Suggest Treatment For Ankle Arthritis

Posted on Wed, 12 Aug 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 12 Aug 2015 Answered on

Tue, 1 Sep 2015 Last reviewed on

Question : I had an ankle arthroscopy about 10 months ago to address an OCD in the talus. After about 3 months, I started doing PT and thought I was getting stronger and better but after about 3 months of that, I took a real dive and haven't been getting better since. I have significant difficulty walking at times, especially if I have been seated for an extended period of time. I have been like this for near 3 months now. I've seen two other doctors that believe my OCD was not properly addressed since my MRI from a month ago suggests it is still there. They have both said that it would require an osteotomy of the tibia to reach the OCD and properly treat. I am not particularly thrilled to have screws put into my ankle so before I do so I would like further confirmation that doing so is the best course of action. My question is, why nearly after 6 months from my surgery, would I be having the symptoms I am having now, if the root cause is still the OCD. My symptoms were not nearly this bad prior to surgery.

Answered by Dr. Aashish Raghu (21 minutes later)

Brief Answer:
Ankle arthritis

Detailed Answer:
Hi there.

Welcome to Healthcare Magic.

Thanks for the query.

The fact that you have an untreated OCD for 6 months following which you have worsening of symptoms suggest that you may have developed ankle arthritis.

The ankle arthritis can occur if the OCD fragment is large and should have been fixed back to the place it chipped off from.

Physiotherapy only makes the muscles around the ankle stronger but if the OCD fragment is causing obstruction to the free movement of the ankle joint then it would not benefit alone. This could be an indication for surgery.

There are many methods to fix back the OCD, one of them being approaching the ankle after cutting out the medial malleolus, fixing the OCD fragment back and creating tiny drill holes around the OCD fixation site or putting in plugs. The medial malleolus will then be fixed back.

I advise you to consult with a Sports Medicine specialist trained in Ankle arthroscopy and Cartilage regeneration techniques for the best possible treatment options.

I hope I have answered your query.

I will be available to answer your follow up queries.

Thanking you.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Aashish Raghu (4 hours later)

To be clear, my OCD was treated back in November. My confusion primarily lies with the recovery process in which the last 3 months have been significantly difficult. Though doctors are suggesting I need to have the procedure done again and done properly, I don't understand why my symptoms are so much worse then before surgery. At the very worst, I figured my issue would be unchanged. Before I agree to have another surgery done, I would like some confirmation that this is likely the best decision and that it has a high likely hood of fixing my issue. If my difficulty is primarily due to ankle arthritis, it would make sense to me that surgery would be unnecessary.

Answered by Dr. Aashish Raghu (6 minutes later)

Brief Answer:
Kindly provide available reports

Detailed Answer:
Hi there.

Thanks for the follow up query.

Kindly upload your MRI reports for me to be in a better position to help you. The size of the ID fragment and configuration on Friday the injury pattern are important in the prognosis.

Kindly also brief me on the type of surgery done and any hospital reports if any.

I hope I have answered your query.

I will be available to answer your follow up queries.

Thanking you.

Regards,

Dr. Aashish Raghu

Above answer was peer-reviewed by : Dr. Neel Kudchadkar