RETURN OF THE ANKLE BLOGGER - ME AND MY NEW ANKLE 30 MONTHS ON

I'm embarrassed that it has been over a year since my previous post to my blog. I've been reflecting on why that is, and also as to why I've just now, almost out of the blue, decided to add this new post to my blog on my ankle replacement.

I think the overriding reason that I have NOT posted in the last year is fundamentally a good one - I have had precisely zero problems with my ankle over the past year, and indeed virtually since the date of my surgery. I had my routine check-up with Mr. Goldberg and his colleagues last June, and all was well. It is therefore perhaps a sad reflection (on me) that, since all has been well, the motivation to talk about it dipped somewhat.

So, if that is the case (and all continues to be great), then why have I suddenly decided to do another post? Well I guess it's down to my brother.

Three Christmases ago, when we spoke on Christmas Day, we knew already that there was a chance I would be accepted on the TARVA trial. And on that day, he said to me "David, I hope this time next year, we can again enjoy a round of golf".

Well, on Boxing Day 2016, we played THAT round of golf, and we celebrated greatly, but it was only three weeks ago, when we spoke again on Christmas Day, that he reminded me of those two conversations.

So, I want to echo what I said in my previous post around this time last year. Participation in the TARVA trial, and the consequent surgery, has literally transformed my quality of life, and I suspect that of many other participants. Moreover, I have been honoured and humbled to be part of a clinical trial which will help our medical professionals form a view on the most appropriate treatment for ankle arthritis, including a view of what makes the most sense not just in patient-outcome terms, but also in health economics terms for our hard-pressed NHS.

What do I mean by that? Well, in my own words, I think it's something like this .......... I've had an ankle replacement, courtesy of Mr. Goldberg and his surgical team. For me, that operation has been transformative. If the replacement survives for at a minimum ten years without need for intervention, then in my view (and probably the NHS's view too), that has been a success. If it lasts 20 years, and I'm still not six foot under, then amazing. If it only lasts five years before requiring intervention, then mmmm....

Meanwhile, my fellow participants who have had an ankle fusion may, I suspect (and purely anecdotal from other patients NOT involved in this trial) have taken a little longer than me to feel the real benefits of their surgery, BUT if their fusion surgery has been successful then, unlike me, they will have the "benefit" of knowing that their "new" ankle is  -  forever!

It may well be (being a scientist myself by training) that there is no definitive outcome to the fusion v. replacement discussion, not least given the large range of patient presentations, but I am absolutely certain that the results of this study will hugely inform ankle/orthopaedic surgeons in their discussions in future with patients, and will also help the NHS direct resources appropriately.

I cannot end this post without doing two things :

• first, encouraging anyone who reads this blog, and who is considering surgery to address ankle arthritis, to consider participating in this ground-breaking study, since not only will you get a resolution to your issue, but you will also help in creating knowledge for physicians to best advise their patients in decades to come

• second, and whilst there are many centres participating in this study (see the TARVA website for one near you) I really must once again thank the whole team of people at the Royal National Orthopaedic Hospital (RNOH), led by Andy Goldberg, for not only a brilliant surgical outcome for me personally, but also for truly wonderful care from admission to discharge and beyond. I truly owe you all a sincere debt of gratitude.

I definitely WILL post within the next six months following my next check at RNOH, but in the meantime just starting to get involved in rock climbing! (Last sentence not for Mr. Goldberg's eyes)!.

Cheers

David