Posts Tagged ‘Ankle Pain’

Total Ankle Replacement Surgery Explained

ankle replacement surgery smallAre you experiencing pain, bruising, swelling and inflammation in your ankle? Are these symptoms associated with a previous injury, osteoarthritis or rheumatoid arthritis? Have you tried physical therapy, bracing and medicine with no success? If so, you may be a strong candidate for total ankle replacement surgery. If not treated properly in a timely manner, the above conditions can cause the cartilage in your ankle to wear away, leading to joint damage, pain and disability. Total ankle replacement surgery is an option to treat severe ankle pain that doesn’t respond to more conservative treatments.

What Are the Benefits of This Surgery?

 

The American Academy of Orthopaedic Surgeons reports more than 90 percent of joint replacement patients have significantly less pain and see a dramatic improvement in their ability to complete daily tasks. We at Emory Healthcare recently presented research demonstrating significant improvements in both clinical and functional parameters after ankle replacement surgery. With your doctor’s sign-off, you can expect to return to walking, golfing, swimming or biking after your recovery.

Are You a Candidate for Total Ankle Replacement?

 

If you have chronic, daily ankle pain that worsens over time, make an appointment to see an Orthopedic Foot and Ankle Specialist who can evaluate your ankle and help you determine your best treatment plan. You may be a candidate for total ankle replacement surgery if:

  • You have ankle pain that interferes with your daily life
  • You stick to mostly low-impact activities like walking, daily chores, swimming, etc.
  • You have advanced arthritis in your ankle joint
  • The surfaces of your ankle joints are destroyed

What Happens During & After Total Ankle Replacement Surgery?

 

Your orthopaedic surgeon will remove your damaged ankle joint and replace it with an artificial one (ankle prosthesis). After you undergo the surgery, you can expect to stay in the hospital for one to three days. When you return home, you may need to use crutches, a walker or a scooter for six weeks followed by progressive weight bearing in a boot for another 4-6 weeks, depending on your doctor’s recommendations. You’ll likely be advised to:

  • Rest
  • Keep your foot elevated
  • Avoid putting weight on your foot
  • Take pain medicine as prescribed

When it’s safe to bear weight on your foot, your doctor may recommend physical therapy to restore strength and range of motion to your ankle.

Most people are ready for their normal activities after three to four months, though you may need to wear a special brace or shoes to aid recovery. Depending on how severe your ankle damage was prior to the surgery, full recovery may take six months to a year.

Overall, this option offers patients more movement and mobility, as well as less stress and risk of arthritis to nearby joints, if compared to other similar treatments. Want to learn more about total ankle replacement surgery at Emory?

About Dr. Bariteau

bariteau-jasonJason Bariteau, MD, grew up in a small town just outside of Albany, New York. After completing his undergraduate degree in Biology at College of Saint Rose, he then pursued his medical degree at Upstate Medical University in Syracuse, NY where he graduated Magna Cum Laude. Following completion of his medical training he developed his surgical skills during his orthopedic surgery residency at Brown University. He then subsequently completed two advanced orthopedics fellowships; the first at Brown University in orthopedic trauma and the second at Baylor Medical Center in Dallas Texas under the tutelage internationally known Foot and Ankle Surgeon James W Brodsky MD. He currently resides in Atlanta, GA with his wife and three children.

Best Ways To Recognize And Treat An Ankle Fracture

ankle-injury

What is an ankle fracture?

A fracture is a partial or complete break in a bone. An ankle fracture can range from a simple break in one bone, which may cause discomfort but not stop you from walking, to more serious fractures, which damage multiple bones that hold your ankle joint in place and may require surgery or immobilization for some time.

There are three bones that make up the ankle joint:

  • Tibia – shinbone
  • Fibula – smaller bone of the lower leg
  • Talus – a small bone that sits between the heel bone (calcaneus) and the tibia and fibula

Any one of the three bones could break as the result of a fall, twisting, rolling or rotating your ankle, a car accident or some other trauma to the ankle. The more bones that are broken, the more unstable the ankle becomes and the longer the recovery time.

What are the signs and symptoms of a fractured ankle?

Common symptoms of an ankle fracture include:

  • Immediate and severe pain, which can extend from the foot to the knee
  • Swelling
  • Bruising
  • Tender to touch
  • Decreased ability to walk or put any weight on the injured foot
  • Deformity or protruding bones

Because a broken ankle can frequently be confused with an ankle sprain, most severe injuries to the ankle should be examined by a musculoskeletal specialist.

What are the treatment options?

First, to prevent further complications, make sure to stay off the injured ankle until you receive medical evaluation from a physician. Other ankle fracture treatments include:

  • Elevate the ankle and apply ice to the injured area to decrease swelling and pain.
  • Rest and make sure to stay off the affected ankle.
  • Depending on the type of the fracture, a splint/cast/boot may be used to stabilize and realign the ankle joint.
  • Some patients may require surgery if the fracture is severe enough.

What is the best way to heal from a fractured ankle?

Healing of an ankle fracture depends on the severity of the injury. To optimize bone healing we advise patients eat a good diet, get enough calcium and vitamin D, and follow treatment instructions from their physician.

Will an ankle fracture heal by itself?

Some ankle fractures will heal without surgical intervention but most require some period of immobilization in boot or brace if treated without surgical intervention.

What should someone with a fractured ankle do to keep relatively fit during the period of immobility?

Patients often worry about their fitness when they are immobilized or unable to put weight on their extremity after an ankle fracture. I recommend my patient at Emory Orthopaedics & Spine Center begin upper body exercises as soon as they can resume activity. We also have patients frequently use rolling knee walkers, which allow them to be as mobile as possible while they are healing.

If you’ve suffered an ankle fracture, seek medical attention from an orthopaedic physician specializing in fractures. The physician will conduct a physical exam, perform appropriate imaging and recommend a treatment plan (non-surgical or surgical) to get your back to your pre-injury functional level safely and as soon as possible. If the injury is severe, please call 911 or visit the nearest hospital emergency room.

ortho-appt-bar

About Dr. Bariteau

bariteau-jasonJason Bariteau, MD, grew up in a small town just outside of Albany, New York. After completing his undergraduate degree in Biology at College of Saint Rose, he then pursued his medical degree at Upstate Medical University in Syracuse, NY where he graduated Magna Cum Laude. Following completion of his medical training he developed his surgical skills during his orthopedic surgery residency at Brown University. He then subsequently completed two advanced orthopedics fellowships; the first at Brown University in orthopedic trauma and the second at Baylor Medical Center in Dallas Texas under the tutelage internationally known Foot and Ankle Surgeon James W Brodsky MD. He currently resides in Atlanta, GA with his wife and three children.

Related Resources
Takeaways from Dr. Olufade’s Ankle Sprain Chat

Is it a Sprain? Or a Fracture?

Dr. Rami Calis
When you injure your ankle, it may be hard to tell whether you’ve sprained it (stretched or torn a tendon or ligament) or fractured it (broken a bone). Generally speaking, here are some things to keep in mind:

  • If you have pain around the soft tissue areas but not over the bone, you probably have a sprain, not a break.
  • If you have pain over the ankle bone, you most likely have a break.
  • If you’re not able to walk on it, there’s a good chance you have a break.

If you’ve hurt your ankle but you’re not sure it’s serious, a general rule of thumb is to watch it for two to four days and use the RICE method—REST your ankle, put an ICE pack on it, use COMPRESSION, such as an Ace bandage or air cast (available at your local drugstore) to stabilize it, and ELEVATE it. If, after two to four days, you still have significant pain or difficulty putting weight on your foot, or you see black and blue marks or blisters, it’s time to see a doctor.

At the Emory Orthopaedics & Spine Center, our orthopedic specialists are experts at diagnosing and treating foot and ankle injuries. We use our clinical knowledge, an MRI when needed (we have the only 3-tesla MRI in the state—think of it as an MRI in HD), and X-rays to help determine whether you’ve fractured a bone or torn a ligament and whether the injury requires surgery. Most ankle injuries, whether fractures or sprains, can be treated conservatively, without surgery. However, if a fracture calls for surgery, we may use a plate and screws on the side of the bone or a screw or rod inside the bone to realign the bone fragments and stabilize them as they heal. Sometimes a soft tissue injury will require surgical intervention, as well, as it may create ankle instability and need to be repaired. However, most cases will do well with conservative care and physical therapy to follow.

When you see your doctor after an ankle injury, it’s important to describe in detail how the injury occurred. Did your foot turn under, out, in, or rotate? The more you can tell us, the more effectively we’ll be able to diagnose and treat your injury. Any information you can tell us is useful. At Emory Orthopaedics & Spine Center, we focus on listening to the patient and tailoring a treatment plan that fits the patient, without compromising care or adequate healing time.

If you’ve sprained your ankle in the past and now find that it twists easily or feels weak, you may have damaged the ligaments, causing chronic ankle instability. Although you may not feel any pain originally, over time you may develop arthritis in your ankle. At Emory, we can try to implement physical therapy for ankle strengthening, but if that fails, it may be necessary to repair the ligaments so that your ankle is stabilized.

Remember—if your ankle hurts, don’t push it. There’s a reason your body is talking to you, so get it looked at by a doctor. Our goal is to keep you active for the long term not just the short term. The worst thing you can do is to try to push through the pain and ignore your body’s communication, as that may lead to long-term ankle joint disability and arthritis. It’s not uncommon for an ankle sprain to be painful for many months after an injury, and swelling may last for four months to a year, but if it still hurts to put weight on it two to three weeks after you’ve injured it, make an appointment at the Emory Orthopaedics & Spine Center to see a foot and ankle specialist.

Have you sprained or broken your ankle? Have you had an ankle injury that required surgery? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About Rami Calis, DPM:

Rami Calis, DPM, is assistant professor in the Department of Orthopedics. He is board certified and a Diplomate, American Board of Podiatric Orthopedics and Primary Podiatric Medicine, with an interest in sports medicine of the lower extremity and foot and ankle biomechanics. Dr. Calis holds clinic and does surgery at Emory Orthopaedics & Spine Center at Executive Park and also holds clinic in Duluth, at our satellite office. Dr. Calis’ professional goal is to improve patient care and quality of life for patients with foot and ankle problems. Dr. Calis began practicing at Emory in 2003.