Treatments

Achilles Tendinosis Surgery

The Achilles tendon is the largest tendon in your body. It connects the upper calf muscles to the back of the heel bone. When the Achilles tendon degenerates and becomes inflamed, it is called Achilles tendinosis. If you have Achilles tendinosis, your tendon can swell and become painful. This condition is common in athletes, runners, and people who have calf tightness. Achilles tendinosis may occur in the middle of the tendon (known as midsubstance Achilles tendinosis) or at the point where the tendon connects to the heel bone (known as insertional Achilles tendinosis).

For midsubstance Achilles tendinosis, surgery focuses on removing the diseased portion of the tendon. If most of the tendon is damaged, your foot and ankle orthopaedic surgeon often will use the tendon that goes to the big toe to support the Achilles tendon after repair. Other procedures may include lengthening the Achilles tendon or calf muscles if they are too tight.

Achilles Tendon Rupture Surgery

The goal of Achilles tendon repair is to reconnect the calf muscles with the heel bone to restore push-off strength. Regaining Achilles tendon function after an injury is critical for walking.

Ankle Arthroscopy

Ankle arthroscopy is a minimally invasive surgical procedure that orthopaedic surgeons use to treat problems in the ankle joint. Ankle arthroscopy uses a thin fiber-optic camera (arthroscope) that can magnify and transmit images of the ankle to a video screen. Ankle arthroscopies can reduce ankle pain and improve overall function.

Arthroscopy can be used to diagnose and treat different disorders of the ankle joint. The list of problems that can sometimes be treated with this technology is constantly evolving and includes:

Ankle arthritis: Ankle fusion is a treatment option for many patients with end-stage ankle arthritis. Ankle arthroscopy offers a minimally invasive way to perform ankle fusion. Results can be equal to or better than open techniques.

Ankle fractures: Ankle arthroscopy may be used along with open techniques of fracture repair. This can help to ensure normal alignment of bone and cartilage. It also may be used during ankle fracture repair to look for cartilage injuries inside the ankle.

Ankle instability: Ligaments of the ankle can become stretched out, which can lead to a feeling that the ankle gives way. These ligaments can be tightened with surgery. Arthroscopic techniques may be an option for treating moderate instability.

Ankle Cheilectomy

An ankle cheilectomy is a surgery that removes a bone spur from the talus or tibia, which are the lower and upper bones of the ankle joint. 

The goal of an ankle cheilectomy is to relieve ankle pain caused by bone impingement or pinching at the front of the ankle. While this may be a sign of early ankle arthritis, an ankle cheilectomy is a joint preserving option that may help with pain and function and buy time before additional treatment is needed.

Ankle Fracture Surgery

The ankle is made up of three bones:

  • the tibia (shin bone), which forms the inside, front, and back of the ankle
  • the fibula, which forms the outside of the ankle
  • the talus, a small bone that sits between the tibia and fibula and the heel bone

The ends of these bones are called malleoli. The tibia has a medial (inside) malleoli and a posterior malleoli. The fibula forms the lateral (outside) malleoli. 

Below-Knee Amputation

The goal of amputation is to remove unhealthy tissue and create a remaining leg that is less painful and more useful. Just like many reconstructive orthopaedic surgeries, the surgical goal is to improve a patient’s pain and function. Amputation can improve quality of life for many patients.

A below-knee amputation (BKA) is an amputation often performed for foot and ankle problems. The BKA often leads to the use of an artificial leg that can allow a patient to walk. A BKA is performed roughly in the area between the ankle and knee. This amputation provides good results for a wide range of patients with many different diseases and injuries.

Bone Marrow Aspiration

Bone marrow aspirate concentrate is made from fluid taken from bone marrow. The bone marrow aspirate contains stem cells that can help the healing of some bone and joint conditions. Bone marrow aspirate concentrate is obtained with a minimally invasive procedure that avoids the risks of an open bone graft procedure.

Stem cells can be used to help with bone healing, cartilage repair and new blood vessel growth. Using stem cells may treat delayed union or nonunion of bone fractures, cartilage defects, osteonecrosis, chronic tendon problems, or chronic wounds.

You should avoid this method if you have an infection or cancer. Make an appointment with your foot and ankle orthopaedic surgeon to discuss your options.

Brisement

Brisement is the injection of fluid into the space between a tendon and its lining, or sheath. This procedure breaks up scar tissue and stimulates healing of a tendon. While most commonly used for the Achilles tendon, brisement can be performed in any tendon of the foot and ankle.

Calcaneal Osteotomies - Evans, Dwyer, Medalizing, Lateralizing

The calcaneus, or heel bone, plays an important role in walking. A calcaneal osteotomy is a controlled break of the heel bone, performed by a foot and ankle orthopaedic surgeon, to correct deformity of the foot and ankle. 

The heel bone can be realigned to achieve a different orientation, which can correct many different deformities and functional limitations. For example, abnormally high or low arches are deformities that can be addressed with a calcaneal osteotomy. The ultimate goal of all osteotomies is to relieve pain, improve alignment and walking, and reduce the likelihood of arthritis. 

Calcaneus Fracture Surgery

The calcaneus is the heel bone. Fractures or breaks of the calcaneus commonly occur after a fall from a height or car accident. Treatment of these fractures may require surgery.

The goal of heel fracture surgery is to restore the shape of the heel bone as close to normal as possible. Restoration of normal alignment and contour is considered the best way to restore function and minimize pain.