La Plata woman re­gains ac­tive life with new an­kle

Re­place­ment surgery ended more than 20 years of pain

Maryland Independent - - Business - By DAR­WIN WEIGEL dweigel@somd­ Twit­ter: @somd_bized­i­tor

Karen Navarro spent more than 20 years putting up with ever-in­creas­ing pain in her right an­kle, even­tu­ally giv­ing up play­ing soft­ball four years ago at the age of 50, some­thing she had done all her life. The dis­com­fort was un­bear­able.

“I just couldn’t take the pain any­more. It just hurt too much,” she said about giv­ing up soft­ball.

“I prob­a­bly hurt it years ago run­ning around the bases,” Navarro added. “I slipped on a wet base, and that’s what started it.”

The La Plata woman said on­go­ing pain started keep­ing her from other, lower im­pact out­door ac­tiv­i­ties that she en­joyed, such as wan­der­ing around car shows and fes­ti­vals, go­ing for walks and work­ing in the yard.

“I’d have to walk for 10 or 15 min­utes and then look for a place to sit,” Navarro said. “I al­ways had an an­kle brace on. I had to make sure I was wear­ing the right shoe [be­cause of the swelling].”

A lit­tle over a year ago, she went to see her doc­tor about in­creas­ing knee pain in her left leg and was told that the pain had come about from the way she walked when fa­vor­ing the painful an­kle.

“I walked so bizarre for 20 years that my knee started hurt­ing on my op­po­site leg,” she said. “I thought, ‘Here we go, I’m fall­ing apart and I’m not even 50.’”

Her doc­tor re­ferred her to foot and an­kle spe­cial­ist Dr. Steven Neufeld in Falls Church, Va., who sug­gested she have an­kle re­place­ment surgery. She had re­signed her­self to hav­ing the an­kle fused to im­mo­bi­lize it, so was sur­prised and ex­cited to find out she might be able to re­gain full use. She signed on right away and sched­uled the surgery for last Oc­to­ber.

A year later, she’s walk­ing around — and rid­ing a bike — pain free, and is look­ing for­ward to re­tire­ment at the end of the year.

“I used to know when it was go­ing to rain, and I don’t feel that any­more,” she said. “I can walk; I can’t play soft­ball any­more — I can’t run on it — but that’s OK, I don’t have the daily pain. I can go for walks and work in the yard and do what­ever I want. It’s just the best thing that’s ever hap­pened to me.”

Neufeld, the founder of the Or­thopaedic Foot & An­kle Cen­ter at the Cen­ters for Ad­vanced Or­thopaedics, said in a phone in­ter­view that an­kle re­place­ments are much like hip and knee re­place­ments but it took sev­eral gen­er­a­tions of de­sign and en­gi­neer­ing to get to some­thing re­li­able that could take the high load bear­ing of an an­kle — seven to 10 times the body weight di­rectly un­der the tibia. He said the first re­place­ments were done in the late 1970s and into the 1980s, but they tended to fail too soon. Later ver­sions im­proved steadily.

“The cur­rent gen­er­a­tion has been out for the last 10 years,” he said. “They’re work­ing much, much bet­ter. We think these are go­ing to last a long, long time.”

The type that Navarro re­ceived has thick titanium plates and an ul­tra-high-molec­u­lar-weight poly­eth­yl­ene in­sert as the bear­ing sur­face. The bone in the foot is shaved down for the lower plate and a notch is cut into the tibia for the up­per plate. Bone grows back in around the plates and an­chors to lock it in per­ma­nently, though there is a two- to three-week period where no weight can be put on it. Af­ter that, weight is in­creas­ingly ap­plied over days un­til the full weight can be put on with­out pain. Sev­eral weeks of phys­i­cal ther­apy help re­build mus­cles and get the pa­tient walk­ing prop­erly again.

“It’s re­ally life-changing,” Neufeld said. “The peo­ple who come and see me are de­bil­i­tated. They’ve put on weight, they’re de­pressed and they’re get­ting out of shape.

“There’s no rea­son to live with foot and an­kle pain,” he added.

Neufeld said the surgery gen­er­ally takes an hour and a half but “it’s very com­pli­cated and dif­fi­cult surgery. It’s got a steep learn­ing curve.” Or­thopaedic sur­geons spe­cial­iz­ing in such work spend an ex­tra year of train­ing in a foot and an­kle surgery fel­low­ship.

He said the con­tin­u­ing suc­cess of the re­cent gen­er­a­tion of im­plants has got­ten more doc­tors in­ter­ested and has con­trib­uted to a grow­ing num­ber of peo­ple walk­ing around on ar­ti­fi­cial an­kles.

“In 2016 we’re much more so­phis­ti­cated and bet­ter at treat­ing an­kle prob­lems,” Neufeld said.

Navarro, a long time IT spe­cial­ist at the Naval Re­search Lab, is look­ing for­ward to an ac­tive re­tire­ment at the end of the year now that she’s back on her feet, and she wants ev­ery­one who suf­fers with an­kle pain to know there is a so­lu­tion.

“It’s a scary thing get­ting a body part re­placed,” she said. “But your qual­ity of life goes up. It’s work — you have to do the ther­apy, you have to go through all the doc­tor vis­its — but in the end, it’s well worth it. I’m healthy now, and I’m ready to re­tire.”


Karen Navarro of La Plata had her right an­kle re­placed a year ago af­ter more than 20 years of pain and is back on her feet.


This is what Karen Navarro’s new an­kle looked like in an X-ray a week af­ter surgery.

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