fusion – Anderson Podiatry Center

Arthritic pain in the foot and ankle is on the rise. With our active aging baby boomers many may find their activities starting to be limited because of this affliction. It is common for many to use anti-inflammatories, such as Advil, for pain. Although this may help temporarily with the pain the long term use may have negative effects.

As wear and tear takes place on our joints from use, or in some cases injury, the cartilage begins to wear thin. The cartilage that lines the joint is very slick, and when it begins to diminish you may eventually have bone rubbing against bone resulting in pain.

At the end of the treatment options lies the possibility of surgery to replace the joint. An example of the surgery is an ankle replacement or fusion of a joint. This can be done to the ankle joint or other joints in the foot. Without a joint your pain can go away, but you’ve now created the need for other joints to make up for the lack of motion in the joint that is now fused. Eventually, they may become arthritic. We have a new solution for you!

Before you consider the surgical risk and extreme lay up of a fusion or joint replacement, consider joint denervation. So what is joint denervation? Simply put, it’s the removal of the nerve branch that tells you the joint is painful.

We have had a high success rate with this surgical concept and minimal down time and risk. The idea is to decide which branch supplies the majority of sensation to that joint and remove it. We usually remove one or two nerve branches, and these branches don’t supply muscles, so you are not made weaker. The numbness that you are left with has minimal to no consequences compared to how much the pain is limiting your activities. In the rare event of no improvement you’re no worse off and you still have the more major surgery option.

The nerves we remove are in the lower leg, and the surgery takes less than thirty minutes. Where the nerve is cut it is buried into muscle so the tip of the nerve is not sensitive. People are able to walk immediately or within a few days. Contrast this with a minimum of six weeks, non-weight bearing recovery when a joint is fused, on top of the increased risk with a major surgery.

So, if you’re facing the pain of arthritis and have the fear of a fusion or joint replacement consider a second look. Don’t give up those activities you like to do, and consider this exciting new option. Please give us a call and we’ll discuss if this is an appropriate procedure for you.

One of the most debilitating problems is arthritis in the ankle joint. This can be caused from overuse or just getting older (wear and tear). It can also be caused by previous injuries including an old ankle fracture or repetitive ankle sprains. In both situations the cartilage that lines the joint may become damaged to the point of almost having bone rubbing bone in your joint. Ouch!

“But doctors don’t understand!”

I hear that a lot from my patients. They come in frustrated as they have been told to exercise more. Maybe they are overweight, maybe they need to better control their diabetes. And they are motivated! But, the pain is stopping them. It’s a vicious circle.

More exercise=More pain.

Many feel they are not being listened to. And yes some think that your feet and ankles are supposed to hurt, that’s just what happens. They may have been dumbed down by all the drug marketing to the point they assume that if something below the knee hurts and a drug doesn’t help, then there may be nothing that can be done. Sound crazy? Well, sadly, it’s becoming a more common mind set.

Major surgery or living with it are the only options patients are getting!

Regarding ankle arthritis: the common approach in severe cases are the options of replacing the joint, just like replacing a hip or knee joint, or fusion of the joint. Both are major surgeries.
On the one hand, ankle joint replacements may not be as successful as replacing a hip or knee. On the other hand, ankle fusion leaves one with a stiff ankle that no longer moves, and a much altered walk.

Stop- consider a simpler, less painful solution.

Before you take the last step to replace or fuse a joint with all the potential risk consider deinervation of the joint. Simply stated this means getting rid of the nerve or nerves that send messages to the brain telling it the joint hurts. The area where the nerve or nerves are removed is just above the ankle.

We have been doing this surgery for 2 years, and our success rate is very high! Patients are able to walk immediately, or within just a few days. I must stress, we don’t remove nerves that would make the joint weaker, but simply remove branches that give the joint sensation. We have seen very rewarding results, and if it fails there is still the option to have the ankle replaced or fused. Patients who had given up are now being active with very significant reduction of pain, and now with no more drugs!

Don’t let the thought of a major surgery stop you from getting better! Just remember, before you fuse or replace consider this simple, proven procedure and simply deinvervate.

Tag: fusion

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