Top doctors recommended?

[Tom]

Hi, all,

I am 26yrs old and recently diagnosed with a loose body and OCD in my ankle (I am an active soccer players for many years and sprained my ankle many times). The doctor suggested me to do arthroscopy to remove the loose body, and for OCD he will see during the surgery if a microfracture is needed (he said chances >50%).

So my questions are:

1. For OCD, it shows on MRI (9*7*4mm) but not on CT. MRI says there is no subchondral fracture or undercutting fluid signal, but mild cycstic changes are seen in the anterior talus. I wonder why the MRI and CT show different results? Is there OCD or not?

2. I am now almost pain-free (<1 out of 10) and able to cycle and walk as much as I want (very mild to non swelling after day). The problem is, because of the small discomfort in the ankle, I couldn't walk fully normally and in a imbalanced position (have to put 60% weights on another leg), and that makes my knee on the other leg feel discomfort and I am worried over time it will cause some problems in that knee. In this case, should I keep walking like this and avoid the surgery, cause I do hear a lot of risk with it, or I need to take it? My biggest concern is that my ankle will get worse after the surgery.

3. The doctor I met are from the top 26 foot and ankle surgeon list in US (https://ryortho.com/2013/10/the-top-26-foot-ankle-surgeons-in-north-america/), but he seems not very patient and the stuff are not very friendly. I met him twice, each time I talked to another young doc (his intern maybe?) for most of time, and talked to him less than 5 mins and he seemed not very happy answering my questions. I know he is surely very busy. But I don't know if I should do the surgery with him... Also do any of you have a list or know any good doctors on ankle OCD (particularly in CA)? I am now in mid-west but will work in Bay area after graduation next summer.

Thanks for any help! Though I am from Asia and don't have Christmas, still happy Christmas and happy new year to your all:)

Tom

[Namelike]

Hi Tom,

So sorry to hear what you’re going through. OCD is really life-changing and I wouldn’t wish it upon my worst enemy. At this point you are pretty much where I was almost exactly 5 years ago. I got my OCD at 24, my first surgery at 26, and am now 31.

Please let me tell you to proceed with extreme caution here. You seem to be much more informed than I was at 26 - I just thought microfracture would cure me 100% and I would be back to full activity no problem. I had a microfracture at 26, was back to 100% within 4 months.. played softball, basketball, you name it.. and then 2 months later the MF failed and I was worse than ever.

I have gotten 2 surgeries since then - bone marrow aspiration and then DeNovo, which I think finally did the trick but I have accepted I will never run again, and I am still dealing with tendinitis in multiple tendons which affects my gait and causes discomfort/pain in 75% of my steps.

 As I said, an OCD is life-changing and having chronic pain will completely affect your mood and psyche, so if you end up getting surgery make sure you do it right the first time. I would strongly advise against MF as I have heard too many stories of it not lasting, especially for young people who want to be active.

If you learn anything at all from me, it is be deliberate and thorough with your decision. Not sure who you saw but I hear Dr Ferkel in CA is great. However, if you can, see 3 or even 4 doctors if you need to - ones who specialize in DeNovo, biocartilage, and MACI - and even consider flying somewhere if you need to. Because once you commit to surgery you are setting yourself up for a potentially very long and difficult journey if it doesn’t work the first time.

Please feel free to read my whole story and let me know if you have any questions.

http://osteochondraldefect.net/forum/index.php?topic=190.0

Mike

[ocdnetadmin]

Hi Tom,

So sorry to hear what you’re going through. OCD is really life-changing and I wouldn’t wish it upon my worst enemy. At this point you are pretty much where I was almost exactly 5 years ago. I got my OCD at 24, my first surgery at 26, and am now 31.

Please let me tell you to proceed with extreme caution here. You seem to be much more informed than I was at 26 - I just thought microfracture would cure me 100% and I would be back to full activity no problem. I had a microfracture at 26, was back to 100% within 4 months.. played softball, basketball, you name it.. and then 2 months later the MF failed and I was worse than ever.

I have gotten 2 surgeries since then - bone marrow aspiration and then DeNovo, which I think finally did the trick but I have accepted I will never run again, and I am still dealing with tendinitis in multiple tendons which affects my gait and causes discomfort/pain in 75% of my steps.

 As I said, an OCD is life-changing and having chronic pain will completely affect your mood and psyche, so if you end up getting surgery make sure you do it right the first time. I would strongly advise against MF as I have heard too many stories of it not lasting, especially for young people who want to be active.

If you learn anything at all from me, it is be deliberate and thorough with your decision. Not sure who you saw but I hear Dr Ferkel in CA is great. However, if you can, see 3 or even 4 doctors if you need to - ones who specialize in DeNovo, biocartilage, and MACI - and even consider flying somewhere if you need to. Because once you commit to surgery you are setting yourself up for a potentially very long and difficult journey if it doesn’t work the first time.

Please feel free to read my whole story and let me know if you have any questions.

http://osteochondraldefect.net/forum/index.php?topic=190.0

Mike

I second everything Namelike said. especially the part about flying across the country for the right doctor. These surgeries are life-changing; make sure you go to the best doctor you can and do all the research you can before making a decision. These surgeries are not reversible, folks! Once they slice open your ankle and start poking around in there , the ability for you to walk again or never ever walk again is completely in their hands