Seeking Guidance on Post-Surgery MRI Findings
I’m reaching out for some guidance regarding my MRI outcomes and whether a second opinion is warranted. In April, I underwent surgery on my ankle to address a lesion located on the inner part of the talar dome. Due to the lesion's position, my surgeon had to excise a portion of my shin bone, which now has two screws inserted. Post-surgery, I began at-home range of motion exercises, mainly moving my ankle up and down to adjust to the new structure added. I followed a non-weight bearing protocol for three months and just received the green light to fully bear weight in a boot two weeks ago. However, my recovery took a turn three weeks back when I began experiencing clicking and grinding sensations in my ankle, reminiscent of the pain I felt prior to the surgery. My doctor requested an MRI, and since then, my discomfort has escalated to the point where my ankle is locking up during movement. At my appointment today to review the MRI results, the doctor informed me that while the lesion is still present, it is healing. He suspects my new discomfort stems from the cartilage not being completely smooth yet and believes it simply needs more time to heal. He mentioned that it was healing at a slower pace than expected and advised restricting my weight bearing to partial support with either a walker or crutches, alongside continuing my exercises to aid the smoothing process. Interestingly, I did not encounter these issues during the initial three months of recovery, and now I’m facing even more severe symptoms than before the operation. If this was merely part of the healing phase, shouldn't I have experienced similar issues throughout? Upon reviewing the MRI report, I noted a concerning finding: "high grade chondral loss of the medial tibial plafond." This detail did not come up during my appointment and was absent from any previous scans prior to my surgery. After some research, I've learned that this finding may point to a different injury affecting my cartilage on another bone, separate from the original issue I was treated for. Despite my doctor’s advice to continue the range of motion exercises, I’m not a medical professional, and I’m truly uncertain about these MRI results. Is it advisable for me to seek a second opinion? The exercises I am performing have become increasingly painful, and I can feel my ankle grinding with each movement. I worry that I might be further damaging the cartilage, resulting in an even larger injury. I greatly appreciate any advice you can offer!
Answers (1)
8/6/2025, 4:31:39 PM
OpenHealth AI
Thank you for sharing your concerns about your recovery following ankle surgery. It's completely understandable to seek clarity when faced with unexpected symptoms and MRI findings. Let's break this down into key points and actionable steps.
Key Points
- Current Symptoms: You're experiencing clicking, grinding sensations, and locking of your ankle, which were not present during the initial recovery phase.
- MRI Findings: High-grade chondral loss of the medial tibial plafond is a new concern that could indicate additional cartilage damage.
- Surgical Recovery: Your doctor indicates that the lesion is healing but suggested you limit weight-bearing activities, which is different from your previous experience.
Explanation
The discomfort you're feeling, particularly the locking and grinding, is concerning and may suggest complications related to cartilage healing or potential new injuries. High-grade chondral loss indicates significant cartilage damage, which may affect your ankle's function and lead to ongoing pain. While healing can vary, the sudden onset of worsening symptoms should not be dismissed.
Next Steps
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Prioritize a Second Opinion: Given the new MRI findings and your increased symptoms, seeking a second opinion from another orthopedic specialist is advisable. They can provide additional insights and validate or question your current treatment plan, especially regarding the high-grade chondral loss.
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Evaluate Current Exercises: Temporarily pause any exercises that exacerbate your pain. Engage only in gentle range-of-motion activities that don’t lead to grinding sensations. Listen to your body; if it hurts, stop.
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Consider Imaging During Follow-Up: Request further imaging or tests (if your new specialist recommends it) to closely assess the state of your cartilage and joint, addressing concerns raised by the MRI findings.
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Pain Management: If you’re experiencing increased pain, consider using ice packs post-activity to manage inflammation, and discuss with your doctor about suitable pain relief strategies.
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Modify Weight Bearing as Needed: Until you receive a second opinion, adhere to your doctor's instructions on partial weight bearing to minimize additional stress on the joint.
It's entirely reasonable to feel anxious, and you should feel empowered to address uncertainties regarding your medical care. By seeking a second opinion and adjusting your current exercises based on pain feedback, you'll be taking strong steps toward understanding and improving your recovery. If you have more questions or need guidance on finding a specialist, don’t hesitate to ask!
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