Question
Hi Dr Katz!  Thank you for your time and expertise here.  To get right down to it,  in 1996 I had a triple arthrodesis of my right foot due to a tarsal coalition.  Ouch big time.  I had a foot and ankle specialist for my surgeon. I had two of the three screws taken  out- at my heel the the outside of my foot.  Well now it is 2007 and that surgery has started to ache like mad! What can be happening there? Is it just arthritis and normal wear and tear?  Is there maintenance for this surgery?  I am pretty scared about even mentioning it to my PCP since the surgery ordeal was so terrible.  I can't find anyone else who has had the surgery and don't know about prognosis...I think the surgeon probably wisely just sidesteps this information at the time the patient is rehabbing.  I have a  terrible time finding shoes... should I ask to go to an orthotist?  I would greatly appreciate any thoughts or experience you have about this and hope it might help someone else.  Thank you  very much!  Please say hello to lovely Tampa for me!  :-) dsk  

Answer
Hi Susy,

It is possible to develop wear and tear after triple arthrodesis, however, there are other concerns.  

It is possible that you have had some movement of the bones or even a fracture.  There may also be some arthritis of other joints, this is common.  Also soft tissue inflammation or nerve entrapment is common.

I would see a Podiatrist that has extensive experience doing this procedure.  You will need to get an MRI or CT scan to evaluate the bones and soft tissue.  It is hard to say what might need to be done.  However, there are custom supports known as ankle-foot orthoses that may help.  In some cases, surgery is necessary but you must see a surgeon that does this procedure often.

I might be able to help you find someone if you give me your metro area.

As far as prognosis, this is typically a life-long problem even after the surgery.  Typically these procedures are only done for severe pain or severe deformity.  The triple arthrodesis is not a cure.  It is a treatment with varying success.

So, I would be evaluated and then go from there.  Someone has to examine your foot and imaging studies.

Feel free to send more questions as you go through the process.

Good Luck.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com

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