Increased mobility and freedom during post-op surgery can do wonders for a patient's attitude. And a positive attitude is proven to have drastic effects on the body's ability to heal. Recent advances in foot and ankle surgery have made operations smoother and new tools have made repair work more durable. This has paved the way to an even speedier recovery—or at least one that feels faster because it's less cumbersome.
Foot and ankle surgeons are meeting this week at the Annual Scientific Conference of the American College of Foot and Ankle Surgeons (ACFAS) in Orlando to review these advances, theories, and findings that put patients on their feet faster after surgery. According to Illinois foot and ankle surgeon and conference presenter Sean T. Grambart, DPM, FACFAS, these advances allow surgeons to test early weightbearing with patients who qualify.
Traditional post-op recovery lasts six to eight weeks and follows the immobilization and non-weightbearing protocol. As the injury and the surgery site heal, patients hobble about on crutches or push themselves around on a knee scooter. Recovery then continues with physical therapy, not only for the injury but also to recover strength to atrophied muscles after weeks of underuse. Anyone who has experienced this traditional recovery will attest how mobility difficulties and loss of muscle strength can cast a cloud on even the sunniest of dispositions.
Even though the immobilization and non-weightbearing approach has been the post-op norm, new tools and techniques now allow surgeons to test alternatives. Bone anchors, locking plate technology, and compression screws make for a stronger repair, and new surgery tools and techniques make for a cleaner work. When followed by early weightbearing, the injured area is put back into its normal use, limiting atrophy and scar tissue.
The results found by Dr. Grambart, who is a Fellow member of the American College of Foot and Ankle Surgeons, show that in some cases, ditching the crutches earlier may be a better option for patient recovery. In these test cases, after just 7–10 days of post-op crutch use, patients have been able to put partial weight on the injured foot. Patients who follow doctor's orders find their healing to progress similarly to non-weightbearing recovery, but with much less frustration, making this a preferable option.
Which patients get to leave the crutches behind? Surgeons are currently cautious in their selection, using a variety of factors to determine if the patient qualifies. The first determiner is the location of your injury. Forefoot injuries qualify because the healthy ankle and heel will bear the brunt of early post-op weightbearing. Patient profile is also determining factor: Healing and recovery are affected by the patient's overall health, so things like vitamin-D deficiencies, smoking, and diabetes may limit the possibility of early weightbearing. In addition, the patient's personality is key, as the patient needs to be trusted with this crutchless freedom. Going crutch-free doesn't mean it's time to do a jig or go for a jog. The patient must adhere to the strict mobility guidelines that allow for proper healing.
For the patients who qualify for this approach, practically crutch-free recovery is good news. It means greater mobility, faster return to daily functions, and less frustration. Dr. Grambart stresses that going crutch-free early in recovery doesn't necessarily speed the healing. But it does make the healing process easier to endure with fewer side effects. That makes recovery feel speedier to patients, if only because their attitude toward recovery is more positive.