Quote Originally Posted by Kinetix View Post
Thanks, physiobob!
Yes, a total ankle prosthesis is the best option, I think.
Since you know London, could you tell me where could he adress to get it mounted and what costs are involved? I think he could get some courage to fly there for his leg.
Thanks again!
Here is an email response I have received from one of the top London guys (Nick Cullen who is a specialist foot and ankle surgeon at Royal National Orthopaedic Hospital). I presented this issue to him over the weekend.

Nick's response:

I'm an Orthopaedic surgeon with a pure interest in disorders of the foot and ankle,working out of the rnoh stanmore and the wellington.

Ankle replacements are coming along well, the mobility ankle specifically seems to have moved us forward, but the long term results are still not there. For a young active man, I think that universally a fusion is the gold standard at present. the problems really lie in implant longeivity and in revision of a failed ankle replacement which often necessarily requires an additional subtalar arthrodesis due to bone loss in the talus which is functionally alot more limiting than an isolated ankle fusion (and obviously requires a second operation i.e total ankle + fusion)

On the whole ankle arthrodesis provides a decent functional result allowing in many cases return to even heavy manual labour, but running jumping etc is unusual, this might be possible with a replacement but has been shown to lead to earlier failure.

I'm sorry If this is a little non specific for you, if you have any more information re: patient age, activity level comorbidity I'd be delighted to be more specific!

Kind regards
Nick Cullen
Nick can be contacted on [email protected]