The
Implant
Pictures of the Buechel-Pappas
ankle joint implant.
Surgical Technique
Here you will find the
abbreviated surgical technique to implant the Buechel-Pappas ankle joint
implant. Be advised that this contains actual surgical images taken in
the operating room and if you have an aversion to such, you should not view
these pictures.
Before & After X-rays
A sample of X-rays before and
after implantation of the Buechel-Pappas ankle joint.
While I know journalists dread the multi page letter, I write nonetheless because of the educational importance encompassed in presenting Total Ankle Joint Replacement as a surgical procedure which replaces a deformed or diseased ankle joint with a titanium prosthesis, heretofore unknown. As I am privileged to have been selected as one of ten surgeons in the United States permitted to implant the Buechel-Pappas Total Ankle Replacement, I feel it is important to provide you with sufficient information relevant to your profession.
Explained in layman's terms:
Individuals who need this operation have exceedingly severe ankle pain. It is not an
overstatement to say that the pain is so disabling that many of them want their lower legs
removed rather than continue to suffer with every step they take. Try to imagine a nail
within your ankle joint with the point moving against the ankle bones with each step, and
you will have some idea of the suffering these patients endure. Many become narcotic
dependent because of their inability to function throughout their daily lives.
Their ankles are so painful because of either rheumatoid arthritis or bone/joint arthritis
from a previously broken ankle. Until Oct. of 1998 the only possible relief was an
operation that
removed the ankle joint entirely and fused the foot to the leg. This means the foot and
leg
become one piece. The patient then walks with a limp with the remaining foot joints taking
the force and movement their prior ankle did. In most cases, the abnormal walking causes
the remaining foot joints to become diseased and destroyed from the stress placed on them.
Usually within 5 years the foot joints must be surgically fused from the stress placed on
them. After 12-20 weeks in a cast the patient’s ankle pain is gone but it for tells
additional limb pain for the remainder of the patients life as the stress is transferred
to the hip and knee.
The titanium ankle joint took 20+ years to develop because of the small size of the ankle
compared to the hip and knee. In addition the hip and knee absorb 2x body weight stress
per step while the smaller ankle absorbs 5x body weight per step. In Oct. of 1998, a
prosthetic ankle joint became available in the same way the now common hip and knee
replacements are available. The diseased ankle is removed and a new one implanted. The
patient is in a cast from the toes to the knee for 6 weeks after which he begins normal
walking activity. Equally important is that many of the patients who under went ankle
fusion may have the fused ankle removed and replaced with a new function.
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