Ankle Arthritis Surgery Procedures To Know
Knowing procedures in the OR is vital for every medical device sales rep. Ankle arthritis surgery is among the treatments you’ll need a good understanding of when speaking with medical professionals.
Arthritis in the ankle occurs when cartilage in the ankle joint deteriorates. This causes pain and limits movement. Conservative treatment options include physical therapy, anti-inflammatory drugs, braces and inserts. But when these options fail to provide adequate relief, surgery may be necessary.
Surgical treatment options for rheumatoid arthritis and osteoarthritis in the ankle include several options. Let’s take a look at common treatments for ankle arthritis.
Common Surgical Treatments for Ankle Arthritis
Debridement and Exostectomy
Ankle arthritis causes bone spurs to develop and accumulate on the front of the ankle joint. These spurs can become large and break off into bony fragments. The cartilage in the ankle also starts to deteriorate, which causes pain and difficulty moving.
An ankle debridement and exostectomy clean up the ankle joint by removing inflamed tissue, and accumulated bone spurs and smoothing out the cartilage. This procedure is typically done in an outpatient setting and is performed arthroscopically.
These procedures can provide pain relief and restore range of motion. However, bone spurs can reform and scar tissue can develop. If this happens, surgery may be necessary. If a person has extensive damage, the surgeon may use open surgery.
Cartilage Repair
Cartilage repair happens when someone has a large, well-defined defect in the cartilage of the ankle. There are three options for cartilage repair.
Microfracture is the simplest option and involves damaged cartilage removal and the creation of tiny holes in the talus bone. These holes allow blood to flow into the holes and blood clots to form. The clots then eventually turn into fibrocartilage. The procedure is performed arthroscopically and on an outpatient basis.
BioCartilage is an extracellular matrix that provides an augmentation to the microfracture procedure. BioCartilage is a mix that is composed of collagen, proteins and other factors that are mixed with the patient’s stem cells and applied to the tiny holes in the talus bone.
The last option for cartilage repair is an osteochondral graft. This procedure uses cylinders of cartilage taken from the patient’s knee or a donor cadaver and grafts it onto the ankle bone. Unlike the other procedures, an osteochondral graft is an invasive procedure and may require breaking bone to reach the area to repair. It’s the final option when other treatments have failed.
Ankle Arthrodesis
If debridement doesn’t provide improved stability or pain relief, ankle arthrodesis, also known as an ankle fusion, may be an option. This procedure fuses the tibia and fibula with the talus bone. It increases stability and eliminates bone-on-bone friction. The surgery may be open or arthroscopic depending on the severity of the arthritis.
After debridement is completed, the surgeon will compress the bones and fix them in place with plates, nails, screws or additional hardware. This procedure reduces ankle flexibility, which may put additional strain on the foot and knee joints.
Ankle Arthroplasty
This is also known as an ankle replacement. The procedure involves the replacement of parts of the talus, tibia and fibula with prosthetics. Depending on the manufacturer implant, the top of the talus and the bottom of the tibia and fibula are removed and replaced with artificial prosthetics and a polyethylene pad, and may or may not be stabilized with cement.
Ankle replacement provides a better range of motion for patients, but success rates are lower than hip and knee replacements thanks to the ankle joint’s multidirectional physiology. Ankle replacements come with longer recovery times and patients are often advised to avoid high-impact activities once recovered.
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