Ankle Transplant

By Dawn Mercer

Columbia - In osteoarthritis of the ankle cartilage between bones breaks down, leaving the person with bone rubbing on bone and a great deal of pain. Thanks to a motorcycle accident 26 years ago, it's a pain with which Glenn Bramble was all too familiar.

He remembers, "The motorcycle went down on the left side, and my toe was twisted. My whole foot was turned around backwards, and it was actually four separate breaks and a dislocation of the ankle."

While Glenn's injury hasn't stopped him, the ensuing arthritis has continued to cause problems, "It's gotten to the point where there's not cartilage at all, it's just bone on bone, and it's quite a discomfort."

Doctors suggested fusion, a common treatment that limits movement. Orthopedic surgeon Mark Myerson has been offering patients something different, "We're actually transplanting bone and cartilage from a cadaver donor, just like is done for other organ transplants."

Dr. Myerson, of Mercy Medical Center in Baltimore, Maryland, says the procedure is a better alternative for younger, more active patients, "The big thing about that is it gives you movement unlike an ankle fusion."

On the other hand, patients must wait for a donor. On the day of his surgery, Glenn learned of another potential problem with the procedure, "One of the tendons attached to the joint had developed a bacteria, and Dr. Myerson said they were not going to be able to use it."

Glenn had to settle for traditional ankle replacement. Dr. Myerson say doctors have historically been hesitant to adopt the transplant procedure, because, when compared with fusion, it has a much greater risk of failure. He says the failure risk has dropped from 70 to 15 percent.

This article posted May 16, 2003.

Ankle Transplant

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