All patients are looking for the top or best Ankle surgeons to evaluate their ankle problem or perform their ankle surgery. We believe that giving different treatment options (non surgical treatment) is a top priority.
At our practice our patients always have three choices:
Each patient is different and conservative treatment vs. surgical correction both differ for the particular type of ankle problem, age and lifestyle. The right treatment must also meet the patient’s expectations in regard to resolution of their problem(s) and future functionality. And if conservative treatment fails, the option to not have surgery is as important as the surgery chosen by your surgeon. Of course surgical training is very important, and continuing medical education on the latest medical advancements is important as well, but it’s the careful planning before and after surgical treatment that produces the best outcome.
Ankle arthritis is a medical problem that involves the interior surface of the ankle joint. This painful condition can be caused by normal aging or “wear and tear”, by an injury or by inflammatory diseases. The problem can involve the cartilage, the inner lining of the joint capsule, the bone foundation upon which the cartilage rests, ligaments that surround the joint, and the fluid within the joint.
PAIN: The pain is characterized as dull to sharp with the first few steps in the morning and also in the evening after increased activities or with minor relief as it is “warmed up” during light walking and massage.
Ankle Arthroscopic video, cartilage grafting technique, Bone Marrow ‘Stem Cell’ injection, and patient experiences below:
Ankle Arthroscope:
This procedure is the gold standard for diagnosing problems within the ankle joint. It allows a small camera to go into the ankle through two small 1 cm incisions to the front of the ankle. Any damage to the ankle joint cartilage and inner joint wall lining is cleaned up and removed. Walking in a removable cast is allowed after 3 to 14 days.
Ankle Fusion:
Ankle Fusion This procedure is indicated for advanced arthritis and no relief of symptoms, restriction of joint motion or severe joint pain. After removal of remaining cartilage from the joint surfaces, internal fixation fuses the joint slightly less than 90 degrees from the leg to allow the front of the foot to clear the ground when walking. Non weight bearing in a cast is mandatory for 8 weeks and then full weight bearing at 12 weeks if there are no complications.
Ankle Replacement:
Ankle Replacement Although many new ankle joint replacement devices are in production, the follow up studies and outcomes are not as successful as other joint replacement procedures like the knee and hip. Dr. Moore has opted to wait until better devices are on the market and does not perform this procedure at this time.
Medications:
Oral anti-inflammatory medication can help with the chronic pain, but are not much help with the acute pain.
Immobilization or Arch Support:
Immobilization can vary from ankle bracing that allow some motion to complete immobilization with a Cam walker. Temporary arch supports, supportive athletic shoes, and custom molded orthotics are a great way to reduce the amount of forces and excessive motion at the ankle joint and other supportive foot joints.
Injections:
Cortisone for relief and Progenitor Cells (‘Stem Cells’) can be directly put into the joint where it can be most effective. These injections can be administered with minimal discomfort.
Reference:
ORTHROP How to tell if you have Ankle Arthritis
End stage Ankle Arthritis treatment
AOFCS Arthritis of Foot and Ankle treatment
If you have ankles that ache, give out, swell, ‘catch’, or simply feel unstable from previous accidents or fractures, then an arthroscopic examination is the best diagnostic and treatment tool for you.
GRAPHIC CONTENT: This is an actual arthroscopic examination with resection of joint pathology (removal of damaged cartilage and bone).ANKLE ARTHROSCOPIC PROCEDURE
Moving over the ankle joint, we’re very excited about the new treatment options for our patients with ankle pain and problems. We have created an entire ankle treatment clinic environment to help our patients who are experiencing ankle pain (including problems such as a sprained ankle, ankle fracture, twisted ankle, high ankle sprain, ankle swelling and ankle joint pain).
As is often the case, when the patient is struggling to explain their specific problem in the ankle, we almost always know where to start helping them. So, for example, patients if the patient says ankle sprain or ankle swelling, an ankle that gives out, an ankle that catches, an ankle that aches at the end of the day or only at nighttime, we know that all of these descriptions usually involve similar problems. So, we will start by offering oral anti-inflammatories and cortisone shots which can reduce ankle pain and push the surgery off into the future if that’s helpful to the patient.
Related to all of this is that fact that all medical specialties, including podiatry, have benefited from the science of arthroscopy. Specifically, the treatment of ankle problems has greatly improved now that we can scope the ankle just like the knee. The technology is really just a little TV camera. And, it’s literally, we don’t have to open it up, it’s two little holes in the front of the ankle joint here. You put the scope in and you can actually see what’s wrong with the ankle once you’re inside the ankle joint with the camera.
Along with the arthroscopy scope and MRI (to check out the ligaments and tendons), we also have some new treatment options with new biologics and injectables that have been developed as a result of stem cell therapy research. Specifically, we can put these materials inside the ankle joint after surgery to make it heal faster and possibly regenerate cartilage in the joint often eliminating any residual joint pain.
Some of our patients are to a level where the ankle joint is completely destroyed resulting in significant ankle pain. In the past, joint fusion was used (and can still be a good procedure occasionally for certain types of patients). We are pleased to offer patients a full ankle replacement (which is often the best solution). This ankle replacement device is a complicated piece of technology that has taken years to perfect. We are very confident with that is designed so that individual pieces can be replaced in the future without requiring the replacement of the entire device (a much simpler process). Moreover, given that the medical industry now has about 15 years of experience with these ankle replacement devices, it’s quite possible that the entire device will last for the life of the patient (as our experience with them has been outstanding in terms of durability).
‘Stem Cell’ research and surgical applications are advancing every year. On the market are several products for usage that range from donor cells to PRP and Bone Marrow Aspirate harvested from the patient.
Bone Marrow ‘Stem Cell’ treatment for Ankle Joint and Ligament
Ankle Arthroscope Surgery
This patient had an extensive work related injury and surgeries on both ankles. She explains her experience with the paperwork involved with her employer and our staff as well as her surgical per-operative period. CAUTION GRAPHIC CONTENT: This is the actual ankle salvage and cartilage graft surgery performed on a patient
APMA Definition, Causes and Treatment
Post Traumatic Osteoarthritis of the Ankle
AOFAS Article: Achilles Tendonitis Rupture Causes, Diagnosis and Remedy
These are links to more information on the subject, not intended to imply an endorsement.
Our doctors have extended specialist medical training focused on the foot, ankle and lower leg. We are board-certified surgeons and experts in delivering care for complex foot and ankle disorders as well as cosmetic or reconstructive procedures and problems related to sports injuries and other medical conditions.
This site is designed to help you understand your condition and make informed choices about treatment options.
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Moore Podiatry, Cosmetic Foot and Ankle Specialists
2616 Farm to Market 2920
Spring, TX 77388
(281) 444-6300
6550 Fannin St. Smith Tower, Suite 2427
Houston, TX 77030
(281) 444-6300
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