The goal of foot and ankle surgery can be twofold: the first is always to preserve motion; and the second pertains to those patients with arthritis in one or more joints, which is to keep the arthritis from worsening, and which in turn offers pain relief.
When the pain of arthritis in the foot or ankle has progressed to constant, and is unrelieved by non-surgical methods of treatment including medication, exercise and the alternating application of heat and cold, and so forth, surgical intervention may be called for. The type of surgery varies greatly, depending on the type of arthritis (osteoarthritis, rheumatoid or post-traumatic arthritis), where it is located (ankle, hindfoot or midfoot) and even the age of the patient.
Dr. Vora might recommend ankle distraction arthroplasty in a younger patient with severe ankle arthritis who is not deemed a candidate for ankle fusion or an ankle replacement. While ankle fusion, also known as arthrodesis, fuses the bones of the joint completely with the use of hardware, distraction arthroplasty is a process that uses an external device to slowly pull the ankle bones away from each other in order to establish a maintained spacing of the ankle joint surfaces with less bone-on-bone rubbing. The intent of this procedure is pain relief that may last for a period of years.
Hindfoot arthrodesis or fusion of all three joints in the back of the foot is commonly seen in patients who suffer from arthritis. Those who present with flatfoot, which is caused by the progressive nature of rheumatoid arthritis whereby the alignment of the foot shifts with the movement of bones over time, may also be helped by a triple arthrodesis. While side-to-side movement in this type of fusion is lost, most of the up-and-down movement of the foot is preserved.
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