Salto Talaris Ankle Replacement Surgery: New Relief for Pain

Lavanyia Glover could barely walk when she first visited Anne Arundel Medical Center, in Annapolis, Md., in 2006.

The then-32-year-old from Bowie suffered from rheumatoid arthritis for years. And the disease eventually destroyed the cartilage in her right ankle, resulting in bone rubbing against bone.

Walking became painful and she had to walk on crutches while doctors tried to decide how to help her.

She was referred to Dr. Justin Cashman III, an orthopedist at Anne Arundel Medical Center who convinced her to undergo a new ankle-replacement procedure. She was skeptical at first, but decided to try the trend-setting procedure.

"It was just so discouraging to keep on going back and forth to the doctors, and they didn't know what was wrong with me," said Ms. Glover, now 34. "(The surgery) really did change my life. I'm working on other things now to help me out (with arthritis)."

Dr. Cashman was the second surgeon in the state to perform the procedure, known as the Salto Talaris ankle replacement.

With Salto Talaris, doctors can make one incision on the foot and add a device that is two pieces of metal held together with plastic to act as the ankle. The plastic in the device is supposed to last 10 to 15 years.

The surgery is an escape from previous replacements because it allows patients to return to their feet quickly, instead of having to recuperate on crutches and casts for several weeks. Ideal candidates for the surgery are thin, ages 50 to 60 years old and have ankles that are not lined up correctly. Dr. Cashman recommended the surgery for Ms. Glover because of the severity of her arthritis, which is unusual for someone in her age group. There are about 15 different types of ankle replacements. However, most of the procedures take more time and involve some type of recuperation. "The real downside to do a procedure (the old-fashioned way) is that it's supposed to get people walking around pain free," Dr. Cashman said. "The problem is that they're in a cast (for several weeks)." Tornier Orthopedics, a global orthopedics company, developed the SaltoTalaris replacement. The Food and Drug Administration approved its use in the United States in 2006. Shortly after the approval, the first surgery in the country was completed in Cleveland. After meeting Dr. Cashman, Ms. Glover wanted to try other alternatives before she considered surgery. Her ankle was fitted with a boot, and she received cortisone injections, but nothing worked. She needed something that would make it easier for her to get around in her two jobs -- running a day care center and working at a hotel. So she agreed to the surgery.
Because the procedure is so new in the United States, Ms. Glover had to write several letters to her insurance company to get approval. She received it and had the operation this past summer. Now her right ankle is fine, but her left foot has started to take a toll since she had to put so much pressure on it in the past. Her left foot is more a condition of her arthritis, and she's been seeing a rheumatologist to make that better. "My mom always told me don't get surgery because when they start working on you, you always have to go in for something," Ms. Glover said. "(Now) I do feel a difference in my right ankle. I feel great because at one point, I could be off my feet laying in the bed (and my foot) is still throbbing. I don't feel that anymore." There are some restrictions to anyone who receives the surgery. Intensive exercise is not recommended and skiers should switch to groom slopes and tennis players should play doubles matches instead of singles, Dr. Cashman said. But recreational swimming, biking and low impact aerobics are fine. "I don't think this is for everyone," Dr. Cashman said. "I certainly do think it's a good step." Source: Maryland Gazette. Provided by ProQuest Information and Learning. Powered by Yellowbrix.
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