OCD in both ankles.. Previous Microfracture surgeries were unsuccessful for both

[wch94]

Well where to start? Back in 2008 when I was just in 8th Grade i found out i had an OCD in my right ankle. This ended my Football season before it started as a captain too btw. I ended up getting the standard microfracture surgery and it actually went really well. After recovery, pt, etc, you know the whole 6 month process i was able to run again and with no pain. For a couple years.. So going on from then until 2012 I entered the summer of my senior year in high school and you can probably guess what happens, my left ankle starts acting up the same way as the right did so many years ago! Found out I had an even worse OCD in that ankle, and this of course once again ended my Football season short (Senior year too!!). Got the microfracture surgery on this one now, and this one didn't go nearly as well as the right one. My doctor pretty much told me I wasn't going to be able to run again but I took that with a grain of salt. probably shouldn't have.. Anyways here i am in 2014, my sophomore year of College, living my life day to day wishing I could do the things that everyone around me can do so easily! I recently met with a new doctor who has suggested an MRI, which I will be getting this Thursday, oh yeah on both ankles. And then on Friday we will discuss options and such. So yeah ever since this all started I have lost a part of myself that used to love working out and partaking in physical activities with friends. I got so depressed about the whole thing at many times where I don't really want to go into detail. I have recently researched alternative procedures because the microfracture obviously isn't going to do me any good this time. I saw the best thing out there right now is the DENOVO operation, but haven't been able to find long term post op discussions on it. If I were to be able to go back to physical activity someday, i'd probably do anything/wait as long as I had to to be able to do so. So that's my story, ill keep posting, but i would love to hear others opinions on my situation and your experiences with OCD's.

[dave1234]

The good news is that your body is much better able to heal after OCD surgery when you are young, unlike some of us other older guys

A few thoughts:
- If you've had problems on both ankles (especially if the OCD occurred in the same spot on both), it could be that you have some kind of misalignment on both ankles/feet.  It's worth looking into orthotic shoe inserts that adjust the angle your foot/ankle when you are walking.  e.g. if you have very flat feet, an OCD can develop on the outside of the ankle joint.  Orthotic arch supports can really help (I always wear an insert in the shoe of my injured ankle; really helps).
- Get a copy of the MRI from your doctor, and bring it to several other doctors to get multiple opinions on the best course of action.  OCDs are tricky injuries to deal with, and its worth getting a few different opinions.  And if you opt for additional surgery, get surgery from a doc who has done a lot of ankle cartilage repair procedures. 
- Microfracture produces fibro cartilage, which does not have the durability and strength of the original hyaline cartilage in your ankle.  Its not uncommon for people who return to high impact activity after MF to have the OCD reoccur after a few years.  So worth being very thoughtful/careful about how much you return to high impact activities (like football, running) after OCD surgery. 
- MF generally works pretty well for smaller OCDs.  Not as good on larger ones.  DeNovo has been used with pretty decent success on larger, more difficult OCDs.  Your MRI should allow your doc to see how big the defect is, and that will help inform the best procedure
- DeNovo sometimes is not covered by insurance, so check with your insurance provider, and also on how your doctor is likely to "code" the surgery (how they code it when they report it to your insurance provider can influence if the insurance provider will pay for the procedure)
- DeNovo implants pieces of hyaline cartilage, so from that perspective, there is a chance that the DeNovo produces cartilage that is more durable than MF.  But no procedure is guaranteed, and even after a "successful" DeNovo, you may not be able to return to things like football and running. 
- DeNovo has been around for only 5 or 6 years.  So that limits the amount of data available.  See the results in the following link for clinical outcomes on DeNovo.  http://www.zimmer.com/en-US/hcp/common/product/denovo-nt-natural-tissue.jspx?cate=biologics. 
- After DeNovo, be prepared for a 1-2 year recovery process.  e.g. my doc said not to try running until the 1 year point post-surgery.  Its a moot point for me, because I don't plan on running again.  I want my ankle to last for the rest of my live, and not wear it away in a few years pounding on the trails!

Best of luck with things
 

[wch94]

Thanks a lot Dave1234 for responding! I've done a lot of research with Denovo and i think that will probably be the best thing for me.. the big question now is who?....Anyway I actually just had my follow up appointment a couple hours ago for my MRI i received on both ankles yesterday. Unfortunately just like i suspected, the previous microfractures were unsuccessful. The defect in both ankles are about the same size, but my left ankle has always hurt more.. My new Doctor who i was seeing actually recommended the Denovo surgery with which he has and can perform. What we would do is get the surgery on my left first and then three months later get the right ankle done. I thought three months post op would not be enough time for my left ankle to start being crutched on but apparently he thinks it would be ok and that he has had a patient do that before, since they were in the same boat as me (OCD in both ankles). So yeah apparently my new Doctor has performed this surgery before and feels comfortable doing it. I got copies of the MRI's and will probably get a second opinion or try to find someone with more experience with Denovo, but it will be good to know my original Doctor can perform it. Shooting for first surgery somewhere in early December since i will be done with classes then. Will keep posting! Glad to hear from anyone! You are not alone!

[wch94]

Here are my MRI images i was given today.
http://s28.postimg.org/vm1m2nea5/photo_3.jpg - Right Ankle
http://s28.postimg.org/qw730axvx/photo_4.jpg - Right Ankle
http://s28.postimg.org/sp9zomj2l/photo_5.jpg - Left Ankle
http://s28.postimg.org/kl6gxmm19/photo_6.jpg - Left Ankle
http://s28.postimg.org/hgvt0u58t/photo_7.jpg - Right Ankle

[wch94]

Going to see Dr. Lew C Schon on November 25, coincidentally during thanksgiving break so this works for me since I am a college student and I live 8 hours from Baltimore where he is located. Taking my MRI's and going to probably have him decide what's up next for both my ankles. I have been recommended to see him by another orthopedic and I have read great things about him on hear and other sites. Will post after our appointment.

[tewchihuahua]

wch94 - I am sorry! I had my first microfracture surgery when I was 16, and I had to sit out my junior year of varsity volleyball, which was super depressing for me at the time. I did play the following year and was able to skateboard and play basketball for at least a few hours each week for the next few years. Fast forward 12 years, and I started feeling the pains again to the point of having to walk with a limp. I had Denovo done 10 months ago, and it took longer than I thought to heal, but it is starting to feel better. Now I have some lateral impingement issues, which the doctor thinks he can easily take care of through a scoped debridement of the ankle in a few weeks. I am hopeful though that I'll be back on the court in a few months. I feel for you. No athletic kid should have to sit on the sidelines watching everyone else. And to have dual OCDs, that is tough! Take it one day at a time. Best of luck.

[wch94]

Just got out of my apt with Dr Lew C Schon of MedStar Union Memorial in Baltimore Maryland. We waited three months and traveled 400 miles to see him and I've gotta say it was well worth the trip. After speaking with Dr Schon we have decided that I am a good candidate for the Denovo surgery and have already set up an apt to get it done. I'm getting it done on Dec 15th. Super soon. We will be getting two packs of the denovo cartilage for the operation. Surprisingly enough our insurance will probably cover the majority of the operation! Dr Schon seemed extremely optimistic about my surgery which was much better than what my previous md said.  I'm getting the left ankle done first and then if all goes well will then get my other ankle done as soon as 3-6 months after. So happy to be getting this done! Getting a ps4 for Black Friday so I'll have something to keep me busy while recovering over winter break. Haha. Will post again after my operation.

[mhop]

I love Dr. Schon.  good luck with your surgery.

[wch94]

Hello fellow OCD members and viewers! I had my surgery yesterday perform by Dr Lew C Schon yesterday here in Baltimore at MedStar Union Memorial. The operation was to be the Denovo procedure and the intention was to you use a second pack is needed. Well the surgery was a success and the dotors used get this... Three, count it... Three packs of the Denovo cartilage! I was really surprised but he said it was a big lesion so it was necessary. Currently recovering about to head back to Ohio tommorow. I'm in pain but I'm happy, excited, and have a lot of time before schools starts back up to heal up a bit. I gotta say that I came to the right place. The whole staff was super enthusiastic people and optimistic about Dr Schons surgical abilities. Had I got it done in Ohio by my other orthopedic , no offense to him but there's no way he would have used as much Denovo cartilage it some as good as a job. Well guys that's one down, one to go! I will probably come back to Baltimore in the Summer so I can get my other ankle done. Will post again probably in a couple moths just to update my status.

[NJKen]

Glad to hear things went well!  Hopefully recovery will go just as smooth as the procedure.

[ocdnetadmin]

Glad to hear this Dr Schon went the extra mile. I'll have to consider him next time I get surgery.

Keep us updated on the ankle progress and goodluck with recovery.

If it goes well I may consider denovo procedure as well. I'm still limping along with my microfracture from 7 years ago.

[Jj333]

Best wishes for a speedy recovery!!  Denovo seems
to be the best option if microfracture fails.  If
mine ends up not working out this is the procedure I will pursue.  I've had major issues with my non surgical ankle since the surgery on my right so I'm in the process of having it evaluated now, starting to wonder if I have the issue bilaterally similar to yourself.  Keep us updated on your progress, interested in how the recovery differs from microfracture (if it does).  I really hope this helps you get back to the sports you love!

[mhop]

glad to hear you were able to have the surgery, and you chose a great doctor to do it.  I was really impressed by Dr. Schon, and the MedStar Union Memorial staff of all levels were wonderful when I had my surgery 13 months ago.  My biggest struggle during the first few weeks was not going stir crazy.  Then, for the first several months I had to work to accept that recovery was slower than planned and that some pain was inevitable and did not equate to the surgery having failed.  Now, I'm doing GREAT and working on strengthening weak muscles to improve my form for when I do start running again (still several months out). 

I'm optimistic for you full recovery.  Sorry you have to do both ankles   but, I think it will be worth it in the long run.  And, you are young, so that should help with your healing time as well. Happy healing.

[wch94]

Thanks a lot to everybody who took the time to read and post to my forum! Recovery is going well and my pain level is starting to decrease, though it might just be the drugs. When I first met Dr Schon he was extremely optimistic about the operation whereas my orthopedic in Ohio was almost the opposite. I felt much more comfortable and at ease having it done in Baltimore by Dr Schon. Anybody with a serious OCD injury I would strongly consider having your ankle looked at by Dr Schon. It was well worth the travel, time, and extra cost to go out there to have him do it. Oh yes, and thank you all for the support! I will do my best to do the same towards others on here.

[Namelike]

Hey, how's your recovery coming along? Have you been able to start doing deep knee bends yet?

I just started last week and am improving a lot. My only complaint so far is probably once I day a feel a sharp pain around where my defect is. Have you been getting that too or is it for the most part pain-free?