<s>[INST] I had an injury in 1982 that spun my left ankle around and around tore every ligamament and they wanted to amputate it also broke my leg at ankle where small and large leg fasten together been on 500 mg. naproxen for 20 yrs. and now my creatin levels have elevated and can t take it any longer.wear a laser have orthotics and start limping after a few hours.it is a train wreck and dr. Horton at ku. Med center in kc said it needs fused no guarantee that pain will be eliminated.i wish they could chop it off at knee and replace but I hunt quail and pheasant and ride motorcycles any suggestions for natural treatment or stem cell or anything but pills to cover pain I m bone on bone and I m 59 yrs old [/INST] Dear patient as per your history it seems you are suffering from ankle arthritis. Also knee pain may be due to knee osteoarthritis.  If arthritis is severe treatment is either joint fusion or replacement. Joint fusion will to relief in pain but joint movements at fused level will be lost. Similarly, at knee level for severe arthritis replacement is better option or fusion is less likely. Other options are like injection of shroud at the joint but have only temporary effect, and they do not modify underlying disease. Stem cells do not have role in severe arthritis. </s>