Concerned

[sazzakablazza]

Hi,

Brief background: I had arthroscopy with microfracture on 13 Apr, was discharged without a boot/plaster and told to walk as soon as possible, tried after a week with a lot of pain so ceased, had 2 week post op appointment and saw a different surgeon who said his patients non weight bear in a boot for the first two weeks so he then gave me a boot.

I am still on crutches 12 weeks post op and in quite a bit of pain. Still taking cocodamol 30s once or twice a day. I have brought my 14 week post op appointment forward to tomorrow but I was just wondering if anyone else was feeling like I am after 12 weeks?
 
Sarah

[SCSankle]

Hi Sarah.

I hope your post-op appointment went well yesterday. I am 8 months post-op and have learned that this recovery is way long and slow. Also that surgeons offer vastly different advice for post-op weight bearing. I was no weight for 8 weeks, then partial for 4. As I've been recovering, I've had good days and bad...and have gone back into the boot a couple of times when it hurt too much to walk. (In fact, I was just in it this weekend, and am still limping around like I was back in March, so not sure what's going on!)

So, certainly follow your doctor's instructions, but I'd let your pain level be your guide. If your ankle hurts, ease back on what you're doing a bit, ice it, elevate it, keep using the crutches if you need to. Don't push it, so your body has a chance to heal.

That being said, given that mine still hurts, maybe you don't want to be taking advice from me! (Ha.) Everybody heals differently, has a different pain threshold, had slightly different procedures, and various doctors -- but the one thing that seems to be common is that recovery is long and slow. Good luck!

[cshires]

5.5 months post-op and still in pain. Still limping and most definitely not back to normal.

Had an updated MRI about six weeks ago and the surgeons comments were "looks like a normal healthy recovery." Defects on MRI were not fully filled in but expected to continue healing over time.

[Namelike]

1.5 years post DeNovo, same story here. Joint itself feels great still have some residual tendon pain as well as weakness in my ankle/leg. Don't even try to evaluate how successful your surgery was until you're a year out - that's how long the recovery really takes.

[sazzakablazza]

So my review on Tuesday didn't go how I thought it was going to;

I didn't see the consultant himself, just one of the dressing nurses, she relayed information from him.  I explained how the pain seems to be getting worse rather than better and that I am still using the crutches etc.  So he reviewed my initial MRI again and apparently my initial injury was really nasty (this had never been alluded to up to this point) and that recovery time is likely to be 1 year plus.  Why didn't they pre-warn me about this so I would have been more prepared for the long recovery?!  I am so fed up and sick of relying on people as I can't drive yet.

I am in the Royal Air Force and live 200 miles from home in a barrack block.  Luckily my sister is posted here with me.  If she wasn't I would never be able to go home as the train costs £100 return and I shouldn't really be doing a 4 hour train journey (with 3 changes!) on crutches on my own.

They didn't even scan me on Tuesday. Apparently it is too soon??? How soon was everyone MRI'd/X-Ray'd after their op?

Sarah

[cshires]

Sarah,

I had an MRI at 16 weeks and I was surprised that it was offered (they did it at my appointment.) From everything I've read, early post-surgery MRI's aren't super informative because healing is in progress and incomplete. Sure enough...that was the result of my MRI. "Defects not yet fully filled in. Progression of normal healthy recovery."

I also have not seen my surgeon since the day of surgery. In my three post-op appointments, I've seen his PA.

[anneb455]

Sarah, being dependent is really hard with the recovery from this injury or defect. I was non weight bearing for 8 weeks and partial for 4 weeks, my surgery was the end of February. I have a lot of swelling and pain at the end of the day and i regularly ice and elevate. I think you are very early in the process, and it is a super hard time. My heart goes out to  you. I have not yet had an MRI, nor do I expect one. There is no one answer for how people progress- let pain and swelling be your guide.

[BLT]

Hi,

Brief background: I had arthroscopy with microfracture on 13 Apr, was discharged without a boot/plaster and told to walk as soon as possible, tried after a week with a lot of pain so ceased, had 2 week post op appointment and saw a different surgeon who said his patients non weight bear in a boot for the first two weeks so he then gave me a boot.

I am still on crutches 12 weeks post op and in quite a bit of pain. Still taking cocodamol 30s once or twice a day. I have brought my 14 week post op appointment forward to tomorrow but I was just wondering if anyone else was feeling like I am after 12 weeks?
 
Sarah

There seems to be a big elephant in the room here that hasn't been addressed...how is it OK be discharged with no boot or cast, and told to attempt to walk as soon as possible?

[cshires]

An elephant indeed. I did read one study (and referenced it in my recovery journal) that indicated that there was no long-term clinical difference between early and late weight-bearing. Even this study however had a period of at least (if I recall) four weeks of non-weightbearing.

[cshires]

Sarah, if you really think you're getting worse rather than better, you might seek out advice (and a new MRI) from a different surgeon. There are several reputable ones referenced on this board. I think most of us on this board would say that recovery is much longer than expected and very frustrating at times. The one common thread though seems to be that the trajectory is forward, not backward. Two steps forward, one step back...but overall a progression of better. The one difference you have from most here is the early weight-bearing. It's possible that despite that, you're recovering just fine (albeit slowly.) But since you did have the early (and really rather unheard of) experience of such early weight-bearing I think, in your situation, I might get a second opinion on what's going on in there. Just my POV. Good luck. You'll find good support here as you need it.

[sazzakablazza]

Thank you everyone for your comments.

Update:

Still no better. Pain meds not being very effective, keep trying different combinations to very little effect. And over the past few days I have started getting a sharp pain on the outside of my ankle (near the bone that sticks out - unsure of clinical term) with every step I take. Anyone experienced anything similar?

Thanks, Sarah

[ocdnetadmin]

Sarah sorry to hear you are still experiencing pain. Make sure to keep your doctor informed of your progress.

Please also post your (approximate) age as that would affect MF recovery.

Without knowing more about your situation, my speculation is that it could take you a while longer to recover.
In some cases if the OCD are very large , then MF may not even "succeed" (success defined as ankle being better after surgery). . I hope that's not the case for you but it is a real possibility.

The most important thing is PATIENCE. I know its' hard but you need to be patient, and find the strength to be patient, as well as positive.

Patience means giving your ankle the time it needs to heal without rushing it back and re-injuring it or making it worse.
Positive means taking pro-active steps towards recovery such as physical therapy, eating healthy, abstaining from alcohol + smoking, etc. (ok the last few are a little preachy but I'm sure they help a bit. When i got MF my surgeon told me he wouldn't even operate on me unless I quit smoking)

There's a balance between strengthening your ankle through walking and aggravating it. Take it really really slowly and really carefully. Don't be hesitant to switch back and forth between crutches and walking.

Finally, keep in contact with your doctor. Maybe even try another doctor, get a second or third opinion.

[SCSankle]

Sarah, I hope you're able to find a way forward soon. Whether that's getting a third opinion or just easing off use of your ankle even more to give it time to heal. You'll get better. Isn't it amazing how much we took our ankles for granted?!

And Alan, thank you so much for this excellent advice. I'm in a bit of a setback mode right now and really needed to hear what you said. It's so hard to stay positive during this recovery and your post was a good reminder that came at the right time for me. This forum in general has been a God send in keeping me sane these past 9 months. My doctor told me it would be 9 months to a year, but I really didn't believe him. (How could it possibly take that long?!)

If you're able to reply back and say what you consider a large OCD, I'm curious.

[sazzakablazza]

Alan, thank you for your advice. I'm 28 in September.

I have contacted my consultant's secretary with my concerns and she is going to pass them on and hopefully I will get a reply soon. I am undergoing physiotherapy through the RAF which is good; slow progress at the moment but my range of movement is increasing which is good! My calf is incredibly tight and is causing me some pain in one of the nerves that runs up my leg so I have been given a tablet to help with that as well as ultrasound from the physio and foam rolling in my own time. Fingers crossed things start to improve soon!

SCSankle, so you are 9 months post op?? How are you getting on?

Thanks guys x

[BLT]

I'd say give it another 2 or 3 months. It's still a little early from April 13.