March 4, 2002

Contact:      Jennifer Kurczek
      Community Relations Director

      (920)361-5481 or



Central Wisconsin Orthopedics adds Total Ankle Replacements
to gamut of services at BMH 


Patients with debilitating ankles may find relief in Berlin Memorial Hospital’s newest surgical procedure: the Total Ankle Replacement (TAR).


Orthopedic surgeon Paul Shuler, MD, of Central Wisconsin Orthopedics, has completed two TARs at Berlin Memorial Hospital (BMH) – making the facility one of few statewide to offer the innovative procedure.


TAR procedures appeal to those patients who’ve suffered severe injuries to their ankles and those who've accumulated repetitive injuries in the foot and ankle. While the procedure can provide a positive outcome for patients with injury to the ankle, it may not be suited to those with other significant foot deformities, Dr Shuler said.


“Total ankle replacements are highly beneficial to younger, more active patients whose only other option is a permanent fusion of the weak ankle,” he said. “A good candidate would present with arthritis of the ankle, whether it be rheumatoid arthritis or osteoarthritis caused by an injury.”


During the three to four-hour procedure, Dr. Shuler first detracts the damaged ankle joint, then replaces it with the prosthetic ankle, and finally fuses the patient’s bone around the prosthesis. Following the procedure, patients must wear an orthotic boot and avoid weight-bearing activity for six to eight weeks. Then, they undergo four to six weeks of physical therapy in which they learn to walk and strengthen the new joint.


In its clinical trials, the prosthetic Dr. Shuler uses, the Agility Total Ankle manufactured by Depuy Johnson and Johnson, provides 90% success for effectiveness over five years. His inaugural TAR patient, Donna Wiegert, an arthritis sufferer, was facing a total ankle fusion when she learned of Dr. Shuler's ability to perform a TAR.


"Prior to the replacement, my ankle was constantly giving out or rolling, causing me so much pain," she said. "Now, four months later, I barely have to use my orthopedic boot or a cane, and I have little pain. It's been a tremendous improvement."


The TAR surgery, combined with a physical therapy program, proved to be just the right mix for Wiegert. Following her procedure, she entered a transitional rehabilitation program at an area nursing home -- where she learned how to properly use her new ankle. Wiegert has since returned to her own home where she can partake in an active lifestyle including a woodcarving hobby, love of family and the outdoors. Dr. Shuler continues to closely monitor her progress.


"Dr. Shuler has been wonderful. He's such a caring and personable doctor," Wiegert said. "I would encourage anyone with ankle troubles to make an appointment with him."


Board Certified in Orthopedic Surgery, Dr. Shuler, who joined Central Wisconsin Orthopedics in 2001, had previously trained to perform specialized surgeries of the foot and ankle in Michigan. Working with BMH’s surgical co-manager Diana Krause, the two found that only four other surgeons in Wisconsin offer the procedure – with a total of 12 completed in 2000. Combining Dr. Shuler’s experience with the hospital’s capabilities, Krause prepared to work the service into the surgical schedule.


“Our surgical department is equipped with the same progressive equipment as most major hospitals, so we knew that we wouldn’t face any challenges adding the ankle replacements,” she said. “Plus, since Dr. Shuler and his partners perform a variety of other orthopedic procedures at our hospital, our staff has established great working relationships with them.”


Dr. Shuler and his partners, Drs. Joel Cler and David Jones, who are also Board Certified in Orthopedic Surgery, offer a full gamut of orthopedic and sports medicine services, including hip and knee replacements, arthroscopy of the shoulder, knee, wrist, elbow and ankle, carpal tunnel repair and treatment of bunions and hammer toes. With their main office located at 191 Memorial Drive in Berlin, the trio has outreach clinics in Ripon, Waupun and Wild Rose.


A graduate of the Michigan State University College of Human Medicine, Dr. Shuler completed his residency at the McLaren Regional Medical Center in Flint, MI. Dr. Cler graduated from the University of Illinois College of Medicine and also completed his residency at the McLaren Regional Medical Center. Dr. Jones graduated from Cornell Medical College in New York and completed his residency in orthopedics at the Mayo Clinic in Rochester, MN.


More information about Central Wisconsin Orthopedics services is available by calling (920)361-2500.