New Jersey woman gets her life back after cutting-edge ankle replacement
RWJBarnabas HealthPublished 6:00 a.m. ET Nov. 28, 2018 | Updated 1:39 p.m. ET Dec. 6, 2018
Kimberly O'Donnell thought she had reached the end of the line with her ankle, which developed arthritis after she had a foot fusion in 2012. "It just never really healed right," said the 61-year-old. "I just never was able to get the full use of my foot back again."
As a result of her arthritis, the cartilage broke down – and although an arthroscopic procedure temporarily alleviated the pain, there was audible bone-on-bone grinding when she moved.
Treating the pain with cortisone shots didn't help. Neither did therapy, nor braces. Doctors even told her she was nearly out of options. However, O'Donnell found a solution – and got her life back – in late summer 2018: She received a total ankle replacement.
Ankle replacements have become more precise and patient-specific.
Ankle replacements aren't new, although they've only become the "gold standard" for treatment in the last decade, said Joseph Saka, DPM, O'Donnell's doctor and Affiliated Foot & Ankle Center podiatrist at Monmouth Medical Center Southern Campus, Lakewood.
Previously, most patients with ankle arthritis might have had the joint fused, which involved removing cartilage and locking the ankle bones together with a plate or screw.
For a patient such as O'Donnell – who is an avid gardener and needs to have a range of motion to do planting – this procedure wouldn't be ideal. "It totally eliminated any motion with the ankle, which is really not optimal if you're active," said Dr. Saka. "You can't bend right; You can't walk right. And it usually requires life-long braces or special shoes."
The specific implant O'Donnell had inserted is the Wright Medical INFINITY Total Ankle System, which is specifically geared for people whose ankle joint has been compromised by severe rheumatoid, posttraumatic or degenerative arthritis.
"That's supposed to absorb shock and provide cushion, and more of a normal, rolling type of motion similar to what the ankle does on a daily basis."
The Wright Medical INFINITY Total Ankle System is particularly enduring – Dr. Saka noted it needs to be replaced only "every 15 to 20 years" – and also more precise than previous implantation systems.
"Many of the other implants relied on inaccurate measurements of the ankle," Dr. Saka said, "whereas [with] this particular system, the cutting jig – the guide to actually help you cut the implant – is actually custom-made." In fact, doctors use a patient's own CT scan, in addition to other computer imaging, as a framework to make the implant. "That is really a humongous benefit because now the cutting dies are perfectly accurate and the implants fit in perfectly," said Dr. Saka, who adds that the CT-driven guides are also "a huge time saver, make [the implant] really foolproof and provides almost dead-on accurate cuts.” "It really makes this implant stand out,” he added.
Recovery after this ankle replacement is much easier.
O'Donnell's experience recovering after her ankle replacement was a welcome change from her post-foot fusion experience when she was in a hard cast for eight weeks. This time around, she first wore a soft cast and then a boot and was allowed to put mild pressure on the area within weeks. "Within probably a month's time, [Dr. Saka] had me walking," she said. "He wanted me to walk because he said it worked so well." Being active so soon after having the replacement is encouraged, Dr. Saka added. "The implant just locks in," he said. "When you do bear weight, you're actually helping the ankle seep in better."
Eight weeks out, O'Donnell said her foot is still a little sore, which is entirely normal. However, her ankle isn't in pain, and she doesn't need to use a walker. In fact, she's already walking with a brace and compression sock. Her bone-on-bone grinding has also disappeared. O'Donnell already considers having the ankle replacement one of the best decisions she's made for her health and quality of life. "It's just absolutely fantastic," she said. "It's worth it.”
"Anybody that's afraid of an ankle replacement – it's better [this] than to walk around with severe, horrible, debilitating pain in that ankle, day in and day out. I lived with it for years, so this is much better than what it was."’
Think the Wright Medical INFINITY Total Ankle System might offer a solution to your ankle pain? Monmouth Medical Center Southern Campus now has experienced surgeons adept at performing this advanced technique, which aims for enhanced quality of life that's pain-free.
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** Source Asbury Park Press