to get around. You really have to not do much and let it heal. It took me almost 20 months to get to little to no pain. It is a long haul type of rehab and just listen to your surgeon to get back to walking with no pain. Have to wear Hokas to help with walking. Good luck you can do this. You will need someone to help you after surgery.

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[jjfc...@gmail.com]

I’m not qualified to answer address your questions since my procedure was a single tibiotalar ankle fusion. I just want to say, remember that people who have successful and uneventful procedures are probably not the ones that are drawn to share comments on a site such as this. Especially the bad ones. Maybe before or after the initial surgery, but once the recovery has proven successful I’m guessing they have better things to do to get caught up with life and all the activities they were missing out on.

 The most important thing is to pick a qualified surgeon. Check credentials, experience and patient reviews if available. Check his or her record for malpractice claims. This is a complicated procedure, more so for you. Always get a second, or even a third opinion. Don’t just go with a surgeon because they’re nice or you’ve been going to them for a long time. 

I am one of those who’s fusion failed and I was referred to a surgeon who’s also a podiatrist not long ago.  He wanted to convert my fusion to a total ankle replacement (TAR), which he has a very successful record with. But, this would be his first fusion “take down” followed by the ankle replacement. He does personally know the guy in Baltimore that developed the technique and was consulting with him. I scheduled the surgery, but also a second opinion (after my spine surgeon expressed concerns). My second is considered one of the best in my state for reconstructive ankle surgery and teaches/trains/mentors other surgeons. He strongly advised against the conversion to a TAR, even though he could and has done them. He said that if it fails, the loss of bone would make further reconstruction “catastrophic” and I could very well end up with an amputation. I canceled the surgery and will have a second fusion with him since only part of my surgery failed to fuse and he says the rest is solid. 

Good luck and let us know how things turn out!

Julie

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On May 6, 2021, at 8:17 AM, DENNIS HULL <denni...@bellsouth.net> wrote:



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[Laura Kott]

Eight weeks into recovery from a sub Talar fusion and gastrocnemius recession surgery. The first eight weeks have been a real struggle with being non-weight bearing.  Luckily I have a very supportive husband because getting around even with a scooter has been very difficult and my husband has had to do all of the work at home. I finally got the OK for weight bearing and it feels great to be more independent.  My advice is to make sure you have a lot of help, get a good all-terrain knee scooter, and a shower chair that you can slide across to get in the tub shower. You can do this!

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[Caroline Levine]

Hi,

I'd been considering a TAR after 3 ankle fusions.  After reading comments here, I've changed my mind.  I do not want to chance an amputation!  I don't want an Arizona boot either.  Will look into the Richie Boot and Hoka clogs.  Just going from Easy Spirit Travel Time clogs to Easy Spirit sneakers is helping already.  So I going back to using my rollator around the house.  My foot has been hurting lately, 3 years after the last fusion, but I think I can baby it and avoid another fusion.  I just can't face the long recovery again.  Yes, the shower chair helped as did the plastic cast cover I found on Amazon.  Before this last surgery, my surgeon suggested same day surgery where you go home right after.  I insisted as a senior, that I needed a couple days of hospitalization.  There was no way I could've gone right home.  Has anyone else had this suggestion?  The surgical group owns the same day surgery so I'm guessing they make more money if you go that way.  

The other enormous help after my last surgery (not the 1st two) is getting a portable commode.  Having to use the bathroom with only one working leg is too dangerous at first.  These commodes aren't expensive and my senior center had one to loarn.. You buy the bags and charcoal blocks on Amazon to make it easier to use

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[Kim Connolly]

Hello,

I had a triple arthrodesis with  foot and ankle specialist at Hopkins.  I have been a Hopkins nurse for 36 years- that and extremely flat feet, plus a bad sprain led me to having this surgery. It is extremely important t have a foot and ankle specialist- a specialty in orthopedic surgery- are for you. you need to follow the strict non weight bearing instructions- mine was almost 10 weeks, as well as actively participate n PT and do your exercises at home.  A shower chair, raised toilet seat, and renting a stair chair to help going up and down the stairs helped me to be independent and recover well. I did not bear weight n my ft at all for about 10 weeks and then it was gradual for 4 weeks. excellent PT at Hopkins.  Dr Casey Humbyrd was my surge but she is now in Philly. Dr James Ficke is a foot and ankle specialist at Hopkins and is the chair of Orthopedics at Hopkins-he was her boss. He is excellent and compassionate.  Would be glad to offer any advice.  I had success- my right foot would be headed to a much worse outcome had I noted a triple arthrodesis. 

Kim

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[Frank Corsi]

Thank you to all of you for your comments and advise. I have a good deal to consider. I need to see how the Arizona boot works before I make a decision.

[vonda cowling]

Dr Ficke also did my triple arthrodesis in August 2019.   I had polio in my right lower leg and foot as a child and had many orthopedic surgeries my last being at age 12.   I used to wear a brace but got to an age when i didn't want to wear it anymore.   I was fine for years i had a limp but i could wear heels.   More recently, I developed ankle collapse, no arch and it hurt just to walk across the room.  that's when  consulted with Dr. Ficke.  My recovery was relatively straightforward.  I was in a cast for 9 weeks... I stayed on top of my pain and had a relatively pain free recovery.    almost 2 years later, i have no complaints... and I am glad I had the surgery.   I just need to remember to stretch my Achilles everyday!   

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[Meg Gwaltney]

Either a lot of us live in or near Baltimore or it’s where the foot and ankle specialists/surgeons are. My left ankle fusion was in 2010 when I was 57 years old. Surgery was performed by Dr  Mark Myerson at Mercy Hospital in Baltimore (I traveled from the Maryland suburbs of DC). Dr Myerson, now retired, was world renowned and medical students and young doctors came to Baltimore from around the world to study under him. He had an ego to match but was a talented surgeon. I was non-weight bearing for 8 weeks, then gradually could put weight on my foot after that while wearing a boot. I think it was 3 months before I could wear a shoe, but I had to buy sneakers 2 sizes larger for my operated on foot because of the still present swelling. Fortunately, Nordstrom’s will accommodate and sell you a mismatched pair. I was amazed, and even was able to return the larger doe and get a matched pair after my foot was back to normal. So now almost 11 years later, I’m doing great. The surgery was a great success and I think I walk normally, although can’t run or perhaps keep up with someone walking at a really fast pace. I have rheumatoid arthritis so I’m extremely grateful for the surgery and being able to walk without pain. It was a long recovery but totally worth it. 

Meg

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[Kim Connolly]

Glad to hear about your success!  I am the same- in much better shape with that foot and ankle then I would have been without the surgery.  Very important to be cared for by a foot and ankle surgeon than a podiatrist- at least for the surgery and initial post op follow up. Foot surgery is the most complex of all orthopedic procedures.