DEAR DOCTOR:

As an Orthopedic Surgeon, Podiatric Surgeon, Family Physician, Internist, Physiatrist, Podiatrist, PT/Rehabilitation Therapist or Rheumatologist, you see patients who have debilitating ankle pain from rheumatoid arthritis or osteoarthritis from previously fractured ankles. Until now, these patients faced ankle fusion as the only possible source of pain relief. Total ankle joint replacement with the Buechel-Pappas Total Ankle Prosthesis is a proven alternative to debilitating ankle fusion. It is so successful that in some cases it is possible to take down a fused ankle and replace it with a functioning ankle joint. Indeed, the era of ankle fusion is over in that the procedure no longer needs to be done except in patients with insufficient osseous integrity, e.g. Charcot joint disease.

I am privileged to be one of ten surgeons in the United States permitted to implant this investigational prosthesis, based on my experience in more than 30 cases in 12 European cities over the past two years. Ankle joint replacement using three distinct prostheses has been performed in Europe for more than 15 years. Collectively, about 1700 cases, some in both ankle were done in Amsterdam, Ireland, Scotland, Japan, The United Kingdom, France, Sweden, Germany, Switzerland, Italy, and The Czech Republic to name several. Ten years after implantation, more than 80% of patients, ranging in age from early 20’s to 83, have pain free ankles. Prosthesis failure occurred in less then 3% to 7% of patients. These patients underwent ankle fusion.

Beuchel-Pappas, rheumatoid arthritis, arthritis, ankle arthritis, steoarthritis, Postoperatively, the patient is in a short leg limited weight bearing cast for 6 weeks. Full ambulation with rehabilitation is allowed after 6 weeks. Like the hip and knee, septuagenarians may have the prosthesis if their health and activity level permit. Patients walk, swim, climb stairs and play golf without difficulty, provided of course, they could play prior to surgery. If not, their new ankle joint motion permits learning.

The procedure is Medicare approved and most companies cover the charges. I hope this note stimulates your interest in a most unique surgical procedure that has proven to be limb and quality of life saving, for patients afflicted with a severely painful and debilitating disease.

Thank you for taking the time to think about this prosthesis. I encourage you to contact me via telephone at (305) 655-1200 or email at ankleimplant@gmail.com.

Yours truly,


Dr. Mark H. Feldman, DPM
Podiatric Surgeon