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Question
Posted by: Trish | 2009-04-06

Arthrodesis vs Replacement?

Hi Doc,
I am female and in my mid 30' s. I' ve had 3 talar fractures in the past 5 years and one oseochondral fracture which was repared with cartilage grafts 4 years ago. I' ve now fractured my talus and malleolus 4 weeks ago. I' ve a new Orthopaedic Surgeon and he specialises in ankles. He' s advised me that there is nothing more he can do but do a arthodesis as I don' t fit the profile for a joint replacement. (He did give me a cortizone injection into the joint but apparently you can only receicve this twice) Is this the case and what would be the factors to consider between an arthrodesis and a joint replacement? I read up on the prognosis on an arthrodesis and seeing as I won' t ever be able to walk normally after that, it is a big decision.

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Our expert says:
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Dear Trish
Why do you get fractures so often? It does not seem normal for your age? One can't keep on giving cortisone in joints as it weakens the ligaments. Arthrodesis causes stiffness of the joint and if you are not sure about this, ask him if he will mind if you get a second opinion from another specialist too or ask him why he feels you are not suitable for a joint replacement? I know that ankle joint replacements are not as well developed as hip and knee joint replacements and seldom done. Prostetic joints do not keep for ever and therefor it is more acceptable to do joint replacements in older people. The stress you need to put on the ankle may also make you unsuitable for a replacement.
Dr Bets

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Our users say:
Posted by: Trish | 2009-04-20

Hi Dr. Bets,

Thanks for the reply, just a follow up, in order to get a second opinion I need to see an Orthopaedic Surgeon who also specialised in ankles. I can' t find a list of that anywhere and my GP also doesn' t know, she referred me back to my current doctor. Is there anywhere that I can get to know who does such subspecialisation?

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