Ankle brace or ankle fusion?

Hi everyone I am lookin for some input from some one who has been through this before. My doctor can not give me a straight answer on this.

I have had RA for about 10 years and have no more cartilage left in the ankle joint which is causing me a lot of pain by the end of the day. My ankle has started to self fuse and I have little motion left in it. my first question, if anyone knows is it possible for the ankle to completly fuse on its own. The second question has any one tried  a ankle orthodic that completly eliminates the movement and if so did it eliminate the pain.

                                                    Thanks

Hi Rodman and Welcome to Healing Well,
I am sorry I can not help you with your question, but we have a very gifted Moderator, Erin, and i think that might be right up her alley. She will be along shortly and I am sure she will have some answers for you,
take care,
flopsie

Welcome Rodman!

Am looking up some info for you...you have to forgive me though, my hands are a little off & painful tonite, but I will leave my post for you tomorrow!

I know you're ankle is in misery!  It's taking a pounding....

By the way, what meds are you being treated with?

 

thanx Flopsie for the referal!    i'll be looking to you when i need a recommendation letter when i land my dream job @ the Bone & Joint Disease Hospital NYC

 

Post Edited (erin kachmar) : 11/3/2005 9:40:20 AM (GMT-7)

Dear Rodman,

Let me start by stating, "I know what you mean by your doc not being able to give you a straight answer!"  My rheumatologist has more "I don't knows" than I can believe.

I take it that you had Xrays showing deteriorated cartilage and fusion of the ankle.

Yes, the ankle can fuse and given time could fuse completely.  The ankle is a joint, and I believe that the ankle, like the wrist and spine, can self fuse as well. (ankyloses, which is joint immobility or fixation happening when the cartilage and bone are deatroyed by RA).

The ankle fusion can also extend to the supprt structures of the bones, tendons, ligaments and thus joint instability and deformity can occur.

What I would recommend:

Be sure that your rheumatologist knows how unhappy you are!  You're in pain and that's not good!  There's a lot of pressure demands on your ankle and the pain needs to be addressed.  The pred, MTX and celebrex are good...but you can add additional pain management.  Talk it over with the doc about a stronger pain med (he might not Rx an opioid, so you might have to see your primary care physician for one).  And also, it might be a good idea to talk about a DMARD/Biologic like Enbrel, Humira or Remicade.  To try to prevent other joints from fusing.

Ankle-foot orthotics will aid in some measure of foot and leg support by preventing dorsiflexion and inversion of the ankle (basically ankle deformity in other words).  I would say it can't hurt to try one!  It would reduce pain by providing proper alignment.  My best advise would be to get a consult with an occupational therapist or an orthopedic doctor or orthopedic surgeon, and they can give you the best route to take further.

I can only imagine how many conflicting views you'll hear from your docs about this.  Rheumatics is an art!  I try to remember that at each appt!  And many times we have to try one thing after another until something works.

But definitely take action on PREVENTING further fusions.  Have you considered the TNF meds like Humira and such?

I hope this made some sort of sense!  Pain and immobiltiy are big issues regarding the ankles.  So there are some options here and things to look into.

I'm not sure if there is a surgical approach to this or not. 

If I can offer any more input on this I'll post it for you!

Take  good care,

Erin

  

Post Edited (erin kachmar) : 11/3/2005 10:18:30 AM (GMT-7)

Dear Flopsie,
You have just made me swell up in tears. Thank you so so much. I'll save that forever.

Anytime.
You said it! It takes one heck of a doctor to really get the big picture. They're out there, but few and far between!
I do hope you get the opportunity to go down some different paths.
One other thing I can think of, is that if you get frustrated with the doctors you see now, there are hospitals that deal specifically just with bones and joints. It might be out of the way, & might be a little costly, but the cream of the crop docs usually practice there.
Sometimes even at your state's top University teaching hospital, there could be some top notch, no nonsense, innovative thinkers.
Take good care
Glad to have you at Healing Well!

Hey Susie,

Good to hear from you.  Thank you for the sweet compliment too!  And also, thanks for being there for me when I was going through all the CD and tests and all in the beginning.  How's it going so far?...not too great, but I know many have worse and I'm gratefulI do not require surgery.  You were great though when I was hit with all this in the summer...you really helped a lot.

My main problems with the Crohn's is partial blockages (2 so far)  and really bad pains (like 3  to 4 times a week) and then episodes of D lasting the entire day (which has calmed considerably).

The joint pain from the RA and Crohn's is still very much disabling...and I'm ticked off because I was hoping things would be better by now.  On Humira, but I suspect that I'll start Remicade come the new year since the GI and Rheummy both thought that's the best thing to do next.

The joints are really excrutiating.

What's new with you?  

I'm on a quest to get in remission!  My goal is to actually put use to nursing school & all that tuition, and actually practice nursing come Summer 2007.  

Reasonable goal right?  Gives me a year for these quacky doctors to get things right!!  The only good thing about having limited mobility right now is that I'm able to like re-read every nursing course lecture we had to sit through (wow, and it actually sinks in this time! hah)...  but I've had enough of RA holding me back...I'm ready to burst!!!!!!!!!!!

{{{{{{{{ hugs }}}}}}}}}}}}

erin    

hey forget it guys, senority rules, and I am older than all of you, so I GET HER FIRST!

This looks like a good place to start. OK, here it is. I'm having ankle fusion surgery in January. Two 1/2 years of every conciveable treatment tried. Braces, boots, cast, meds, cortizone, 2 surgeries, Enbrel injections for 12 weeks, drained, looking for infection, even went to infectious disease doc looking for some weird strain of lyme disease. All treatments complete failures. Every single blood work came back stone cold normal. No gout, or any recognizable infection. However, the CT bone scan came back white hot in the ankle joint. It's swollen like a softball and feels freshly broken every day. 

 Just got back from seeing a hot shot surgeon in Charlotte who confirmed what my local doc said-- fusion is the only way left to go.

Now the questions-- is there any kind of alternative treatment I'm missing? Will this work? Can I get rid of my pain? I'm out of ideas. I need my life back. Thanks for letting me rant

 

Hey Yaz,

Look at the 7th post from the start of this thread. Is this any help? or have you already read this? Rodman I believe is going through the same thing.
Perhaps by putting this back up here, someone who's got some info on this personally will find it.
The best to you
erin

bump