tord’s AchillesBlog

Met with the podiatrist/surgeon today, in order to assess what could be done with ankle. He rapidly concluded that the primary problem was the loose fragment that was knocked off my talus bone. However, he said both the position and the size of the fragmented indicated that it could be surgically removed without the need for drilling or rebuilding cartilage.

This is good news in the sense that it means a smaller operation and much shorter rehab. He indicated one week compression (no cast!) and NWB  and then gradual return to WB with only light ankle support of a rehband, achimed, or similar generic soft ankle support brace.

But it also left me wondering: If you don’t fill the crater that is left in my talus bone, and there is damage to the cartilage in the ankle, doesn’t that means my ankle will never really heal? Unfortunately, that is the case. He said that transplanting cartilage to a chip fracture that is smaller then 2 square cm has proven to yield little benefit in the long run, and that in the short run you are in for 3 months to FWB. With drilling of the crater without transplanting cartilage, I would still be 8-10 weeks to FWB, and the benefits in the long run would be minor.

With this minimally invasive surgery, I would be off the crutches in 3-4 weeks. Which sounds much better.

But, apparently, I will need to find a new hobby. Taking up running doesn’t seem to be an option. Mainly because he doubted the MRI in the sense that the cartilage on my shinbone, which appears to be in excellent condition on the MRI, must be expected to be damaged. He wouldn’t know for sure until he opened my ankle up for the surgery, but he said in almost all cases he had operated, he found tha cartilage to be much more damaged than the MRI’s indicated. And with damaged cartilage, he gave me 10 years to destroyed ankle if I took up runing again, while cycling or XC skiing would be something I could do forever without any problems. With healthy cartilage, however, I should be able to run for at least 50 years before experiencing problems. He gave me a 10% chance. Not great.

My second problem, my peroneus brevis tendon, he claimed was an old injury. He could not understand how that could be related to the ATR, except that an already damaged and weak peroneus brevis tendon would be vulnerable to some overstretching during impact, and then to tendonitis during ATR rehab. We chose to let it be for now, and focus on the fragment in my ankle joint. In any case, I will not engage in any explosive sports with sharp side-to-side movements, like football, so I would not be in a position to challenge the weak tendon too much.

I will take the message back to my PT, and discuss further. Hopefully, I’m in at surgery before Easter.

But I will have to adjust to the idea of finding a new hobby. Not cool.

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