Answers for your Ankle
During the many doctor’s appointments I had before and after my peroneal tendon repair surgery I asked my doctor countless questions. I am a very inquisitive person, but even with my never ending inquiries there were plenty of questions I forgot, or didn’t think, to ask.
Since I am sure that many patients forget to remember what to ask, here are some questions you may have about your peroneal tendon surgery, or the recovery process, and the answers my doctor gave to me.
1. How accurate is an MRI? Will it show with certainty if I need to have surgery or not?
Unfortunately, the answer to this question is no. Apparently, although an MRI will give a doctor a good idea of what is going on, it won’t necessarily accurately illustrate the extent of the damage to your tendon. According to my doctor, sometimes an MRI will indicate that surgery is the best option for a patient, so the patient will go ahead with surgery, only to discover, after the fact, that the damage wasn’t extensive enough to justify the procedure after all. The reverse was true in my case; my tendon was much more injured than the MRI suggested.
So it seems that while an MRI is a good diagnostic tool, it’s not error proof. That’s why my doctor recommended I try physical therapy and orthotics before resorting to surgery, just in case a less invasive option would take care of the problem. But in the end, if nothing else helps, the only way to know exactly what is going on with your tendon is to cut you open and take a look at it.
2. What risk factors contribute to peroneal tendon injuries?
Evidently, if your feet have high arches you have a much higher risk of injuring your peroneal tendons. Also, your probability of tendon tears rises if you walk abnormally. You put a lot more strain on your tendons if you maintain your weight on the outside of your feet as you’re walking. You should instead push from your heels, through the balls of your feet, to your big toes-that’s a normal step. I have high arches and an irregular gait. So basically, I was a tendon injury waiting to happen.
3. How long will peroneal tendon repair surgery take?
This surgery takes about an hour.
4. How successful is peroneal tendon repair surgery?
I’m sure there is some variation depending on how skilled your orthopedic surgeon is, but according to my doctor the success rate is about 90%. That means 90% of patient’s tendons show marked improvement, or are completely normal, following surgery. This surgery is considered “unsuccessful” if there is no significant improvement after the procedure. My doctor has never seen a case where the condition of the tendon worsened after surgery.
5. Do I have to be put completely out for this surgery?
Other doctors may do things differently, but mine put me completely out. In addition to general anesthesia, I was offered a nerve blocker for my leg. A nerve blocker completely blocks nerve sensations for hours. People that have a low pain tolerance tend to be big fans of the blocker. However, getting a blocker does slightly increase your risk of permanent nerve damage. In the end, I decided that it wasn’t worth it for me. I can handle quite a bit of pain and I did just fine without the blocker.
6. How long will I have to stay in total at the hospital/surgical center?
I’m sure this depends on the facility, but I was at the surgical center for about 6 or 7 hours in total. Preparations for the surgery took me about an hour and after surgery, regaining consciousness took a bit as well. You shouldn’t have to stay overnight.
7. Will I have to take antibiotics after surgery?
This is obviously up to your doctor’s discretion, but I didn’t have to. I was given antibiotics intravenously during the procedure so I wasn’t prescribed any antibiotic medications afterwards.
8. What medications will I have to take after my surgery?
I was only prescribed Percocet and Phenergan after my surgery. The Percocet was prescribed for the pain, obviously, and the Phenergan was prescribed in case the Percocet made my stomach hurt-which it did.
9. How long after surgery is there an increased risk of re-injuring your tendon?
According to my doctor, your body does the majority of its healing in the first three months after surgery. After you hit the three-month mark the risk of re-injury goes down significantly. However, apparently for a full year after surgery the risk is still greater than normal because I have been instructed to wear my ankle brace while doing any type of physical activity for a year.
10. I have been experiencing shooting nerve pains up the side of my leg. Is that normal after peroneal tendon surgery?
Yes, that is normal. Because you have a lot of nerves in your feet it is evidently impossible for the doctor to gain access to your tendons without damaging some of these nerves temporarily. Also, because the tissues in the surgical area are so inflamed after the procedure, the nerves get all bunched up in the swollen mass. This causes them to behave abnormally. The good new is that this effect should only be temporary. As you become more mobile again and the tissues start moving around in your foot, your nerves should slowly untangle themselves and you should no longer experience these pains. I had some issues with severe shooting pains about 3 or 4 weeks after my surgery. I haven’t had any problems with them for months now.
11. I’ve noticed that my skin feels strange around my incision, a little numb. Is this normal?
Yes, once again, it’s because your nerves were damaged during your surgery. Apparently this is common and the numbness should improve with time. Though, my doctor said for some people it never completely goes away. My numbness issues have definitely gotten better over the last few months but there is still an area about an inch or two wide above my incision that feels like it just got a shot of Novocain. I guess only time will tell if that spot will remain permanently numb.
12. How long should I expect my ankle to stay swollen after surgery?
Your feet have a tougher go of it after surgery than most of your other parts. Since they have to carry your weight constantly, they really don’t get a chance to heal the way everything else does. Due to that fact, the doctor said to expect some swelling in the incision area for 1 to 2 years.
13. When can I expect the muscle mass in my leg to return to normal?
I know the muscle loss in your affected leg is extremely depressing. Seeing my warped shapeless leg jiggle like there was no tomorrow was sad indeed. But there is good news. As soon as you start bearing weight on your foot again your muscle mass comes back pretty fast. It has been four and a half months since my surgery and my legs are almost identical again. Yeah!
On a side note, just so you are aware, if the tear in your tendon is large enough apparently the doctor has to sever the ligaments that criss-cross the tendons in order to perform the surgery. This was the case with my surgery. So all that pain you are feeling might be more justified than you realize.
I hope this helps all of you with your question about what to anticipate with peroneal tendon surgery. It’s definitely not an enjoyable experience but knowing what to expect can make things a little more bearable. Having just gone through it all, I feel your pain-literally-and wish you a speedy recovery!