Tendon debridement ...
 

[Closed] Tendon debridement - anyone experienced this frankly horrible looking surgery?

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Hello,

Bit of a medical problem which is pointing to surgery (tib-post tendon debridement plus breaking my heel off and resetting it) and wondering if anyone has experienced something similar, if it worked and how long rehab was?

[u] Brief Medical History[/u]
I'm 47, 5ft 10" and 11.5 stone
I developed significant ankle pain in december last year after a 2 hour ride, previously I've been doing 5 - 8k miles per year for about 10 years.
Initial diagnosis was achilles tendonitis, 3 months of physio didn't change things
Next diagnosis was tibialis posterior dysfunction, 3 more months of physio didn't fix things
Saw a consultant, diagnosis is stage 2 tib-post dysfunction, the tib-post tendon may have a tear and my heel is mis-aligned to the rest of my leg.
I have an MRI on saturday to check this theory out, then its probably time to get the knives out, expectation is fib-post tendon debridement combined with breaking and resetting the heel. (don't google this if you have a weak constitution)

Given I can't do any exercise at the moment despite huge amounts of physio (swimming, carrying small children, kicking a football, walking for an hour all aggravates it) I fear the consultant may have a point.

cheers
Matthew


 
Posted : 27/10/2016 2:15 pm
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Sounds painful

I also suffer with heel pain from the Achilles, when walking almost feels like its burning/getting hot. Probably no where near your problem though.


 
Posted : 27/10/2016 3:31 pm
 Duc
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Never been near this particular treatment but having suffered some long term miss diagnosed lower limb stuff for years I had surgery to correct it about 8 years ago.

Frankly I wouldn't make that decision again without making sure I have exhausted every option. The fairly invasive surgery I had to correct my compartment syndrome has never really fixed the problem just made it better. Whilst most surgeons do a fine job they specialise in a surgical solution so they'll rarely recommend a non surgical solution. Have you seen a decent podiatrist as they tend to be less knife happy.

Since having mine done I've learnt how to manage the problem in the other leg just fine since.


 
Posted : 27/10/2016 7:10 pm
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Whilst most surgeons do a fine job they specialise in a surgical solution so they'll rarely recommend a non surgical solution. Have you seen a decent podiatrist as they tend to be less knife happy.

Since having mine done I've learnt how to manage the problem in the other leg just fine since.

My thoughts exactly! Surgeons are incredibly skilled and it never ceases to amaze me how they manage to do what they do but I'm always in favour of absolutely exhausting every conservative (ie non-surgical) option first 🙂


 
Posted : 27/10/2016 8:34 pm
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A podiatrist is a good shout actually! Feet and ankles are all that they look at all day so they should know what they are doing lol. Try and get one who's been at it for 10+ years if you can 😉 I definitely wouldn't go for the surgery without trying that first!


 
Posted : 27/10/2016 8:38 pm
 ton
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wish i could have found a alternative to surgery for my ankle. been wishing i had not had it done over the last few days.
open heart surgery took less getting over.

have a good proper look round to see if there are any alternative treatments, before going down the surgery route.


 
Posted : 27/10/2016 8:43 pm
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As they say. I'd want a second opinion from another consultant before going in for that sort of surgery. Its no problem to ask for one. also ask the consultant how many he has done and what the success rate is like.


 
Posted : 27/10/2016 9:39 pm
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I've had the very same surgery! Debridement and calcaneal osteotomy (or something like that). Have psoriatic arthritis and ankle was a bit poorly - saw a surgeon who was perhaps a wee bit scalpel happy. I think I maybe could have looked a bit more at non-surgical options, but the surgeon said given the condition of the tendon in MRI, surgery was probably the best bet. Maybe he would just say that.

My ankle was a bit crap for a good long time after the op, but think that was mostly the arthritis rather than the surgery. I had plenty of other bits almost as sore. Now I'm on drugs that control he arthritis well my ankle's been pretty good. Managed a good walk over liathach last week without pain, so I'm pretty happy about things just now. So, for me it worked. It's hard to say how it would have been if I hadn't had the underlying arthritis, but the recovery did take a while. Pain after the op wasn't too bad. Bloody big scar on inside of ankle and wee one on outside. Still got bits of metal in there. Getting 30-40 staples out of the wound was an interesting half hour!

Another positive is I can use the scar as an excuse not to go running when people try to convince me that would be a good idea.


 
Posted : 27/10/2016 9:56 pm
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thanks all, some good and highly valid points.
I've been seeing a well recommended podiatrist since March who is also a triathlete (but no-one is perfect), I was pushing him for a plan B which involved him sucking air through his teeth, scratching his head and coming back to either surgery or living with the pain and inconvenience. Having experimented with various orthosis I'm not convinced that is the answer either.
I'm scheduled to see the surgeon mid Nov and will push for a second opinion before pressing the button. I had some shoulder reconstruction a few years ago which was unfeasibly painful, I'm imagining this would be worse and extremely inconvenient.

getting old is pants!

thanks
Matthew


 
Posted : 27/10/2016 9:59 pm
 Duc
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Given (from your User name) you're somehwere near Northampton have you been into the Podiatry clinic in Northampton - its attached to what is widely regarded as the best Podiatry school in the country and its got to be worth a shout. I'm deeply sceptical of orthotics that do anything correctional - it was actually said to have partially caused my problems by making the muscles in the back of my legs shorten.

My Mrs is a SPorts massage therapist and studying to be a podiatrist at Northampton at the moment (in the spirit of full disclsure) so our household firmly leans to non surgical solutions where ever possible given my experience and hers with some fairly invasive back treatments some time ago


 
Posted : 28/10/2016 5:12 pm
 Duc
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Mrs Duc posting now: Hi Yardley_Hastings, has your podiatrist tried orthoses? Im not talking about a £300 pair but just a simple pair that have a heel wedge or arch support in? Amongst other jobs Tib Post is an arch supporter and helps the foot prepare for propulsion, if it is failing the various joints within the foot try to compensate for the lack of movement. This can affect the heelbone and it can invert/evert in relation the leg or even in relation to the forefoot. All of these compensatory measures need to be taken in to account. You say your heel bone is misaligned to your leg, is this weight bearing or non weight bearing? Or both?
Also, depending on the level of dysfunction of tib pos (it will be interesting to see the findings of your MRI) a combination of conservative measures could work. Do you have a fallen arch? Quite flat feet?
You sound like a great case study and I am sure the Northampton School of Podiatry would be happy to treat you! It wont cost you an arm and a leg to visit and if you book into the sports clinic you can take advantage of the very skilled senior clinical tutoring team.


 
Posted : 28/10/2016 5:34 pm
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I've suffered from ankle pain for years and know body could get down to the coarse of it, physio said it was a detached ligament by my heal,then it was tendinitis then after a mri the surgeon said it was chipped cartilage???, he said an op would be 50% successful to get rid of the pain if that was the culprit ..plus 2 months off work. Sod that..found a cure for my pain and stiffness in my ankle by taking rhustox once a week, I've not touched a pain killers in months . It may be worth checking it out to reduce the symptoms, sounds like anything is worth a go to get you back riding again.


 
Posted : 28/10/2016 6:26 pm
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Hello Mr & Mrs Druc,

I do indeed live in Northants, up in Kettering these days.

I had 8 weeks with a loaned pair of really stiff orthosis (Interpod Control Flex) which whilst they didn't make it any worse didn't make it any better. I've also tried a pair of Superfeet inserts which feel like they are the wrong shape for my feet and make everything ache. I've also used a pair of arch supports for cycling for the past couple of years after a stress fracture in my foot

in terms of arches - quite fallen on the rhs and not great on the lhs, pain getting worse on the lhs

I've been seeing John Chapman (podiatrist) at the County Clinic since March and Julian Northover (Consultant Orthopaedic Surgeon) at NGH. I'll have a look at the podiatry clinic, keen to avoid surgery.

thanks again
Matthew


 
Posted : 29/10/2016 4:49 pm