Dr. Mark Herr
Contact: Paul Meznarich
715-838-5805
EAU CLAIRE, Wis. – Rice Lake resident Linda Wiese doesn’t take walking for granted. A real estate broker, avid shopper and ATV fanatic, Wiese’s work and recreation keep her on the go.
But for two agonizing years, every step sent piercing pain shooting through her right ankle because of arthritis.
“It made you want to pick your foot up and never put it down again,” she said. “I went through a lot of pain pills.”
Doctors recommended fusing the bones that connected her leg to her foot, but at 65 years old, Wiese couldn’t reconcile spending the rest of her life with limited mobility.
Had it not been for developments in technology or the persistence of a group of orthopedic surgeons, she may not have had a choice. But now approaching the one-year anniversary of her ankle replacement surgery, Wiese is among a growing number of people benefiting from a procedure once shied by professionals.
Ankle replacement, the primary alternative to fusion, has been around for 30 years but wasn’t necessarily embraced by the medical community. An early study out of Mayo Clinic reported that the high failure rates of ankle replacements made them a worse alternative to ankle fusion.
“It really reduced the interest of patients pursuing the procedure or surgeons performing them in those early years,” said Luther Midelfort orthopedic surgeon Dr. Mark Herr, who trained at Mayo Clinic.
But two recently published studies are showing that advances in joint replacement materials and designed, coupled with improved surgical techniques, are paying big dividends for ankle replacement patients. Good news for what the American Orthopaedic Foot and Ankle Society estimates to be the 50,000 new cases of ankle arthritis reported each year in the United States.
One paper presented at the society’s summer convention reported that 58 percent of total ankle replacement patients achieved a minimum 40-point increase on the Buechel-Pappas mobility scale from their pre-operative scores, as compared to 15 percent of fusion patients. “Prospective Controlled Trial of Scandinavian Total Ankle Replacement versus Ankle Fusion: Initial Results” earned the convention’s notable Roger A. Mann Award for “outstanding clinical papers.”
Ankle replacement research from two Mayo Clinic orthopedic surgeons, Drs. Richard Claridge and Bernard Sagherian, found similar results, as reported in September’s “Foot and Ankle International” medical journal.
Five years after their ankle replacement surgeries, subjects in Claridge and Sagherian’s study had an average Ankle-Hindfoot mobility rating of 76 (out of 100) compared to their pre-operative average of 34. Eighty-three percent of them also reported the ability to increase walking distance and physical activity following their surgeries.
“That’s the great thing about this procedure,” Herr said. “It can literally give a person their life back.”
Despite the high rates of mobility, ankle replacement does come with higher rates of complications, making proper patient selection critical — a reality that Herr doesn’t hide.
“Dr. Herr didn’t sugarcoat anything,” Wiese said. “He told me exactly what the surgery would do and what it wouldn’t do. He didn’t beat around the bush.”
Wiese’s pain relief following surgery last November was instant; however, she had to stay off her feet for six weeks and then be on crutches for another six weeks.
“I’m a person who has to be on the go,” she said. “So it was hard to be limited for that length of time.”
Wiese underwent physical therapy at Luther Midelfort Northland in Rice Lake, and by her first step, she could tell the surgery was a success.
“As soon as they let me start walking on it, it felt normal,” she said.
Now that Wiese is back walking around, she says she enjoys going on walks, hitting the sales at the malls and riding her ATV. She and her husband rode more than 1,500 miles this summer on the trails throughout northern Wisconsin.
And that motor hum was music to Herr’s ears.
“I’m always a little anxious at a patient’s one-year follow-up,” he said. “But when Linda told me she and her husband had ridden more than 1,000 miles, I knew she was going to be just fine.”
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In partnership with Mayo Clinic, Luther Midelfort offers a full range of quality medical services, including cardiac and orthopedic surgery, cancer and trauma care programs. Through a network of community-based healthcare providers in west-central Wisconsin, Luther Midelfort provides access to experts close to home.
In my opinion, total ankle replacement is a viable surgical solution for pain reduction in the joint. It is a bone-conserving, less-invasive approach than in the past. If your doctor has recommended ankle replacement for you, based on your unique and specific condition then you should go on with this. A total ankle replacement results in increased mobility and pain reduction.