66yom, 1.83 m tall weighing 120kg, used to be very sportive | Figure 1

TheFastDoctor

Family Medicine

66yom, 1.83 m tall weighing 120kg, used to be very sportive playing Rugby.. needed fusion of the lower 3 lumbar vertebrae, surgery to the neck during which the surgeon accidentally entered the spinal cord, causing hemipareses on the (R) which was partly restored after further surgery. Still weak and some paraesthesiae on the right hand side. But the bigger problem is mobility, painful (r) ankle, knee and hip. Post examination (no obvious neurology) I considered the almost stiff ankle could lead to overuse injury of the knee and hip. Arthrodesis may aggravate this... What do you think about a possible ankle replacement? I did suggest he lose about 40 kilograms but lack of mobility may hinder this.

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