Gary’s Story: Total Ankle Replacement


September 5, 2018

Gary remembers the pain in his stomach after the ulcer formed. He’d been taking Naproxen for six years, and quite regularly for the last two. It was all he could do to keep the intense pain and swelling in his ankle at bay.

Gary and Dr Sagar Desai

Faced with no longer being able to ride horses, Gary was referred to Dr. Sagar Desai, a foot and ankle specialist at Humber River Hospital.

Despite the pain, Gary got up every morning and went to work. A professional horse trainer for the last 40 years, he’s the kind of guy who never stops. Gary owns and operates Pickering Horse Centre with his wife and family. They love their work.

That’s why Gary was so upset when he learned that he may never ride again. After consulting with a surgeon at a Toronto hospital, the prognosis wasn’t good.

Gary broke his left ankle twice early in his career from two separate riding accidents. He recovered from both injuries, but over time the dull ache in his ankle turned into considerable discomfort, followed by intense pain. Arthritis had set in and surgery was the only option. The first surgeon he saw recommended an ankle fusion, which is the most common way to treat acute ankle arthritis in Ontario. But for Gary, it would have meant the end of his riding career.

“When you ride, you balance yourself in the stirrups on the balls of your feet. You need to have good flexion in the ankles and knees.” explains Gary.

After an ankle fusion, patients can no longer bend their foot. The ankle is permanently fused to the shin bone and the patient’s gait is forever altered. Faced with no longer being able to ride horses, Gary insisted on exploring other options.

Through a joint assessment program, he was referred to Dr. Sagar Desai, a foot and ankle specialist at Humber River Hospital. “I still remember the look on Dr. Desai’s face after he examined the X-ray,” Gary said with a smile. “He said ‘I don’t know how you’ve been walking, let alone riding!’ I told him I don’t have a choice. I love what I do. But the last two years or so before the surgery were hard. I was walking like I had no foot, essentially dragging my arthritic ankle behind me. My health really declined because I couldn’t ride or exercise. I was 57 but I felt like 70. I tried my best to stay positive, but it was hard not to let negative thoughts creep in at times.”

Gary was in luck. With the support of two very generous donors, Dr. Sagar Desai recently expanded Humber River Hospital’s Total Ankle Replacement Program.

Gary back on his horse after total ankle replacement

About five months after Gary’s surgery, Dr. Desai gave him the green light to ride again. “I love riding so much, it’s my life’s work and my life’s passion. I can’t thank Dr. Desai enough.” says Gary.

“With an ankle replacement, I’m actually inserting a prosthetic joint that acts as a buffer between the ankle bone and the tibia. It’s a technically challenging procedure that requires a lot of training and expertise, and the upfront cost is higher because the prosthesis is expensive,” explains Dr. Desai. “I’m very thankful that our donors and our Hospital have invested in this program. It’s going to make a huge difference for patients like Gary.”

Gary’s surgery went extremely well.

“For years I thought about my ankle every second of every day because of the pain,” Gary says, “Two weeks after my surgery with Dr. Desai, the pain was completely gone. Dr. Desai has been phenomenal. So positive and so confident. He knew right away that I was a candidate for this surgery.”

About five months after Gary’s surgery, Dr. Desai gave him the green light to ride again. Gary took it easy at first, but as he explained: “It really is like riding a bike. The muscle memory is there, it just takes time to regain your form and build up your fitness again. But it’s all there.”

“I love riding so much, it’s my life’s work and my life’s passion. I can’t thank Dr. Desai enough. He changed my life with this surgery. He’s given me a new lease on my livelihood.”