Patient pain-free and mobile again after total ankle replacement by UConn Health's Dr. Lauren Geaney
Dr. Lauren Geaney, UConn Health foot and ankle surgeon, sees Joe Marinello for a follow-up appointment six months after performing a total ankle replacement on his right foot. (Tina Encarnacion/ UConn Health photo)
A somewhat uncommon procedure is proving to be an effective solution for problems associated with ankle arthritis.
When pain becomes persistent and mobility becomes limited, an ankle fusion will address the pain. But some patients are candidates for an ankle replacement, which comes with added benefits.
"It allows patients to maintain their range of motion, and gait is better with the ankle replacement," says Dr. Lauren Geaney, UConn Health foot and ankle surgeon. "But a lot of people aren't aware total ankle replacement exists as a really great option to help pain and restore function in patients suffering from ankle arthritis."
At this time last year, Joe Marinello, of Wethersfield, was struggling with pain in his right ankle that had progressed to the point where he had a bad limp and was using a cane.
"I had pain most of the time when I moved, so my mobility was very limited, and I just didn't do a lot of things," Marinello says. "I took a lot of ibuprofen and whatever to deal with the pain, and a lot of the pressure of doing things, like shopping and doing other stuff, was put on my wife."
To me she walks on water, because she's got me walking with no pain. — Joe Marinello
Marinello, 86, says the problem went back to a bad day on the baseball field in 1961, when he was playing third base for Marietta (Ohio) College.
"I slid into home and my bottom spike caught home plate, flipped me over," he says. "I busted my ankle, and actually the foot was 90 degrees and the tibia bone was on top."
He says a doctor at a bone clinic in Parkersburg, West Virgina, reset the bones in his foot without surgery.
"He had to set it at a certain angle so that everything stayed together," Marinello says. "It was a little crooked at first, but through therapy, the muscles straightened out. I broke it in May, and went into the service in September. And instead of me doing all the marching, I had to do the running, but then I went to the infirmary, and by February I was playing baseball for the squadron."
Being an athlete his whole life, it took until about 10 years ago for the decades of running to finally take their toll. He started seeing Geaney, who started him on cortisone shots. They would provide about three months of relief, but as the years went by, they lost their effectiveness.
"Ankle arthritis is much less common than hip and knee arthritis, and ankle replacement is a newer procedure," Geaney says. "The technology and our knowledge of ankle replacements even in the last 10 years since I've been in practice has grown exponentially. When I first started, I was doing about one a year, primarily because we didn't know as much about who did well. Now I'm doing about one a month or so."
Initially concerned about downtime and recovery, Marinello came around on the idea of ankle replacement surgery.
For the first 11 days after the surgery on March 20, his foot was in a splint and he was under doctor's orders to not put any weight on it. He went back to get the stitches removed and graduated to a walking boot with limited weight bearing.
"I could put it down, but I had to put pressure around my walker, I had to stay with the walker," Marinello says. "Then on April 28, she looked at it, and said, 'Put your shoe on.'
"I have had no pain since she did the surgery. I had swelling from the surgery, but I had no pain. It was incredible."
"I think he had an excellent outcome," Geaney says. "This is a great surgery to restore patients to low-impact activity like walking, hiking, biking, or swimming."
That is, after staying off the repaired foot for a few weeks, followed by rehabilitation. Geaney says it can take up to a year for full recovery.
Marinello's course of physical and occupational therapy lasted four months, at which point he reported, "The only thing she doesn't want me to do is run, and I haven't run in years, and she doesn't want me to climb a ladder. Other than that, I get my boat, I go fishing, I shop with my wife now, I help her, I carry stuff. I'm living pretty much a normal life based on my age. But to this day, I can't believe I'm walking with no pain. I'm mobile. I walk straight. There's no limp and there's no pain."
And he developed quite a fondness for his surgeon.
"To me she walks on water, because she's got me walking with no pain," Marinello says. "I talk to her like I'm talking to a friend. She's so personable and down to earth, it's incredible."
