Gordon Philpott - Ankle Replacement, Tendon Transfer, Foot Correction

The Dean River in British Columbia is legendary for the number of anglers fishing for large steelhead and Chinook salmon. The rocks are slippery, the water is cold and swift, and balance is critical while fly-fishing for the big ones.

Despite the stamina needed in such conditions, Dr. Gordon Philpott was in the thick of things less than one year after undergoing complex ankle and foot surgery.

“That’s the hardest wading I do when I go fly fishing,” he says with a smile. “It’s exciting. The fish are huge and the opportunity to fish there is like season tickets at the Met. You pass your spot on the Dean River down from father to son; it’s that special.”

For Dr. Philpott, a retired general surgeon from St. Louis, fly-fishing was a hobby that grew into a lifelong passion and resulted in trips around the world. So when his balance started to fail due to ankle stability and muscle weakness in his lower leg, he wanted a solution that would enable him to keep fly-fishing and traveling.

“When I was a surgeon in my 40s, I had a slipped (herniated) disc that pinched a muscle in my leg, causing permanent weakness,” says Dr. Philpott. “I developed foot drop. That’s what started all of my problems. It dragged, and I stumbled, spraining my ankle several times over the years, which then created chronic instability.”

While he could still carry a full surgical load and kept up fly-fishing and tennis, his condition worsened over time. To compensate for the one muscle weakness, other leg muscles over-compensated, causing his foot to turn outward. He also developed painful arthritis in his ankle. Looking forward to more fishing trips in his retirement, Dr. Philpott sought out a specialist in complex ankle injury and repair. In 2010, he turned to Washington University Orthopedics foot and ankle specialist Jeffery Johnson, MD, one of the few orthopedic surgeons in the country to specialize in complex ankle replacement, ligament reconstruction and tendon transfers.

“We discussed fusing the ankle bones but that wasn’t an option for me because that would have limited my mobility and I wanted to keep wading the streams,” says Dr. Philpott.

As it happened, Johnson was just beginning to use an innovative ankle joint implant called the INBONE® Total Ankle System. He also was seeing success with combining the implant with corrective bone, ligament and tendon surgeries for better overall stabilization. Unlike most hip and knee joint replacement surgeries, ankle replacement surgery requires a comprehensive approach and often involves tendon transfers and complex reconstruction to tighten ligaments, correct deformed bones and muscle imbalances and, at times, also lengthening the Achilles heel tendon.

Johnson, who has since performed more than 100 of these complex ankle replacement and correction surgeries, stresses physical therapy to restore ankle movement following the procedures. He also requires patients to return annually for ongoing evaluations of the implant to ensure it doesn’t fail early. He estimates that ankle implants can last 10 years or longer.

Dr. Philpott, who underwent ankle replacement, foot bone correction, tendon transfer and ligament reconstruction at age 76, was thrilled with his results. “It took about a year to fully recover and I wore braces for awhile, but the pain was gone and that made me feel great,” he says. “I had my surgery in March of 2011 and was able to go fly fishing on the Big Horn River in Montana the fall of that same year. It was wonderful to be back in the water!”

Now 80, Dr. Philpott still ties his own flies and heads out on several fly-fishing trips annually. “I have one new fly rod and another one is coming soon in the mail,” he says with a laugh as he points to a wall full of photos showcasing recent trips. “Retirement is great, especially when you can still move around and not have any pain.”

“I’m thinking of new places to fish all of the time.”

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