“Once more unto the breach, dear friends, once more” – seven months after the ankle replacement I was back at the Linksfield Clinic in theatre. I knew it was coming, and that dear reader, was a two-edged sword. On the one hand I was not looking forward to all the many inconveniences a life on crutches can bring. On the other hand I was prepared mentally and emotionally for the slow and uncomfortable ride.
As mentioned before (here) I would have to have additional surgery. Not all candidates who undergo a total ankle replacement will need further remedial work, but I was not so lucky. Thanks to the damage sustained in the initial accident and subsequent years of wear and tear I needed a subtalar fusion. The subtalar joint is located just below the ankle joint between the talus bone and the calcaneus – heel bone. The main job of the subtalar joint is to allow for side-to-side movement of the foot and ankle. This movement aids walking, especially on uneven surfaces.
This procedure causes two bones that normally move against each other through a joint to heal together. In my case the fusion was appropriate to aid the deformed joints to support the replacement. Once the area heals together, it acts as one unit and can restore function to provide significant pain relief. Generally speaking the fusion is also very durable.
To be sure after surgery pain medication was required. It was the same drill as before – in the first few weeks after surgery I had to rest and elevate the operative leg to control swelling and allow the skin incisions to heal. When sitting upright there was throbbing and discoloration in the toes as the blood rushes back to the foot, but typically this resolved itself with elevation. The surgeon, my physiotherapist daughter and indeed the pain itself reminded me it was important to keep weight off the foot.
I was then put in a cast – for the second time, after the initial surgical bandages were removed. What followed was the same long and drawn out healing process as before. One thing I did have in my favour this time were the happy memories of my daughter’s wedding. Yup I did moonboot it down the aisle with the most beautiful bride this side of her mother.