Role of Arthroscopy in Various Ankle Disorders

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Professional Ankle Arthroscopy Services | Sforzo Dillingham

What is ankle arthroscopy? Ankle arthroscopy surgery is a minimally invasive type of surgery performed to help alleviate ankle pain.  Small incisions are made about the ankle and a camera is used to look inside the ankle.

Injuries like the osteochondral injury of your talus, ankle fractures, forms of tendonitis, ankle impingement, and ankle sprains are some of the causes of ankle or foot conditions that may require arthroscopy procedure. In some cases, ankle arthroscopy can become an alternative treatment method to open ankle surgery.

Arthroscopy plays a critical role in diagnosing and treating different ankle joint disorders. 

Some of these problems may include:

Ankle arthritis: This is condition refers to end-stage ankle arthritis. The procedure applied in treating ankle arthritis is called ankle fusion, and it involves ankle arthroscopy. This treatment option provides a minimally invasive way of performing ankle fusion. 

Ankle fractures: Your surgeon may suggest ankle arthroscopy along with the open surgical procedure to repair an ankle fracture. This treatment procedure ensures normal alignment of cartilage and bone within your ankle. It also helps locate injured cartilage inside the ankle when performing ankle cartilage repair. 

Ankle instability: Whenever your ligaments stretch out (within the ankle), they can make you feel like the ankle is giving way. Your orthopedic surgeon can use the ankle arthroscopy technique to repair damaged ligaments or tighten them through surgery. The arthroscopic technique is the ultimate solution to treating moderate instability in your foot. 

Reasons for Ankle Arthroscopy

You need to know that not every ankle pain problem is treatable by an arthroscopic procedure. However, there are numerous reasons why you should opt for ankle cartilage repair, ankle debridement, or knee scraping surgery. 

Some of these reasons include:

1. Restoration of Your Ankle Cartilage Damage

Sustaining injury on your ankle joint can cause cartilage damage. If you don’t get treated at the right time, your ankle cartilage may cause generalized arthritis around the ankle joint. With ankle arthroscopy, our surgeon Dr. Christopher L. Dillingham at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, will be able to assess the injured areas of your cartilage damage before restoring the normal cartilage surface to the ankle joint. In this case, your Ankle cartilage repair may involve stimulating new cartilage growth using a microfracture, chondrocyte implantation, or cartilage transfer. Alternatively, your surgeon will repair the damaged cartilage surgically. 

2. Removal of Bone Spurs in Your Ankle Joint

Sometimes bone spurs may form in the front of your ankle joint. This formation of bone spurs causes your ankle to pinch whenever you push your foot towards the shin. Another name of this condition is anterior ankle impingement syndrome, footballer’s ankle, or athlete’s ankle. To remove these floating bone chips in the ankle, you need to go for ankle arthroscopy. In addition, the removal of bone spurs from your anterior ankle can help improve the motion of your ankle joint. 

3. Surgical Removal of Inflamed Synovium

Synovitis describes the inflammation of soft tissue lining around your ankle joint or synovium. This type of inflammation can easily manifest as ankle swelling after knee surgery, pain, or complete loss of motion. Synovitis occurs due to acute trauma, rheumatoid arthritis (inflammatory arthritis), and degenerative joint disease or osteoarthritis. Ankle arthroscopy can help remove inflamed synovium. 

Ankle Arthroscopy Diagnosis

Before the treatment for your injured  ankle starts, the surgeon will perform some diagnostic tests such as:

1. X-ray: Usually, the X-ray provides images of bones within the ankle. In the case of a broken bone joint, your orthopedic surgeon will be able to point out the exact place that needs arthroscopic surgery.
2. MRI: Magnetic Resonance Imaging (MRI) is another test that your surgeon will perform to rule out other problems that may affect your ankle. This non-invasive imaging technology produces clear three-dimensional detailed images for effective diagnosis of the injured ankle.
3. EMG: Electromyography is a diagnostic procedure that Dr. Christopher L. Dillingham at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine performs to assess the condition of the muscles and nerve cells around the ankle. Your surgeon will identify damaged muscles, nerve cells, and even ligaments within the ankle through EMG.

Ankle Arthroscopy Treatment – Surgical

Surgical procedure using ankle arthroscopy with debridement is carried out under regional or general anesthesia. Once adequate anesthesia is administered, the surgeon creates an incision or “portal” that provides access to the damaged ankle joint. Mostly, portals are strategically placed in a specific location to help minimize the potential for damage to surrounding blood vessels, tendons, and nerves. These portals also reduce the size of ankle surgery scars after recovery. 

The Procedure of Ankle Arthroscopy

During the ankle arthroscopy procedure, your surgeon will follow these steps:

1. Adequate regional or general anesthesia is established, followed by the application of a tourniquet.
2. The leg is propped and draped carefully in a sterile fashion.
3. Mechanical distraction devices are used to help the surgeon temporarily enlarge the space of the injured ankle.
4. At least two small incisions are made. One incision is used to insert a small camera, while the other is for inserting surgical instruments.
5. Sterile fluid can flow inside the ankle via the incisions to further open the joint.
6. At the end of the procedure, the surgeon places small sutures in the skin to secure or close the portals.
7. A sterile compressive dressing, a boot, or splint is applied before taking you to a recovery area.

This procedure applies to both right and left ankle arthroscopy.

Risks of Ankle Arthroscopy Surgery

Just like other ankle surgery types, ankle arthroscopy has its own risks. Ankle swelling after the surgery and visible ankle surgery scar are some of the common risks that come with this procedure. Other risks include injuries to the tendons or nerves surrounding the ankle joint, damage, and infections to the ankle joint cartilage. 

Post-Operative Care of Ankle Arthroscopy Surgery 

Post ankle arthroscopy surgery care includes:

• Elevation of the affected leg
• Taking oral pain killer medications for several days
• Restriction of bearing weight on the injured leg
• Progressive weight-bearing with crutches
• Active range of motion as part of physical therapy
• Progressive strengthening routine
• Routine follow-up with your doctor

Find the Best Ankle Arthroscopy Center near me in Sarasota, Florida

At Sforzo I Dillingham I Stewart  Orthopedics + Sports Medicine in Sarasota, Florida, our doctors specialize in performing different types of surgical operations, including ankle arthroscopy. The doctors go the extra mile to help those suffering from ankle pain (due to injury or trauma) get the expert care and treatment you deserve. 

Our surgeon Dr. Christopher L. Dillingham at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, works hard with patients to determine the most appropriate treatment option for their condition. At Sforzo I Dillingham I Stewart Orthopedics you will get expert medical care and treatment in line with your ankle injury. All doctors are board-certified and fellowship-trained orthopedic surgeons with many years of experience in performing technically difficult surgical procedures. 

Final Thought

Arthroscopic ankle surgery is a treatment option for different types of ankle pain, including loose ankle, posterior ankle pain, and cartilage damage. During the surgery, a small incision is made by your surgeon to pave the way for the arthroscopy camera to be inserted inside the damaged ankle joint. These incisions also help your surgeon to insert surgical instruments to remove or repair damaged structures. 

Arthroscopy recovery time may vary depending on the nature of your ankle injury and damage to the cartilage. Typically, the ankle arthroscopy recovery time can range from three weeks to six weeks. For additional information on ankle arthroscopy surgery, contact Sforzo I Dillingham I Stewart  Orthopedics + Sports Medicine today.

Treatment Foot & Ankle

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As healthcare is ever changing, Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, is doing things differently…

• Christopher R. Sforzo, M.D.

  
  
  
  Christopher R. Sforzo, M.D. is a board certified orthopedic surgeon and fellowship trained in hand and upper extremity surgery. He provides expert care in the treatment of problems involving the shoulder, arm, elbow, forearm, wrist and hand.
  
  He performs many procedures using minimally invasive techniques includi

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• Christopher L. Dillingham, M.D.

  
  
  
  Christopher L. Dillingham, M.D. is a board certified orthopedic surgeon and fellowship trained in hand, shoulder, and arm surgery. He specializes in the treatment of problems with rotator cuff disorders, carpal tunnel syndrome and nerve injury, joint replacement, arthritis surgery, fracture repair, foot and ankle

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• Charles E. Stewart, M.D.

  
  Charles E. Stewart M.D. is a board-certified, Johns Hopkins fellowship-trained orthopedic surgeon specializing in adult complex reconstruction of the lower extremity.  His specialties include lower extremity sports injuries, meniscal injuries, ACL reconstruction, partial knee replacement, total hip and knee arthroplas

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• Philip A. Meinhardt, M.D.

  
  Philip A. Meinhardt, M.D. is a board certified orthopedic surgeon and fellowship trained spine surgeon. He specializes in adult spinal surgeries including reconstruction of spinal deformities, minimally invasive/microscopic spinal procedures, decompression, spinal instrumentation, fusion procedures and microscopic cer

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Testimonial

After tearing my rotator cuff, not only was I experiencing pain but my quality of life was diminished. Playing golf and working out were painful rather than enjoyable. Graci and I sought out Fellowship trained Dr. Christopher Sforzo and the team at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine. I was treated non-surgically and am now pain free, mobile and enjoying everything I did before.

– Dennis and Graci McGillicuddy

As avid golfers and tennis enthusiasts, our rotator cuff injuries left us in pain, and unable to enjoy our sport. In researching for the most qualified surgeons, we found that Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine not only had the highest level of training and experience, but they were also highly recommended by friends and associates who had excellent results. We, too, had outstanding…

– Mike Wilton, Bud Polley and Arnie Vance

I was visiting the area looking at property and considering a full time re-location from Minnesota when I was in a traffic accident. The result was a very painful shoulder injury that would ultimately require bilateral RTC repairs. I was unable to undertake regular day-to-day activities or participate in my favorite sport – tennis. It was essential that I choose a shoulder specialist that could quickly set…

– Pat Cooper

Over the years we had seen several orthopedists in town but were never impressed. They seemed to lack knowledge or compassion or both. Then when Liza was in high school, she went to Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine for a minor sports injury. They not only diagnosed her somewhat obscure problem, but explained things in a way that she understood without being patronizing…

– Liza, John and Betsy Kane-Hartnett

As a very busy business owner in Sarasota, having not one, but two, massive rotator cuff tears had a debilitating effect on both my personal and professional life. From my first consultation with Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, I knew I was in good hands. The surgeons are board-certified and fellowship-trained, which gave me the confidence in achieving a successful outcome. More importantly,…

– Bob Kirschner

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Ankle arthroscopy – Nordorthopaedics

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Reviews

Svetlana, Ukraine

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I am 59 years old, my diagnosis is aseptic necrosis of the hip joint. I was completely calm and confident, the manager Elena protected me from any worries. In the clinic, everything is so rationally organized, thought out to the smallest detail, that the patient is simply obliged to recover. The patient is the king there, everyone loves you and fulfills all desires. Surgeon, anesthesiologist, nurses work as one team for the result! Everything was done according to all the rules of medical art. I wish success and prosperity to the Nordorthopedic clinic!

Vera, Ukraine

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Excellent Clinic, everything went well, on the second day I got up and on the 3rd day I left for rehabilitation. The clinic staff is excellent as well. I was met, brought to the hotel, the next morning they brought me to the clinic, then after the operation they took me to rehabilitation and after 21 days they took me to the airport. I recommend the clinic for joint operations!

Anna, Ukraine

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On March 21, 2022, I was fortunate to be at the Nordorthopedics Orthopedic Clinic, where I had a hip arthroplasty in my right leg. In 2019 year, I was successfully operated on my left leg in the same clinic. Now I I can be a healthy person. A deep bow to the miracle surgeon Sharunos Tarasyavichus. He has truly golden hands. Many thanks to all the medical staff for their care, pleasant treatment of clients. I would especially like to express my gratitude to the customer service specialist Elena Pozharitskaya. She solves all issues with great responsibility and love. I am immensely grateful to everyone for giving me life.

Gerry, UK

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I was on the UK National Health Service’s waiting list for hip surgery for almost two years and was told that I might have to wait another two years, then I decided to consider options for private clinics. I spoke with several people who had surgery at the Nordorthopaedics clinic and they confirmed the professionalism and good care in this clinic. I just had a hip replacement at Nordorthopaedics and would recommend this place to anyone. Everything was professional, well organized, the staff paid a lot of attention. The price of the surgery was great and you would be surprised how much it cost.

Karen, Canada

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The clinic looked too good to be true, but everything they claim is true. The care I received from the doctor and nurse was excellent. There is also an option for follow-up treatment at a rehab center which I highly recommend. This gives you time to recover from surgery before the long flight home.

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Our patients

Elimination of Elena’s hallux valgus

Video about the operation to eliminate valgus deformity of the foot, performed at the Nordorthopaedics clinic in Lithuania. In this video you will see our patient Elena from Kaliningrad, who told us about her motivation and problem.

Elena’s knee arthroplasty

Video of the knee arthroplasty performed at the Nordorthopedics clinic for patient Elena. Elena, who arrived at the clinic for the second time, spoke about her recovery after the first operation.

Hip arthroplasty by Irina

Video about hip arthroplasty performed at the Nordorthopaedics clinic. In this video you will see our patient Irina from Russia, who told us about her motivation and impressions.

Rehabilitation center

Rehabilitation center in Druskininkai – equipped according to the latest modern standards. The center has a cozy and pleasant atmosphere, corresponding to the standard of a four-star hotel.

Nordorthopaedics Center of Excellence

One of the world’s leading medical technology companies and manufacturers of orthopedic prostheses Smith & Nephew has chosen Nordorthopaedics as its exclusive partner in the Baltics and the clinic is now the company’s center of excellence in the region.

Our surgeon – Vytautas Kimtis

• Work experience over 20 years
• 500 ankle joint replacements
• 1.000 ankle arthrodesis operations

901 50 Fluent in Russian and English

• Co-author of 3 scientific articles presented in various medical journals.

• Find out more

Our clinic

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How do we differ from other clinics?

Experienced surgeons

Our clinic employs highly professional and educated surgeons. They have over 10-20 years of experience in the field of orthopedic surgery. Each of them performs 500 operations per year. In addition, our surgeons are members of various prestigious surgical societies, both Lithuanian and international. Our joint replacement surgeon S. Tarasevičius is the author of 150 scientific publications in various medical journals. More information about our surgeons can be found here.

Modern clinic

The clinic is equipped with modern diagnostic and surgical equipment, similar to what is available in clinics in Western Europe. Professional Russian speaking staff will take care of you. The rooms are fully furnished and equipped with TV, toilet and air conditioning. The clinic has free Wi-Fi.

One of the largest surgical centers in the Baltic States

Our clinic is one of the largest surgical centers in the Baltic region. We work with patients from different countries, including the UK, Ireland, Norway, Sweden, Spain, Denmark, Germany, Switzerland, Canada, etc.

Despite the size of the clinic, we provide our patients with personalized care and assistance. Most large public hospitals, due to the large number of patients, do not have sufficient resources and medical staff to give individual attention to each patient. While we are fully focused on providing exceptional care and undivided attention to our patients.

At no additional cost, patients are cared for as long as they need at the clinic. This may take up to 3 days. We only discharge our patients from the clinic when they are in good condition and ready to leave.

Half price

Price for all inclusive, which is twice lower than in Western European clinics.

Our clinic employs professional doctors with higher education and experience, and uses the same materials as in clinics in Western Europe. Most often, the quality of the equipment of our clinic exceeds that in the clinics of Western Europe. The difference in prices is only explained by the significantly lower average salary and taxes, which is the main reason for medical travel around the world.

Medical care according to European Union standards

Our clinic operates in accordance with the highest standards of the European Union. This helps to ensure the quality of medical care.

24/7 personal assistance

During your entire stay in Lithuania you will receive personal assistance as well as transport to and from the clinic, hotel and airport. You don’t have to worry about anything. You will be assisted from the moment the plane lands at Vilnius or Kaunas airport until your departure.

No Queues

We don’t have a queue so we can schedule your operation as soon as you are ready.

Russian-speaking staff

Everyone in our clinic speaks Russian, including nurses, assistants and the surgeon.

Testimonials from former patients

You can find many testimonials from our previous patients on the Internet. Reading these reviews on Google or Facebook can help you make your final decision.

Direct flights

Regular flights from all major airports in Russia. It is also very easy to get to Lithuania by train. Lithuania is closer than you think. Here you can find a list of all major flights and trains. Please note that airlines often add new flights and new destinations, so please contact us if you need help choosing the flight that is best for you.

Country authority

Lithuania has been part of the EU and NATO since 2004. Lithuania has one of the fastest growing economies in the entire region and the second fastest internet speed in the world. Lithuanian medical schools have trained many medical professionals who are highly regarded and work in many foreign hospitals, including UK hospitals. Our clinic operates in accordance with the highest standards of medical institutions of the European Union.

What is arthroscopy and under what conditions is it necessary?

Ankle arthroscopy is a minimally invasive joint surgery designed to treat ankle pain and improve overall joint function through small incisions. Then, using a special miniature camera (arthroscope), the surgeon examines the cartilage, ligaments, and bones inside the joint. The arthroscopic approach is used to diagnose and treat the following joint problems:

Ankle arthritis

Ankle instability

Anterior impingement syndrome

Synovitis

Loose intraarticular bodies

Posterior impingement syndrome

Ankle arthritis

Ankle instability

Anterior impingement syndrome

Synovitis

Loose intraarticular bodies

Impingement – rear end syndrome

Advantages and disadvantages of ankle arthroscopy

Ankle arthroscopy has many advantages:

• 
  First, ankle arthroscopy is performed through tiny incisions, so recovery is quicker and easier.
• 
  Scarring is minimal, so the patient experiences less pain and postoperative care is greatly simplified.
• 
  Compared to open ankle surgery, ankle arthroscopy has a lower risk of complications and a relatively shorter recovery time.
• 
  The patient can return to professional sports 4-6 weeks after the operation.

However, all transactions involve a certain level of risk
However, all transactions involve a certain level of risk. Remember that surgical complications are extremely rare and our medical staff provide the highest quality of patient care. We believe that the patient should be well informed about the possible complications, which include the risk of infection, bleeding, blood clots, and damage to adjacent vessels and nerves.

Ankle arthroscopy preparation

First consultation

The patient needs to go to the clinic to get a preliminary consultation. During the first consultation, the patient should be prepared to discuss their medical history, allergic reactions, and medications they are taking at the time. The initial consultation is designed to decide on a treatment plan and evaluate the patient’s overall health.

Smoking and alcohol

It is strongly recommended that you stop smoking and drinking alcohol at least 4 weeks before surgery. Smoking affects blood clotting and impairs blood flow, which increases the risk of complications.

Medications

We encourage patients to make a list of all medications they are currently taking so they can discuss it with their doctor. Certain medicines such as aspirin, ibuprofen, coumadin, naproxen, should be avoided before surgery due to their blood-thinning properties. Some herbal teas, garlic, and fish oils should also only be taken with a doctor’s approval.

Patients should follow a healthy diet, eating foods rich in all vitamins and minerals. Vitamins (A, D and C) and minerals (zinc, calcium and iron) are responsible for the proper functioning of the immune system and bone formation.

After the operation date is clear

Once the date of the operation is clear, it is time to prepare for the postoperative recovery period. The first few weeks after surgery, patients mostly rest at home. Thus, it is necessary to rearrange the furniture and stock up on easy-to-prepare foods.

On the day of surgery

On the day of surgery, patients should wear loose clothing so that it can be easily put on over the ankle cast if required. It is better for the patient not to use nail polish or cosmetics and to leave valuable jewelry at home. In addition, you should refrain from eating and drinking 8 hours before surgery

How is ankle arthroscopy performed?

Before surgery

During surgery

After the surgery

Before surgery

During surgery

After the surgery

Ankle arthroscopy recovery

After surgery, patients wake up in the recovery room. Feeling tired and dizzy is completely normal and to be expected. A bandage is put on the operated leg and kept in an elevated position so as not to reduce swelling. During the first few hours, the pain is relieved by intravenous administration of drugs. Usually, most patients can get up and walk with crutches on the day of surgery. Before discharge from the clinic, patients are prescribed pain medication and given information about postoperative wound care. Stitches are usually removed after 2 weeks after surgery.

While at home, we recommend that patients rest as much as possible and keep the operated leg elevated. Consider purchasing a foam ramp to keep the leg elevated overnight. Many patients can expect to return to work within 1-2 weeks after surgery unless advised otherwise by their doctor. Recovery may take at least 4-6 weeks before the person can return to sports, driving, and other physical activities.

Postoperative wound care

Proper postoperative wound care promotes wound healing, reduces the risk of infection and prevents scarring. Any incision in the skin is an easy access for germs that can enter the body and cause an infection. To prevent infection of the surgical site, wash your hands with soap and water or use alcohol-based disinfectants before and after touching the operated area. The bandage should be clean and dry for the first 24 hours. Through 5-7 days the patient may shower and gently wash the wound with soap and water without wetting it too much. The bandage should be changed every day as it gets wet or dirty. Keep in mind that if the wounds are closed with non-absorbable sutures, you should not try to remove them yourself, it is better to wait until the doctor removes the sutures properly.

Physiotherapy and return to sports

Each week of rehabilitation has different goals and objectives. Gradually going through the stages of recovery eventually leads to a successful return to daily activities and professional sports.

Week 1 . The first week after surgery involves a lot of rest. The operated leg should be slightly elevated so that it does not hurt or swell. Light bruising and moderate pain is normal. Over-the-counter medications such as naproxen or ibuprofen help relieve pain. If the operation was done on the left ankle, the patient may start driving after the first week.

Week 2-3 . 2 weeks after the operation, patients come for a follow-up appointment, during which the doctor checks the operated joint and, if necessary, removes the sutures. Patients are instructed in recovery exercises that include rotating the foot (“drawing” circles), moving the foot up and down, bringing the knees to the chest, and gentle stretching. Exercise should be performed three times a day to prevent ankle stiffness. Patients may begin walking short distances, but the leg should be kept elevated for as long as possible. Some may start working from home. However, returning to standing work should be delayed by at least 4 weeks.

Week 4. The patient should continue to move regularly and increase the frequency of exercise up to 6 times a day. If the wounds are completely healed, the patient can move on to swimming or cycling.

After surgery, the joint may remain slightly swollen for up to 3 months. Returning to professional sports requires a gradual increase in the level of activity and the complexity of training. The time it takes to fully recover varies from patient to patient.

Results of treatment of the ankle joint and foot

Patient Viktor T., 58 years old, builder

The primary injury more than 40 years ago, as a result of a fall from a height, was treated conservatively, without a positive effect.

In 2015 he asked for a consultation complaining of pain, deformity, inability to support the injured limb and walk normally.

• After a clinical examination and examinations, the following diagnosis was made: Post-traumatic deforming arthrosis of the left ankle and subtalar joints, stage 4. Diabetes mellitus type 2, moderate to severe course.
• Completed: arthrodesis of the ankle and subtalar joints.

The postoperative period was uneventful, and after completing the rehabilitation course, the patient was able to return to the profession.

In 2016, the patient underwent a second surgery, during which the fixators were removed.

As in 2015, the postoperative period was uneventful.

Before surgery

6 months after surgery

Patient Maria Z., aged 23, ballet dancer

During her career, the patient had repeated injuries to both ankles and feet.

In 2015, she asked for a consultation with complaints of pain in the anterior-outer parts of the right ankle joint that occurs during and after physical exertion, the inability to rehearse and perform; the patient was repeatedly consulted in various medical institutions in Moscow, for a long time she was treated conservatively, without a positive effect.

• After a clinical examination and examinations, the diagnosis was made: Anterior-lateral soft tissue impingement of the right ankle joint.
• Completed: ankle arthroscopy.

The postoperative period was uneventful, and after completing the rehabilitation course, the patient was able to return to the profession.

One month after surgery

In 2017, Maria again applied for a consultation, complaining of pain, swelling in the posterior sections of the left ankle joint and foot, inability to fully rehearse and perform.

After a clinical examination and examinations, the diagnosis was made: Triangular bone syndrome, tenosynovitis of the extensor tendon of the first toe of the right foot.

Taking into account the busy touring schedule of the patient, a course of conservative treatment was initially carried out, including: intra-articular injections, shock wave therapy, physiotherapy.

This made it possible to reduce the pain syndrome and made it possible for Maria not to interrupt performances and rehearsals. As soon as possible, the patient was operated on.