I had a couple of foot and ankle surgical cases yesterday. Both Karen and John (names are changed to protect the . . . health information – google HIPPA) had significant arthritis. Karen’s arthritis started in her foot and John in his ankle. Now this kind of arthritis has little to do with Rheumatoid arthritis. This is the: hurt your foot/ankle so bad that the joint does not work like it used to kind.
In Karen’s case she severely sprained her foot and actually had a dislocation which was not diagnosed properly. Believe it or not, the kind of injury she suffered is very difficult to pick up by the non-podiatrist health care professional. Even radiologists have a difficult time with this one. See Lisfranc injuries in my website’s Conditions list. Amazingly this occurred 20 years ago and had finally gotten so painful she sought out a foot and ankle surgeon. I had to fuse the affected joints.
In John’s case he severely sprained and likely fractured one of the joints in his hindfoot as a kid. His father decided that his son could walk it off but the limp never went away. Not only did the injury affect the foot but he also had to have knee replacements because of the imbalanced way he walked. He finally came in and despite injections and immobilization with an ankle brace needed his joint fused also.
In either case was surgery avoidable? Perhaps not. There are advances in surgery, however, which may take less recovery time. In Karen’s case she dealt with increasing pain over 20 years. In John’s case – for over 40 years! So a consult with your podiatrist may get you better quicker. In the fortunate situation the fracture/dislocation is reducible then perhaps your podiatrist would not have to take you to surgery and could relocate it, cast it and save you long term foot pain.
With arthritis I only like to take patients to surgery if: 1) The pain is out of control you just can’t take it anymore – you are crying “Uncle!” or 2) You are unable to do the things you want to do. Lets face it foot and/or ankle surgery is never convenient. You do not walk on your hands. It requires time off and an even longer period of time not putting weight on it. The primary purpose of surgery is to get you out of pain.