Question: Hello,
I have had ankle instability and weakness since childhood with numerous sprains. On 6/8/14 I began having severe pain in my right ankle and outer calf to the knee after feeling a pop earlier in the day. I went to the ER and was told I had a medial XXXXXXX dome lesion after having xrays. I was placed in a splint and on crutches and told not to weight bear. I was then referred to an orthopedic surgeon. I had an MRI on 7/1/14 and here is the report:
"There is a subtalar arthrosis with subcortical bony erosion and bone marrow edema involving the anterior subtalar articulation. The focus of bone marrow edema adjacent to the anterior inferior talus subtalar facet measures 12x7mm. The area of cortical erosion along the anterior facet measures approximately 4x6mm.
There is a cystic fluid collection within the sinus tarsi measuring 3.5x6mm.
There is a small tibiotalar joint effusion and a small subtalar joint effusion.
An osteochondral lesion involving the medial XXXXXXX dome is present without significant osteochondral collapse. The subcortical mild marrow edema measures approximately 10mm anterior posterior x 5mm medial lateral. The overlying articular cartilage and cortical surfaces are flattened."
I had arthroscopic surgery on 7/17/14 and am 5 weeks post op today. The surgical report states there were no loose bodies, and the surgeon shaved the bottom portion of the anterior tibiofibular ligament because of erythema. I was given a presumptive diagnosis of antereolateral ankle impingement.
Since surgery I have had no relief in original symptoms/pain and they have increased. My big toe is completely numb, I can't raise my toes at all, I have severe swelling and my ROM is nearly gone. I have been doing PROM and AROM exercises for 2 weeks now since I was cleared to do so and cannot improve any of my symptoms. When I try to range my foot/ankle, especially in dorsiflexion, it feels like my ankle is locked and I can feel a popping on the outside of the ankle joint.
I start formal PT today for 4 weeks and after that the surgeon intends to discharge me. I have worked as a PTA for 20 years and treated numerous patients like myself after ankle arthroscopy and I have never seen a case where there were these kinds of problems 5 weeks later. It seems to me that based on the MRI, there's more going on than was addressed and I'm thinking I may need another surgery to unlock my ankle. I'm not getting adequate circulation which is why it's so swollen and purple.
Any insight you can offer is greatly appreciated.