New Surgical Technique Repairs Arthritic Ankle Damage

News from the 2005 Annual Scientific Conference of the American College of Foot and Ankle Surgeons -


There's good news for anyone with
painful arthritic ankles -- a new surgical procedure imported from Europe is
showing encouraging results for relieving chronic arthritis pain without
taking away the overall movement and function of the joint.


The new ankle procedure was first reported in France and involves an
external-fixation procedure that applies tension to expand the joint and leave
room for new cartilage to form, thereby eliminating painful bone-on-bone
pressure, according to ACFAS President-elect James L. Thomas, DPM, FACFAS, a
foot and ankle surgeon practicing at the University of Alabama Birmingham.
"This is an exciting new approach for treating chronic ankle arthritis," said
Thomas.


In an oral presentation at the American College of Foot and Ankle Surgeons
Annual Scientific Conference, Brad Lamm, DPM, AACFAS, a foot and ankle surgeon
affiliated with Sinai Hospital in Baltimore, reported that ankle-joint
distraction with external fixation for treatment of ankle arthritis is
starting to gain acceptance among foot and ankle surgeons in the US, although
its use has been limited.


"Most patients with ankle arthritis want to preserve a functioning joint
and are looking for alternatives to ankle-fusion procedures and joint
replacements to relieve their pain," said Lamm. "While fusion surgery has
been a mainstay for many years and works very well for pain relief, fusing the
ankle joint makes it immobile and permanently stiff. Ankle joint distraction
with external fixation preserves the joint, eliminates pain and increases
function," he explained.


Though new for treating ankle arthritis, minimally invasive, external-
fixation techniques are widely used by foot and ankle surgeons to repair
fractures. Bones are immobilized with pins, screws or wires, which are
secured outside the skin with clamps and rods that form an external frame.


For treating ankle arthritis, wires inserted through the skin are attached
to the frame, and the resulting tension pulls apart the ankle joint, creating
space for new cartilage to replace what was destroyed by arthritis. Prior to
applying the fixators, the foot and ankle surgeon may perform ankle
arthroscopy to clean out arthritic tissue and bone spurs.


Most external-fixation surgeries are performed in less than three hours
and the risk of infection is minimal. The patient can walk with the frame in
place the day after surgery and the fixators remain in place for about four
months until new cartilage is in place.


Thomas noted that even though the initial experiences with external
fixation for chronic ankle arthritis have been encouraging, more long-term
studies are needed before the procedure becomes a mainstream treatment for
these patients.


For further information about foot and ankle conditions and treatments and
to locate a foot and ankle surgeon in your area, contact ACFAS at
FootPhysicians.


The American College of Foot and Ankle Surgeons is the professional
organization for foot and ankle surgeons, doctors of podiatric medicine (DPM)
who are graduates of four-year podiatric medical colleges and have completed
surgical residencies. The organization is dedicated to developing surgical
standards for the care of the foot and ankle, sponsoring research, and
providing continuing education for its members.


American College of Foot and Ankle Surgeons

FootPhysicians