Kent Emry first worked with Justin Brohard, DO, in late 2022. Emry fractured his ankle about 20 years ago, which over time led to post-traumatic arthritis.
Dr. Brohard, a foot and ankle surgeon, first looked at nonsurgical options, including injections and bracing, before performing ankle replacement surgery in early 2023.
“We go through the front of the ankle to see the entire joint. I remove bone and cartilage. Then we put in the artificial implant made of metal,” said Dr. Brohard. “In between the two pieces of metal there is plastic that works like a hinge, so you still have all the ligaments and tendons around the ankle.”
Dr. Brohard said that surgery is about 95% effective.
“The purpose is primarily pain relief but also preserving motion and function,” he added.
The orthopedic surgeon said currently the technology lasts about 10 to 15 years before revision is needed. Emry was only 52 when Dr. Brohard replaced his ankle.
“I’ve seen him five times since surgery,” he said. “The last time I saw him was earlier this year, and he had no pain.”
Before surgery, Emry said he was in so much pain he could hardly stand.
“After the ankle surgery I could walk again almost immediately,” he said. “It made such a difference for me.”
Emry’s ankle replacement was the first time Dr. Brohard used that specific implant in Salem. It wasn’t approved for use at Salem Health yet, and Emry was one of the patients in the clinical trial period.
“After his remarkable success, Emry wrote a letter to the hospital advocating clinical approval so that more patients could get the same kind of implant,” said Dr. Brohard. “Now we have it on the shelf for other patients to get. In total, I’ve done 15 ankle replacements since joining Salem Health Orthopedics.”
The orthopedic surgeon notes that in the 90s, ankle replacements only lasted five to seven years, leading to more revisions and higher complication rates.
“We want to change the dialogue so that patients understand that it is a good surgery for pain relief that can last a decade or longer,” said Dr. Brohard.
About 6,000 to 7,000 ankle replacements are done in the U.S. each year, exceeding ankle fusions. The orthopedic foot and ankle community expects the number of annual ankle replacements to grow by at least 200 percent in the next 15 years.
“The best candidates are middle aged or older, relatively active individuals who want to maintain their lifestyle with less pain in the ankle,” he said.
More specifically, Dr. Brohard works with ankle arthritis patients.
“You may have heard that ankle replacements are not a good solution, but in the last 30 years our technology has made a lot of advancement,” he said. “Now this is really the frontline surgery to help with function and pain.”
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