By Thomas J. Haverbush, M.D. Orthopaedic Surgeon
Transforming patient information into patient understanding.
I know all of you have been breathlessly waiting all week for the thrilling conclusion of “Arthritis of the Foot and Ankle.” Your wait is over. Ready. Here we go........
I often tell patients in the office there is, or should be, a “menu of treatment” for various conditions, this being one of them. By that I mean there are always options and the patient should be told what they are just like you have choices on a menu. It is my job to help the patient make the right choice for them in a particular situation.
Since the great majority of my patients do not want to hear about surgery as the first option in the office I will do the same here.
Nonsurgical Foot and Ankle Treatment
All of these don’t apply to every situation, but there are a lot to work with here.
• Nonnarcotic pain relievers. Don’t begin taking Norco, Vicodin etc.
• Anti-inflammatory medications can reduce pain and swelling.
• Shoe inserts or pads placed in your present good supporting shoes.
• Custom made shoes often have a stiff sole with a rocker bottom.
• Custom made inserts (orthotics)
• An ankle brace
• A cane
• Physical therapy
• Weight control
• Medication such as a steroid injected into the foot or ankle.
So don’t give up hope if you haven’t tried some of these measures which can be very effective.
If arthritis hasn’t responded to nonsurgical treatment, then surgical treatment might be considered. The choice of surgery I may choose will depend on the type of arthritis, the impact of the disease on the joints and the location of the arthritis.
Surgery performed for arthritis of the foot and ankle can be placed in three categories. Arthroscopic treatment, fusion of a joint and arthroplasty (replacement of the affected joint).
Arthroscopic surgery has been around for decades and everyone knows about it (unless you live in a cave!). But many patients do not know that it can be used in smaller joints too.
The arthroscope and instruments are smaller, but the principles are basically the same. There are a wide variety of small instruments to aid us in debriding or cleaning up the joints and to remove tissue and bone.
Sometimes when a joint in the foot or ankle is so damaged by previous trauma or disease it is best to fuse the joint together so it does not move anymore and therefore doesn’t hurt.
I have a wide variety of pins, plates and screws available to fuse joints. Sometimes a bone graft is needed to aid healing which I typically take from the patient’s pelvic bone.
Arthroplasty of Joint Replacement
Joint replacement of the hip, knee and shoulder are very common place in today’s Orthopaedic Surgery world.
Total ankle replacements however are done very occasionally. The results after total ankle replacement have never been as successful as total hip and knee replacements. There are many technical reasons for this that I don’t need to go into.
Well, our mini course on foot and ankle arthritis is ending. Hope you learned something and hope you have a good week.
Lakeview Times Orthopaedic Zone
All Orthopaedic Surgery problems including this week’s subject can be evaluated by Dr. Haverbush at his office.
315 Warwick Drive
Alma, Michigan 48801
Office is across the street from Gratiot Medical Center.
Please call to make an appointment usually the same week you call.
Attention!! Besides what you read today there is a huge amount of musculoskeletal information on the office website www.orthopodsurgeon.com. Please check it out.