Surgery May 25

Great site. Thankful for those that created it - helps to understand what to expect. 53 yr old male, having surgery to repair rupture on 5/25. All sorts of questions. When will I ride a bike and play golf again? When can I go back to the office? More to come.I hope as time passes, my posts of experiences will help others as yours have already assisted me. Thanks.

5 Responses to “Surgery May 25”

  1. If your docs didn’t give you a full and up-to-date report on the latest scientific studies that have shown NO advantage to the surgery (compared to immobilization in a boot, followed by the same kind of fairly quick rehab protocol that works post-op), you should check out my blog, and click on “A more complete review of the options — surgical vs. non-operative”.

    If you’re open to challenging your health professionals with the latest scientific studies (4 of them, published between 2007 and not-quite-yet) and taking some responsibility for your own protocol, you’ve got a few days to do some work!

    I’m on my second ATR. Surgery on the first (8 yrs ago), everybody said there was no choice if I wanted a good strong result with a low risk of re-rupture. I still believed that old myth when I tore the other one in December, and I went to the fanciest sports-medicine surgeon in Toronto, so he could stitch my AT back together. He told me he had stopped doing the surgery 4 months earlier, after hearing a team from Univ. W. Ontario present the results from their just-completed study. And he’d spoken to them and gotten a copy of their exact protocol, and recommended that I follow it, starting with a fixed boot for two weeks of NWB on crutches, then transitioning to WB and physio, etc.

    That’s what I did, and I’ve “enjoyed” this cure a lot more than the first one, so far. (Just past 5 months now, and back to all my normal activities EXCEPT volleyball, and my ankle-AT-calf are not holding me back, though I still go out of my way to “work” them when I’m bicycling and climbing stairs and sometimes doing heel lifts etc.

    There are at least two bloggers here (mike753 and gunner) who have also avoided the surgery after learning about the studies and discussing the options with their surgeons. I think Mike’s surgeon phoned mine, to check some details. I’ve also posted the exact protocol my surgeon gave me, so anybody can use it.

    So far, all three of us are pleased with our choices and our progress — touch wood, since there are no guarantees in any of this! And we’re all happier and saner because we have a protocol — a clear “road map” of where we’re going, instead of wondering what our God-like Surgeon will decide to do with us when we get to see him for a few minutes in a week or two!

    So whether or not you decide to keep the appointment and get the operation, ask your Doc if he’s got a written copy of your rehab protocol to give you. And while you’re at it, ask if that protocol has been tested and found to produce excellent results in a careful study.

    Good luck and good healing, whatever you decide!

  2. Great reading your comments normofthenorth. I was very fortunate that I was given the nonsurgical option as I am in my 60s. Had to be in a cast for 6 weeks though and the my surgeon is too busy to spend more than a minute with me. As I live in Toronto it would be great to know who your surgeon is.

  3. Ifixteeth, I went first to the Sports Med. Clinic at U. of Toronto, then got referred to Dr. Rick Zarnett at Sports Med. Specialists, 150 Egl. E. He’s also the Chief Surgeon of the Toronto Argos (our local pro football team, for the rest of you).

    I was almost in my 60s when I had surgery on my first ATR, and it went well and has worked just fine ever since. I was 64 when I tore the other one, last December. But I’ve been playing volleyball with a bunch of 30-somethings for years now, and holding my own quite well!

    Having a modern non-surgical “cure” is a blessing, IMHO. Having an inaccessible surgeon definitely is NOT. Casting is not a benefit either, as boots have a number of advantages, clinically and personally. If you’re eventually going to be fitted with a boot (as you should), then every cast you skips saves the system time and money, as well as improving your life and your expected outcome.

    I’m assuming you’re NWB on crutches for the whole 6 weeks, and that’s a nuisance (and a high falling-down risk) personally, and is also apparently associated with WORSE outcomes than earlier WB, according to the studies I’ve seen (though I haven’t focused much on that issue). Everybody who posts here, once they’ve gotten to FWB and ditched the crutches, comments on how much better their lives have become, being able to carry things around, help around the house, etc., etc. Delaying that breakthrough in return for proven better outcomes would be a tough choice, but since the studies show the outcomes of long NWB are identical or even WORSE, it should be a total no-brainer for anybody who’s paying attention.

    Unfortunately, many surgeons are too busy and overworked — and maybe also too impressed with their own unfounded opinions or those of their colleagues! — to pay attention to the best recent randomized studies published in the peer-reviewed literature. That’s where patient empowerment has to come in, I think.

    I started PT at 2 weeks “post-non-op”. Hard to know whether it helped a lot, but getting to wiggle my foot around out of the boot at PT and at home sure felt like a benefit. Staying at the same toe-down angle for 6 wks (as you’re doing) is consistent with the modern protocol I followed (and posted on my blog), but staying NWB and completely immobile definitely is not.

    Good luck!

  4. Thank you.
    Was in a cast for 6 weeks. For the past 4 weeks I have been using the LDK airwalker. I have progressed from two crutches to one crutch and now to a walking stick. I often walk on flat surfaces unsupported now.
    I haven’t started physio yet as all of the ones I have spoken to are unfamiliar with the non surgical regimen and I am afraid of rerupturing. Would appreciate knowing who your physiotherapist is.
    I have been doing some gardening with the boot but I haven’t been to the gym since the rupture. I may try the stationary bike today.
    I am 63 but not quite as active as you.
    Appreciate all your posts.

  5. My physio was Chris at Sports Med. Specialists, 150 Egl. E. I don’t recall his last name offhand (an Italian name), but he’s the only Chris there, AFAIK. I think I was his first patient following this protocol, but he seemed to stay busy with me and “do no harm” (my MAIN criterion for a good PT!).

    After 10 weeks, I’d expect your leg to be roughly comparable to where a post-op surgical patient would be. Of course, some ortho surgeons don’t like PT for those patients, either. There’s a huge variation in approach, and very little of it is based on any good evidence. It’s all “TLAR” and “Goldilocks” and the assumption that safe/conservative means slow. . . And (of course) following last year’s practice!

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