Natalie Akoorie

Natalie Akoorie is a reporter at the NZ Herald based in Hamilton.

Hamilton man to have pioneering surgery for ankle

Brett Maber's ankle has given him grief since an outdoor cricket accident at 18.  Photo / Christine Cornege.
Brett Maber's ankle has given him grief since an outdoor cricket accident at 18. Photo / Christine Cornege.

A Waikato father-of-two who has hobbled for years after a cricket injury is going to the United States to have his right ankle replaced with an implant in pioneering surgery.

Brett Maber, 35, who has endured years of pain since the injury at 18, will fly to the US next month for the four hours of surgery because the implant is not available in New Zealand.

The Hamiltonian said the US$30,000 ($36,600) operation would give him the best chance at walking normally and pain-free.

"I have painkillers every morning and I couldn't happily walk without painkillers for more than a couple of hundred metres. Even on heaps of painkillers I couldn't have a round of golf, probably couldn't do nine holes."

Mr Maber, an active sportsman who once represented Waikato secondary schools in triathlons, broke his ankle badly playing indoor cricket.

He saw a specialist but once the break healed and the pain disappeared, he continued using the ankle without realising the cartilage - the tissue between his ankle bone joints - was wearing away.

In 1998, he had surgery to repair the ankle but the damage was already done and subsequent surgeries in 2003 and 2006 to reconstruct the ankle and trim calcification were only temporary solutions.

These days, Mr Maber walks with a lopsided limp and his ankle is so swollen by calcification - a build-up of calcium salts in the soft tissue which has caused it to harden - that he can't function without pain.

As a result, his right calf muscle is severely under-developed and he has suffered lower-back problems.

Five years ago, when the pain began getting unbearable, Mr Maber sought advice from leading NZ surgeons, who told him fusing the joint was the only way to get rid of the pain.

But Mr Maber, a national sales manager for Power Farming in Morrinsville, said fusing the joint was not an option because of his active lifestyle.

Two years ago, he began researching other options and last year he found the Inbone Wright implant.

Although total-ankle replacements were first available in the 1970s, they were not particularly successful until about six years ago when a new generation of implants were developed.

One of them, the Inbone Wright system, allows for a rod to be drilled up into the bottom of the shin bone which then connects to the artificial prosthesis implant, creating better guidance, less chance of it shifting and better longevity.

Such replacements are aimed at elderly or obese patients whose ankles have worn out, with most candidates aged 55 or over because in the past the replacements have lasted only 10 to 15 years.

But Mr Maber, who is now at the point where he cannot keep up with his children, who are aged 5 and 3, said he did not want to wait another 20 years.

"I'd rather risk it and have 15 years now and have it fused when I'm 50 than the other way round.

"You don't know what the future holds. I'd hate to wait 15 years and then get hit by a bus."

Fusing the ankle locks it in place so there is no movement but would likely cause lower back and knee problems for the rest of his life.

Mr Maber said that though it was expensive, the surgery was an investment he was willing to risk but he hoped to secure medical insurance to cover the cost.

The worst-case scenario was if the surgery didn't work and he had to have the ankle fused anyway.

"The reason I'm travelling halfway around the world is because I can't live with it any more."

He will have day surgery at the University Foot and Ankle Institute in Los Angeles in mid-April and will stay there with a cast on his foot for 2 weeks. He will then wear a moon boot for six weeks.

Then Mr Maber plans an aggressive rehabilitation programme, including physiotherapy and learning to walk properly again. After that, he will know if the surgery has been worth it.

- NZ Herald

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