Yep, I had ankle surgery again yesterday which is why I didn't post as I didn't get home until late and frankly I crawled upstairs and went to bed.
The docs went in a bit blind this time, going only on my symptoms and the fact that during a fluoroscopic examination last Saturday and after the docs gave me a local anesthetic into the joint and played with the ankle and put it under stress. That is the first time they caught the slight movement on the fibula. We also identified 2 nerves that had been giving me problems.
They first did an arthroscope where they found synovitis again but not to the extent of the last surgery done 6 months ago but again enough that it was an abnormal buildup and in just 6 months time. On an normal person one wouldn't find synovitis at all. But I have never been normal. During this scope they did not find one of my nerves that went to my big toe that we knew was entrapped since I had no feeling at all in the toe. They finally found it on the lateral side of the ankle between fibula and the talus - definitely not where it was supposed to be. So they put it back in its groove.
So in the diagram above it shows 3 ligaments that are rarely torn. Again I am not normal. I tore them. In fact, after the scope, they opened up the lateral (outside of the ankle from the mid ankle to 5 inches above and found no ligaments except the one they had repaired twice (the ATF). Under the fluoroscope they were able to see the tibia and fibula and talus all moving independently of each other. Normally there are the ligaments that allow these to move with each other. Not mine - they were loosey goosey with nothing preventing the other from moving out of position. This was the reason I felt the instability but they could never find it on the MRI or any other test. Kinda felt nice to be vindicated - that it wasn't all in my mind.
So they used a synthetic tissue called Artelon to make these 2 ligaments (the anterior inferior tibiofibular ligament and the posterior inferior tibiofibular ligament. They had repaired the posterior talofibular ligament and the calcaneofibular ligaments but they had loosened up with all the other instability so they reconstructed and used the Artelon to strengthen them. They also found the other nerve I had been having problems with and found it bound down in scar tissue. They released it and hopefully scar tissue won't reform around it again.
Then they addressed the scar tissue between the tibia and fibular where the syndesmotic injury was. There was nothing viable there so they scraped all the tissues out and replaced them with the Artelon, roughing up the bone then suturing (sewing) the tissue to both bones. They then passed 2 syndesmotic screws through the fibular and through the tibia to hold it all together and let it heal in place for 8-12 weeks then remove the screws and see if I can stand. (2nd picture) If that doesn't work, I might have to have a permanent screw across the 2 bones but we will cross that bridge when we come to it.
Getting used to being non-weight bearing wasn't too hard. I took a shower tonight. Trouble has been amazingly friendly and cuddly and not wanting to leave my side. Hubs finally had to physically remove him from the bathroom so I could even get into the shower. His pitiful meows could be heard for miles until I was reunited with him. He won't even let hubs come near me now.
All in all, about what I expected. Pain about what I expected. Should be able to return to work in a week from Monday. Still planning on making my first trip downstairs Wednesday to help make cappelletti, stew the chicken and then prepare Thanksgiving supper of soup and chicken. Friday I will start the turkey prep to take to inlaws house for Saturday dinner (lunch to you Yankees).
