A new ankle – 40 years later!
Grandmother takes part in improved surgical procedure
Forty years ago, Kay Cuellar was involved in a car accident that would not only cause sharp pain later, but also lead to a total ankle replacement.
Cuellar, a grandmother of six and an employee of the U.S. Postal Service, spends about eight hours on her feet each day. Throughout the years following her accident which seriously injured her right leg, Cuellar put much of her weight on her left foot. After many years the added pressure on her left ankle became too much to bear.
She began to slow down at work, sit out during
playtime with her grandchildren and abandoned hobbies she enjoyed such as gardening, she said.
Eventually, the pain became so intense that Cuellar had to physically pick up her leg with her arm by the end of the day. By 2017, she went to Alan Kravitz of Yuma Foot and Ankle Surgeons following various doctor visits and referrals.
Kravitz discovered she had arthritis and suggested she get an ankle replacement.
“The procedure she had done was a total ankle replacement for severe anklejoint arthritis,” Kravitz said. “We performed her procedure at Yuma Regional Medical Center and the surgery lasted approximately two hours. She had extensive arthritis diagnosed on X-ray and using a CT scan. Her surgical procedure involved removing the arthritis, removing the destroyed cartilage in her joints and replacing it with an artificial joint.”
The artificial joint, he says, is primarily made of titanium as well as other materials.
Kravitz has been practicing in Yuma for 21 years and has performed about a dozen ankle replacement procedures.
“The procedure has been around for over 40 years but there have been significant technical advancements in the last 15 years that have increased the frequency of which the ankle joint is being replaced,” he said. “We are now on to the third generation of implants and we have learned to use thinner implants that require less removal or recession of healthy bone on both sides of the ankle joint. The instruments that we use have made the procedure much more reproducible and predictable.
“In this patient’s case we used a special CT scan to help create custom instruments that were used only for her ankle replacement,” Kravitz added.
According to Kraviz, as cartilage wears away, it develops into bone-on-bone, which can be very painful and is a common condition.
“Classically, a joint fusion would have been the previous gold standard for treating severe ankle arthritis,” Kravits said. “But, by doing a replacement, we are able to allow her to preserve motion in the ankle joint so it reduces her pain, improves her quality of life and reduces her symptoms of stiffness that many people have trouble tolerating.”
The ankle joint replacement is typically ideal for patients 50 and older who are not severely obese and who do not have any uncontrolled medical conditions, Kravitz noted. He said that it is typically performed for patients with severe rheumatoid arthritis, osteoarthritis, or as was Cuellar’s case, post traumatic arthritis which often results due to injury.
Cuellar’s procedure took place in May of last year. Following the replacement, she said she spent about three months in recovery. Now she has resumed her position with the U.S. Postal Service and spends her free time at parks with her grandchildren.
“I just wanted the pain to go away, which it did,” Cuellar said. “I have no pain. Once in a while I have muscles cramps in both legs but other than that, nothing.”
Worldwide, Kravitz said over 25,000 ankle replacements are being completed each year. He noted that foot and ankle problems should not be ignored because they can intrude on one’s quality of life.
“I like the saying, ‘The foot or ankle is easy to ignore until it begins to bother you and then it affects every aspect of your life’” Kravitz said.
He added that while the replacement lasts for many years, a follow-up will be needed in the future.
“I like to tell my patients that all machines wear out over time and ankle joint replacements will likely need to be replaced in about 10 to 15 years,” he said.