Change Of Pace

Total ankle replacement surgery ends painful bout with post-traumatic arthritis

Arthritis invaded Diane’s ankle, leaving little cartilage in the joint. After replacement surgery, she’s ecstatic to be walking pain-free again.

Though she claims to have a great affection for it, the singer Madonna once referred to her hometown of Bay City, Michigan, as “a smelly little town” tucked between the thumb and fingers of the state’s mitten-shaped lower peninsula. 

Diane Petee, another Bay City native, echoes those sentiments. 

“Bay City is about a two-hour drive north of Detroit, and it’s always cloudy, cold and dreary there,” she says. “It gets very little sun, which is one of the reasons why we moved to Florida.” 

“We” is a reference to Diane and her husband. Together, they made their escape to Florida in 2014, not long after both retired. They “love it here in Florida,” according to Diane, who says she’ll never forget “the worst winter” she ever experienced in Bay City. 

“It was about 11 years ago,” she recalls. “We had terrible snowstorms that whole winter, and one day, while I was taking my dog, Arizona, a little Shih Tzu, out for a walk, I slipped on the snow on my porch and fell and broke my left ankle.” 

That’s the bad news. The good news is that Diane was then working for an orthopedist as a licensed practical nurse. Two days later, that orthopedist put Diane’s ankle back together with plates and screws. 

He then issued an ominous warning. 

“He told me that I already had some arthritis in that ankle, and that eventually I was going to have a lot more and it would be a problem for me,” Diane recalls. “And that’s exactly what happened. About 10 years later, arthritis took over my ankle. 

“I can even remember the day I realized it happened. It was one day last fall. A friend and I were out antique shopping and, all of a sudden, my ankle just started aching real badly. It was killing me. 

“I tried toughing it out for a while, but the pain wasn’t going away. It got so bad, I had to stop walking the dog. I gave those duties to my husband. He even did the grocery shopping for us for a while. It was after that that I went to see Dr. Anthony.” 

Post-Traumatic Arthritis 

Diane, who also has arthritis in her knees, has long been a patient of Nicholas J. Connors, DO, of Advanced Orthopedic Center. Upon learning of Diane’s ankle pain, Dr. Connors referred her to his colleague at the practice, Steven R. Anthony, DO. 

Upon first visiting with Diane, Dr. Anthony ordered a series of x-rays of her ankle that showed she was suffering from post-traumatic arthritis, which Dr. Anthony describes as “the most common form of arthritis of the ankle.” 

“This is what we typically find in someone who has broken their ankle or sprained it severely several times in the past,” Dr. Anthony details. “Through those injuries, the cartilage and joint are damaged, and that’s what happened with Diane.” 

As it is with damaged knees and hips, the degree of arthritis in the joint determines the course of treatment. In Diane’s case, there was virtually no cartilage left in the ankle, so Dr. Anthony suggested total ankle replacement surgery. 

“There are several surgeries that can be performed on someone with ankle arthritis,” Dr. Anthony explains. “Total ankle replacement is the largest one and is typically reserved for patients over the age of 60 who are not obese or overly active. 

“This is not a surgery you’re going to perform on someone who still wants to run a half-marathon or manage a 2,000-acre ranch in Arcadia. Like tires on a car, the joint is going to wear out pretty quickly in someone like that.” 

Diane had no plans to put excessive stress on her ankle, and because it had been surgically reconstructed already, she agreed to have the replacement surgery, which begins with the surgeon ordering a CT scan. 

From the CT scan, a 3D model of the ankle is constructed. The CT scan and 3D model are used as guides to “pre-size the implant” ahead of surgery and show the surgeon where to cut the bones before fitting the implant. 

“The incision is made right down the middle of the front of the ankle,” Dr. Anthony describes. “Through that incision, we flatten out the round top of the talus, which is a very small foot bone with a round top, and shave it to make it a square top. 

“We then take a square cut off the bottom of the tibia, or shin bone. A square metal plate is placed on the bottom of the shin bone and a flat metal plate with a rounded metal top is placed on top of the talus. Then, a piece of plastic goes in between.” 

Pain-Free Again 

The procedure can typically be completed in less than 90 minutes and allows for normal, painless up-and-down movement of the ankle. 

Diane underwent the surgery in February 2022. By summer, she was walking pain-free again. 

“I still had some pain on and off for a couple of months after the surgery, but it’s fine now,” Diane relates. “I’m doing great, and so the bottom line is, I’m really glad I had the surgery. 

“I have to admit, I was a little hesitant at first, partly because I’d never heard of anyone getting a total ankle replacement. But Dr. Anthony did a great job explaining the procedure, and he did a great job. 

“He’s a wonderful doctor. I spent years working for what I consider to be one of the best doctor’s I’ve ever known, and Dr. Anthony is right up there with him. They’re neck and neck.”  

Florida Health Care News

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    • Advanced Orthopedic Center

      Whether you are a professional or collegiate athlete, an active retiree, a "weekend warrior," a high school football star or a hard-working employee anxious to make a difference, the Advanced Orthopedic Center is here to help you feel better a... Read More

    • Steven R. Anthony, DO

      Steven R. Anthony, DO, is a board-certified orthopedic surgeon specializing in the treatment of foot and ankle disorders. He completed his undergraduate studies at Florida State University and later attended the West Virginia School of Osteopat... Read More