Total Ankle Replacement: Episode 77

  • In this episode: Total Ankle Replacement is going through a bit of a renaissance. It was attempted in the past with mixed success but has in the last few years become a more common treatment options for those dealing with ankle pain and ROM loss due to arthritis or trauma.

  • Chip Review @ (11:16): Chex Mix – Hot & Spicy Ghost Pepper (Thank you Jean)

  • Trivia question of the week @ (10:12): – What two nations share the longest border?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

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Brief overview of the episode:

Total Ankle Replacement, aka Total Ankle Arthroplasty (TAA) is an uncommon procedure. Rare, even really rare are appropriate ways to describe it. This procedure was most common in the mid 90’s and occurs at least 40% less than that now.

The reason it is so rare is that it historically has not been a viable option. People who underwent the produce would end up with a number of issues. Poor life span, stress deformation of the prosthetic and surrounding tissue and also significant bone loss occurred way to often.

Over the last few months of 2019 we started to see and hear about more total ankle replacements being done and end up treating some individuals who had it done.

Unlike other joint replacements TAA does not allow for immediate weight bearing. Commonly 6 weeks of non-weight bearing in a cast or walking boot is prescribed. This results in the use of a knee scooter, walker or crutches needing to be used. Joint swelling is a big problem following total ankle arthroplasty. This is difficult to manage when someone is casted or generally restricted with their movements.

Total ankle arthroplasty is not often recommended as a treatment option because it has historically not been success. As technology advances maybe this will change. In many cases an ankle fusion will be a more comfortable and better functioning option.

Other episodes you might enjoy:

Foot & Ankle Health with Dr. Mohammad Rimawi: Episode 40

Knee Pain: Episode 2

Hip Pain: Episode 15

Dry Needling: Episode 51

  • In this episode: Functional Dry Needling (01:30)

  • Chip Review: Calbee – Hot & Spicy Thank you Steve Kovisto (13:21)

  • Trivia question of the week: Which women has appeared in the most FIFA Women’s World Cups?(11:53)

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

What is Dry Needling? There are a number of theories. We are going to go in depth on Functional Dry Needling (FDN). With this particular style of needling you are looking to improve movement. By improving movement, pain and discomfort should also reduce.
The other models include the Trigger Point model, Energy Crisis model, Radiculopathic model, and the Motor End-Plate model. I always like to think of FDN in a more simple way.
FDN helps to reset the muscle. So if the muscle is over firing, spasming or chronically tight you can get it to relax by putting a needle in there. If it doing the opposite so not firing you can put the needle in there and get it activate. The analogy I like to use is that of a computer. We’ve all experienced a time when our computer is not working, as we like. So the first thing we do is shut the computer down and turn it back on again. We reset it and that more often then not will get it to start working again.
So with the body if we can get it to start moving better often times we can get the pain to reduce and eventually go away. The important thing to remember is that FDN along is usually not enough to make a lasting change. We always like to follow up all out treatments with a series of therapeutic exercise. These exercises are going to ensure a long lasting change.
Other episodes you might be interested in:

Pain: Episode 29

Ice or Heat?: Episode 23

Radicular Pain: Episode 22


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