Foot and ankle

Total ankle replacement is an operation to replace a worn-out ankle joint by resurfacing the ends of your tibia and talus with metal components with a plastic insert in between them to allow gliding motion. These metal parts are attached to the bones with pegs or stems. They have a special coating to help your bones grow into them. Ankle replacement, also known as Total Ankle Replacement (TAR), is a new and improving technology. Thanks to better technology and research, we have a third generation of implants that are uncemented, three component, mobile-bearing implants.

Ankle fusion is an operation to turn a stiff painful joint into a stiffer but painless joint.  During this operation, the damaged cartilage is taken out from the ends of the bones. Then, the two bones are held tightly together using screws or plates until they join and become one solid bone (this is called bone fusion).

Greater understanding of the many complex components of hallux valgus and lesser toe deformities has led to more patient-specific surgery.  Surgery should only be considered if all non-surgical measures have been explored and if symptoms are significant.

An ankle arthroscopy is a procedure where two or three small holes are made in the front of your ankle. A tiny camera (about three to five millimetres wide) is then put into your ankle, letting the surgeon see and address issues inside the joint.

This method can treat various soft tissue and bone issues, like removing bony spurs, removing loose bone fragments, or smoothing out inflamed soft tissues (synovitis). The success and recovery rates depend on the particular problem you have, and the consultant surgeon will talk about these with you before any surgery.

The ankle is a hinge joint between the leg and the foot, and allows up/down and side/side movement. Stability is provided by strong ligaments either side of the ankle.

The lateral ligament (on the outside of the ankle) is made up of three bands connecting the fibula (the prominent bone on the outside of the ankle) and the talus (ankle bone) and calcaneus (heel bone). If the ankle is twisted, the ligaments can become stretched or torn. This is known as a sprained ankle.

This operation is usually performed under a general anaesthetic. An incision (cut) is made over the outside of the ankle. The stretched ligament is cut and then overlapped and sewn together again under tension. A thick band of tissue called the extensor retinaculum is sewn over the top, further re-enforcing it. The skin is then carefully sewn up and a plaster of paris cast is applied from below the knee to the ball of the foot. A patient will remain in plaster for four weeks and in an ankle brace for up to eight weeks after this.

This operation is usually done under a general anaesthetic. An incision is made over the outside of the ankle. There are two tendons called the ‘peroneal tendons’ that run along the outside of the ankle. A small portion (usually 1/3) of one of these tendons is used as a tendon graft. It is taken from the tendon along its length and passed through small drill holes in the ankle bone (fibula), tightened and fixed to the heel bone (calcaneus), which will reform the ankle ligaments. The skin is carefully sewn up and a plaster of paris cast is applied from below the knee to the ball of the foot. A patient will remain in plaster for four weeks and in an ankle brace for up to eight weeks after this.

Various foot conditions can cause discomfort, restricting your ability to move comfortably. It’s crucial to keep your feet strong and healthy. The foot is a complex part of your body, with 26 bones, 33 joints, and many tendons, ligaments, and muscles. Sometimes, the structure and mechanics of your feet or ankles can change (for various reasons), and surgery might be needed to address these changes. Typically, surgery is only considered after trying all non-surgical options.

The tibialis posterior is a muscle in the lower leg. The tendon from this muscle runs behind the inside bone on the ankle (called the medial malleolus), across the instep and attaches to the bottom of the foot. The tibialis posterior is important as it helps to hold the arch of the foot up and stop the foot rolling over. Sometimes the tendon becomes stretched and inflamed. This condition can be called Tibialis Posterior Tendon Dysfunction, Tibialis Posterior Insufficiency or Acquired Adult Flat Foot.