I am 31 (RA for 15 years now) and need to have surgery on both my feet because walking is getting too painfull and picking a pair of shoes completely impossible.

My big toe has curl to the inside and they are all stiff and hammer toes and m biggest doubt now is what to do! I have spoken with different surgeons and while some say that I should go for fusion/arthrodesis/resection (reasons: it will take away the pain, I will walk normally and not loose any strength) others are for joint replacement (reasons: not as agressive).

As always there is a downside in each. Fusion means no mobility (is this relevant on the foot?) and also the pain can creturn; joint replacement can have future complications and require future surgery and does not take away the pain.

Has someone gone under any of these options? What happened? Complications in the post-surgery? What would you reccomend for a 31 year old woman?

Looking forward, thanks a lot,

Ana (l.sousa@mrtravel.pt)

I told her about the Yahoo ankle fusion board, you can join..lots of posts there about ankle fusions

My earliest subtalor was when i was 42..I ended up getting them repeated, and then triple arthodesis fusion.   I do need an artificial ankle, but i go to one of the top guys , at a teaching hospital in Chicago area, that specialises in feet only, and he is a pioneer in artificial ankles..

BUT he agrees i am ok, with my heavy duty orthotics, and an Arizona brace, if i need it.

The subtalor, the foot  can move up and down, just not sideways...now my triple, only the toese move. but i can move my foot back and forth from the ankle

Each case is differant, foot surgeries are hard, non weight bearing...mine was more congenital from birth, and my right foot needs to be rebuilt, i am seeing my surgeon, just for followup xrays in november..

I would find a teaching hospital, the asst professors, that just do ankles/feet, and get 2 opinions.  They will ask you what your pain level is....It's just that each case is differant, but i really don't have much pain in the succesful fusion, my feet were collapsing in (navicular, talor prob)

Ask a lot of questions, get a couple opinions, and maybe Donna will answer this post...she has had great success

Best wishes



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Methotrexate 15 yrs, Enbrel 3 yrs, Humira 5 yrs, Rituxan 1 yr, now diagnosed with PSA and RA, back to Enbrel 50mg.x2 a week

Cris46

Thanks for the advice, all the help is most welcome.

However it looks like you both had ankle situations and for now my cocern really are the toes (big and smaller ones also).

Any personal experience here?

Thx,

Ana

Yes I had a ST ankle fusion last summer-the toes are another issue-About 17 years ago I had them operated on also. Joint relacement was not an option-not available yet--my toes were all dislocated and it was like I was walking on rocks with every step I took-the bones had shifted on top of each other. The os wanted to fuse also.  I would not let him- i was younger than you at the time-It would have meant no more shoes for me-no heel at all nothing with a point or lift--think about it-they are fused and cant bend.. I opted for a temp fix--I knew it would only last 5 yrs but i hoped it would buy me time for more options. It actually lasted closer to 7--they cleaned out all of the joints and pinned them-let them scar in place then pulled out the pins-now they are dislocated again but they are side by side not on top of each other. It is not painful to walk but it is impossible to find shoes! When I had my ankle surg I wanted the dr to fix my toes but he wouldnt-he said since they dont hurt to leave them-you dont know what could happen next time--he siad he would fuse them-my advice is to go to the best orthopedic foot specialist you can find for your opinions-make sure it is a specialist in foot/ankle!  not a general os. I went to Hosp for spec surg in NYC. good luck