By the time she was in her mid-40s, Dawn Scheets found herself struggling to walk. It was a pain on several levels.
Dawn Scheets, Chili, Wisconsin
"I just hated being asked why I was limping," Scheets recalled.
If an injury caused her pain, it was years earlier, perhaps when she twisted her ankle playing basketball in high school.
She suspects she has degenerative arthritis, a debilitating condition her father also suffered.
Working as a nurse, Scheets was on her feet much of the day. Her ankle became progressively worse.
In the last few years, she had to lean on walls or grab furniture to relieve the pressure.
All she could do was go home and rest.
This was not the quality of life Scheets imagined, especially at her young age.
Total ankle joint replacement
A former colleague, Nurse Practitioner Jacqueline Buttke, told her about a relatively new procedure, total ankle joint replacement, and Christopher Bibbo, D.O., at Marshfield Clinic.
He is the only orthopedic surgeon in central Wisconsin to perform all the various types of total ankle implants.
Scheets said, "If it can make me better, I want it."
She had previously received injections to manage pain, which provided short-term relief. She also wore a brace to immobilize the ankle.
These non-surgical options are often tried first, Buttke said. The other surgical option was having her ankle fused. That would take away the pain, but not the limp. "This preserves some motion in her ankle," she said.
Dr. Bibbo asks patients why they want ankle replacement and what they hope to do afterward.
"I wouldn't be a good candidate if I wanted to hike or hunt," Scheets said, because the walking surfaces would be too unpredictable. "It was my hope just to get through eight hours of work and go to my kids' activities."
Dr. Bibbo has performed total ankle procedures at Marshfield Clinic since 2001. "It's evolved exponentially in the last 10 years," he said.
Advances in implant design
While not as common as total hip or knee procedures, ankle replacement has become a more viable option because of advances in implant design.
Newer designs don't require cement. Rather, the bone grows into the ankle prosthesis, as it does in knee and hip replacements.
The implant Dr. Bibbo placed in Scheets' ankle in January 2008 mimics the anatomy and movements of the natural ankle joint.
The procedure, known as arthroplasty, is technically demanding, Dr. Bibbo said.
It requires a good understand of the anatomy and biomechanics of the ankle.
Scheets was in a cast for six weeks and off work for nine weeks. She could put no weight on the leg.
With the help of Physical Therapist Aaron Homolka and her family, she worked hard to increase her range of motion. "Dawn did well, she was very motivated," Buttke said.
"I'm so thrilled I did this," Scheets said. "I get so much more done in my life."
In the evening, she can go to her son's baseball games, where she's even able to climb the bleachers. She can walk the dog.
The increased exercise has helped her. "People notice I've lost weight. I'm in better health," she said. "I don't limp – that's the best thing. It's a real self-esteem thing."