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Foot & Ankle Problems Message Board

Foot & Ankle Problems Board Index

My daughter started having ankle pain in 5th grade. She was a talented dancer, primarily ballet. As she moved onto Pointe ballet her pain worsened. All the this time we saw our pediatrician and orthopedic surgeon. She proceeded to do very well in Pointe ballet and other genres of dance with acceptances into professional ballet companies in summer intensive programs. She had a very high pain tolerance and was consistently told by ballet instructors that pain was part of dance. Both physicians ended up diagnosing her pain as osteoarthritis. Several xrays were taken, rest of the ankles advised, and arthritis pain medication--topical gel. We adhered to all recommendations and treatments. The pain only worsened each year as she advanced through dance training. She started to have knee problems...then I sought second and third opinions--she was 13 years old at this time. It was startling what the xrays and previous doctors missed. Both second and third opinions said in no way was this ever arthritis. She had bilateral OCD with stage 5 cysts with necrotic bone chips and damage to her cartilage (bone covering). Lesson learned--if there is consistent pain in your ankle joint--insist on CT scans and not rely on xrays alone. And beware of dance companies who don't know enough about anatomy and pain in dance.

We sought out the best surgeon we could find for this condition in the US. Southern California had three of the top surgeons for her case. We selected one in LA. He had never seen anything like this before--the uniqueness was it was bilateral and advanced in a young girl. Usually this condition is found in adults with a rigorous athletic resume over decades of time. Nonetheless he recommended (with a panel of surgeons from in and outside US) open surgery with an autograft from her own leg bone (soft callous to replace the large cyst in her talus bone), bone chip debrivement, cartilage transplant (live, cadaver cartilage) along with a stem cell treatment using her own bone marrow in 4/2013. He wanted to select a solution that could last her a very, long time--possibly her lifetime. She was in a wheelchair for 2 months, non weight bearing crutches for 2 weeks, then a walking boot for 2 weeks, then 30 PT appointments while attending high school (She got PE credit for her physical therapy sessions!). Her left ankle took about 9 months to fully function properly and 18 months to fully recover (no pain present). She will not be able to ever competitively/professionally dance or run again but we are blessed with the outcome of her left ankle. She can walk, she can go to spin class, exercise on the eliptical, go to Disneyland without a wheelchair, and go on college tours. She could not do this in 2012/2013.

Her right ankle has the same condition but with more subchondral damage along with a huge cyst. She is set for surgery next week. During the pre-op appointment where new CT scans and MRIs were taken another startling surprise occurred--the huge cyst was gone--even though she had been relying primarily on that ankle all through her left ankle recovery. We are amazed at what prayers and positive thinking can do! The doctor is now going to do a much less evasive procedure-arthroscopic procedure vs open surgery (which was quite painful and immobilizing). He will be removing the necrotic bone chip, possibly replacing the cartilage and possibly micro-drilling the crater. The recovery will be so much easier and shorter. She is almost 17 now and is so blessed and relieved from this new development.

My recommendation is take the pain seriously in your ankles and seek the best ankle surgeon out there. If damage is advanced, study all options and seek 2nd and 3rd opinions. Don't be afraid of surgery but get the best surgeon out there. Understand that your ankles are weight bearing and you may not be able to continue impact sports but walking again without pain is the best blessing ever. Autograft vs allograft--autograft worked for us beautifully.

Hope this helps anyone approaching OCD issues to take it seriously and don't be too conservative--it is your ability to walk at stake.

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