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going in for a THIRD hangland's "bumpectamy"

Posted by edie f on 5/20/05 at 15:15 (175382)

third on my R foot that is, second on my left ...
my doctor has never hear of it reocurring for a third time ... anyone else heard of that?

first surgery (R and L) was in 96
second (on R, also had my achilles surgically lengthened at the same time) was in 2001

i'm a 31 year old, very active female. i just want to know if this will be my last surgery ... PLEASE, this is getting very old!!!

Re: going in for a THIRD hangland's "bumpectamy"

Ed Davis, DPM on 5/20/05 at 20:24 (175393)

edie:
Recurence is caused by too much motion remaining at the tendon-bone interface after surgery. Biomechanics that lead to this include calcaneal varus (a inward tilt of the heel bone), any of the numerous things that cause overprontion (rolling in of the foot).

The longevity of success in the procedure is directly proportional to the control of the abnormal biommechanical forces causing the excessive motion.

Another factor is the manner in which the achilles tendon is stabilized against the bone. The more stable the achilles attachment, the less motion. That is why most surgeons will use devices such as bone anchors to create a stronger or broader achilles attachment.

If the abnormal motion is not controlled, then there is no theoretical limit to how often the problem can recur.

What type of experience and understanding does your doctor have with this type of surgery and associated motion issues?
Ed

Re: going in for a THIRD hangland's "bumpectamy"

edie f on 5/25/05 at 13:24 (175711)

ed,
thanks for your reply. you mention in your message, over pronation. i actually over-supinate (weight on the outside of the foot, right?). it's quite extreme, especially on my right foot.

when i had the second bumpectamy on my right foot, in 01, the doctor also surgically lengenthened my achilles. that surgery seems to have been successful (at least so far) as the bone did not grow back in the area where the achilles primarily attaches to the heel. instead a growth has developed more toward the inside of my heel. according to my doctor, that growth is most likely NOT a result of extra tension in the achilles, b/c that's now really where the achilles attaches (for the most part). would you agree? what do you think would cause such a growth?

the bump took longer to re-ocurr on the left foot. presumably b/c the over-supination in my left foot is not quite as bad, nor is that arch quite as high. so this time when he removes the bump, he will surgically lengthen the achilles.

what are your thoughts on all of that? what do you recommend to prevent regrowth? i have custom-made orthodics. i exercise daily and i do not intend to change that anytime soon. i do not do high-impact activities like running or jumping. i would certainly like to be able to do one day though. any feedback is appreciated.

Re: going in for a THIRD hangland's "bumpectamy"

edie f on 5/25/05 at 15:10 (175716)

ed,
thanks for your reply. you mention in your message, over pronation. i actually over-supinate (weight on the outside of the foot, right?). it's quite extreme, especially on my right foot.

when i had the second bumpectamy on my right foot, in 01, the doctor also surgically lengenthened my achilles. that surgery seems to have been successful (at least so far) as the bone did not grow back in the area where the achilles primarily attaches to the heel. instead a growth has developed more toward the inside of my heel. according to my doctor, that growth is most likely NOT a result of extra tension in the achilles, b/c that's now really where the achilles attaches (for the most part). would you agree? what do you think would cause such a growth?

the bump took longer to re-ocurr on the left foot. presumably b/c the over-supination in my left foot is not quite as bad, nor is that arch quite as high. so this time when he removes the bump, he will surgically lengthen the achilles.

what are your thoughts on all of that? what do you recommend to prevent regrowth? i have custom-made orthodics. i exercise daily and i do not intend to change that anytime soon. i do not do high-impact activities like running or jumping. i would certainly like to be able to do one day though. any feedback is appreciated.