Author Topic: 14 year old ankle OCD options  (Read 3370 times)

Offline darboy4boy

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14 year old ankle OCD options
« on: May 09, 2012, 12:10:30 PM »
Son diagnosed with OCD in right ankle 18 months ago.  Very active soccer/football player, 13 when diagnosed.  Tried non weight bearing for 6 weeks, followed by year off of everything but just walking.  (longest year of all our lives!).  Upon starting to try running again, he says the ankle feels exactly the same as when they found it.  MRI and CT scan show nothing has changed, time off has not "filled in" any of the dead area as hoped. 

He only feels pain if he is "pounding" down on foot.  IE:  sprinting, jumping rope, High knee movements.  No pain if walking, on eliptical, or easy jog on treadmill.  Our question is what option would you choose going forward?

Doctor A says operate now and "see what we find", Doctor B says go ahead and try one season of a sport to see if you can tolerate
the pain...but will probably need surgery in the future.  Poor kid just wants to get back in something, and starts high school in fall.
If we operate soon, he should be off crutches when school starts in fall which is a plus, but out of sports for another year.  If we give a season of sports a try, could he damage it more? 

Sorry for lengthy post but we are really struggling with this one!  Thank you
« Last Edit: September 08, 2012, 07:39:22 AM by ocdnetadmin »

Offline ocdnetadmin

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Re: 14 year old OCD options
« Reply #1 on: May 20, 2012, 03:01:20 AM »
As I was reading your post a warning bell went off in my head, because I see the same signs of a potential life-long mistake that I made:

You (or your son) sound rushed, and a bit impatient which is understandable. It is as if you're an athlete and you want to rush back in time for the championship playoffs. However, OCD is an injury that just doesn't work with short-term thinking. I would advise you and especially your son to take a breath, step back, and think long, long-term. Rule out any sports indefinitely. Again, rule out sports indefinitely. No fall sports. No winter sports. No spring sports. Nothing until the ankle is fully healed. Just concentrate on the ankle for now.

Now which doctor to listen to? My first Doctor preferred a conservative approach, which was to try rehab, try ankle brace, and generally try to avoid surgery for as long as possible. The reason is that the surgeries for OCD are non-trivial and will affect your ankle forever, for better or for worse. I agree with the conservative approach especially as your son is still young and doesn't seem to be competing for any gold medals soon.

I, being impatient, left that doctor and went to a new doctor who would perform MF surgery for me. He told me there is an 80% success rate for MF (but what does "success" mean? and how is that measured anyway?). After the surgery and recovery I realized: my ankle was better in some ways, but worse in others, and two: there was no reason to rush. Getting the surgery a year or several later probably wouldn't have made any difference. OCD injuries don't go anywhere and from what I've read they rarely ever heal on their own.

I could run, albeit with sore pain the day after, before MF. Now I can't run or jump without seriously upsetting my ankle. There is a decent possibility that the surgery was unnecessary and possibly detrimental.

Basically, I want you to understand that the current surgeries out there aren't very effective, IMO, for getting a person back to athlete level. MF produces inferior cartilage that has a high chance of breaking down again. I have heard of athletes competing for several years on MF before it breaks down and needing to get another. That is one avenue to consider.
Another avenue, OATS, can be highly invasive and has a long recovery. not to mention the trauma to the knee.
The third, most promising avenue, is the stem cell growth treatments, still in the pioneering stage and often not covered by insurance. If you have the patience, that is what I would advise for the long-term. Then again I don't care about competing in high school or college anymore so you'd have to consider your priorities.

Goodluck.