“Before, they didn’t really have another choice,” he said. “Things are less figured-out, in the foot and ankle world.”
Herbst offers his patients both options, but many have chosen the new replacement. One reason is that it typically lasts between 10 and 20 years — much higher than the eight- to 10-year average for most other replacements. Herbst’s implant uses a special kind of plastic that’s more durable, he said.
There are a few other differences, including improved bonding with the bone. Zimmer’s Trabecular metal is porous, making it more conducive to bone in-growth.
It’s also placed from the side, where others are placed from the front, which, among other things, makes scarring less noticeable. Herbst said the tibia bone in the calf is broken on the way in, and repaired on the way out.
“There’s less bone loss, from a volume standpoint,” he said, adding “it really looks like a normal ankle. It mimics natural foot geometry.”
There are some conditions that would preclude the use of an implant, he said. For example, they don’t jibe with some deformities, if the patient has a history of infection or certain diabetic conditions, which could lead to problems or the replacement loosening.
But things are going fine for most patients, such as Coon, who’s considering having his other ankle replaced, too.
“Might as well,” he said. “The other one feels pretty good.”
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