Pioneering foot and ankle surgery offered in Dorset
PUBLISHED: 10:26 22 March 2016 | UPDATED: 10:26 22 March 2016
State-of-the-art pioneering foot and ankle surgery is offered right here in Dorset, as Mr Heath Taylor, Consultant Orthopaedic Surgeon specialist at Nuffield Health Bournemouth, explains
We see a mixture of patients seeking advice on ankle and foot surgery, from young people with sporting injuries, to older patients suffering with arthritis.
We also commonly see people in their 80s and even 90s who are still fit, and want us to help them maintain their active lifestyles as long as possible. Total ankle replacement is a revolutionary ankle surgery which is enabling us to do exactly this.
One patient, Mr Garside, came to discuss his options with us. He was suffering with arthritis and pain in his right ankle and was looking for the best treatment to solve this issue.
Traditionally when looking at surgical options, fusion surgery can help to ease pain however, it also stiffens the joint so a person would lose the normal up and down movement in their ankle.
In Mr Garside’s case, his ankle was tilting and collapsing over, a common occurrence with arthritis. He still had movement so we looked at total ankle replacement with a combination of metal and plastic implants. A key advantage of this type of surgery is that it removes the arthritic joint but keeps the movement.
One of the most important parts of the ankle replacement is getting the alignment of the implant correct. Previously we used x-ray guidance which was less precise. With total ankle replacement a patient has a CT scan of their joint. The scan details are sent to America where a special 3D printout of the ankle, called a ‘jig’, is produced.
The jig is based on the patient’s exact anatomy, and from the information provided medical engineers plan how we will fit it onto the leg with something called a ‘Preoperative Navigation Guide’.
We get to approve the plan before the jig is cut – this whole process takes between four to six weeks. Once cut, it arrives back to us as the perfect size match for the patient. The angulation of the joint is even corrected; so the operation takes much less time due to the precision and it is also much more predictable.
With a standard ankle replacement operation it can take a lot of time to assess the alignment using a lot of x-rays to get guide pins in the right place. With total replacement, the incision is made, the custom made joint is fitted onto the patient’s bone, and four pins are placed. It’s quick, efficient and exact.
The surgery itself is between one-and-a-half to two hours, the custom jigs reduce operating time by 20 to 30 minutes, with the majority of patients going home the next day with a half plaster which stays in place for around two weeks, before a follow-up examination. Then they’ll be wearing a walking boot and be fully weight-bearing without crutches. With conventional fusion surgery, the average is another four or so weeks in plaster and then on crutches.
Less than three months after having his ankle replaced, Mr Garside was back cycling and managing around 15 to 20 miles on his bike. It’s very rewarding to see patients benefitting from cutting edge surgery so they can live independently and keep active.
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