Our office specializes in treating, preventing, and repairing injuries & defects of the foot and ankle.
LEARN MORE ABOUT OUR EXPERTISE >>
Arthroscopy & Tendoscopy of the Foot & Ankle
We apply arthroscopy & tendoscopy for many pathologies including:
- Ankle joint (osteochondral lesions, arthritis, fractures, ligament injuries, posterior ankle impingement)
- Subtalar joint (arthritis)
- Metatarsal phalangeal joint (Hallux rigidus)
- Peroneal tendons
- Posterior tibial tendon
- Flexor halluces longus tendon
- Achilles tendon (Haglund’s deformity, Achilles tendinosis)
Depending on the size and characteristics of your Osterochondral lesion, we have two different treatment options:
1. Reparative Treatment – Bone marrow stimulation (Microfracture)
2. Replacement Treatment – Autologous osteochondral transplantation (OATS)
In the great majority of cases, individuals who see a physician for their injury are instructed on how to reduce pain and inflammation. They may be advised to wear an air cast or participate in physical therapy to strengthen the ankle muscles, in order to make a full recovery.
The remaining population—about 10% of people—develop ankle instability, a condition in which, although the ligament has healed, it has done so in a lengthened position. As a result, the person is prone to a feeling of the ankle “giving out” and to additional sprains. Athletes such as ballet dancers, who already have looser-than-average ligaments, are particularly likely to develop this condition.
Surgical treatment is reserved for patients who have persistent symptoms despite functional treatment. Surgery is often achieved with anatomic ligament repair (modified Bröstrum procedure) but some patients require ligament reconstruction using free tendon grafts. We have developed a novel method of hybrid reconstruction using the peroneal longus tendon.
Sports Injuries to the Foot & Ankle
Tendon Injuries to the Foot & Ankle
Arthritis of the Foot & Ankle
The gold standard of surgical treatment of advanced ankle arthritis is traditionally fusion of the ankle joint. The arthrodesis can be performed arthroscopically with minimal invasive incision. Arthroscopic arthrodesis allows patients to quickly rehabilitate and fusion rates are comparable or better than a traditional open procedure.
Distraction arthroplasty with a external fixator is also an option. This technique stretches the joint apart for a period of time with a frame and unloads the ankle joint, allowing healing of the damaged joint. This can be helpful in patients in whom it is desirable to prolong the need for fusion or replacement.
After a blood sample is obtained from a patient, the blood is put into a centrifuge, which is a tool that separates the blood into its many components. Platelet rich plasma can then be collected and treated before it is delivered to an injured area of bone or soft tissue, such as a tendon or ligament.
PRP is given to patients through an injection, and ultrasound guidance can assist in the precise placement of PRP. After the injection, a patient must avoid exercise for a short period of time before beginning a rehabilitation exercise program.
Shockwave therapy is a non-invasive method that uses pressure waves to treat various musculoskeletal conditions. This causes blood vessel formation and increased delivery of growth factors to the affected area to stimulate the repair process and relieve pain111. Shockwave therapy is not painful and takes only 5 minutes. Shockwave therapy has been used for treatment of a variety of conditions including: Plantar fasciitis, Achilles tendinosis, Peroneal tendinosis, Posterior tibial tendinosis, stress fracture, and various kinds of soft tissue injuries.