FAQ Category: Ankle


Next week I am having arthroscopic surgery to remove a tiny bone caught between the lower leg bone and the heel bone. I expect to have a full and easy recovery. But I would like to know more about other patients’ experiences. Does anyone “fail” with this kind of operation? What happens then?

It sounds like you may have an os trigonum. This bone is located on the talus, which is part of the ankle. When the foot and ankle are plantarflexed (toes pointed downward), the os trigonum (and soft tissues attached to it) get pinched between the tibia (lower leg bone) and […]


I am a dance instructor in a large city. I’ve always known I have an extra bone (os trig?) in my ankle that should come out but I haven’t wanted to be off work for any length of time. Now it looks like I’ll be forced to have it done because I can hardly walk on it much less dance. I see that most of these procedures leave only a tiny scar. The surgeon I spoke with called it “minimally invasive.” That doesn’t matter to me now so much as the recovery time. Is there any kind of surgery that can get me back on me feet faster (fastest)?

Many people are born with that extra little bone in the ankle called the os trigonum or os trig for short. Studies show that up to 50 per cent of all people have this anatomic anomaly. Without an X-ray or other imaging study, they might never know about it. It […]


Next week I am having arthroscopic surgery to remove a tiny bone caught between the lower leg bone and the heel bone. I expect to have a full and easy recovery. But I would like to know more about other patients’ experiences. Does anyone “fail” with this kind of operation? What happens then?

It sounds like you may have an os trigonum. This bone is located on the talus, which is part of the ankle. When the foot and ankle are plantarflexed (toes pointed downward), the os trigonum (and soft tissues attached to it) get pinched between the tibia (lower leg bone) and […]


I am a dance instructor in a large city. I’ve always known I have an extra bone (os trig?) in my ankle that should come out but I haven’t wanted to be off work for any length of time. Now it looks like I’ll be forced to have it done because I can hardly walk on it much less dance. I see that most of these procedures leave only a tiny scar. The surgeon I spoke with called it “minimally invasive.” That doesn’t matter to me now so much as the recovery time. Is there any kind of surgery that can get me back on me feet faster (fastest)?

Many people are born with that extra little bone in the ankle called the os trigonum or os trig for short. Studies show that up to 50 per cent of all people have this anatomic anomaly. Without an X-ray or other imaging study, they might never know about it. It […]


I can’t believe this but I helped a friend push his car off the road and got a ruptured Achilles tendon for my efforts. Didn’t know how bad it was until it was too late to repair. Now I’m facing major surgical reconstruction. What are my chances or a full recovery?

Adults of all ages can experience a rupture of the Achilles tendon. A simple event like running to catch a bus, stumbling on the floor, or playing with children can lead to this type of injury in the nonathletic adult. And yes, even helping a friend push a car can […]


Have you ever heard of using the hamstring muscle to repair the Achilles tendon? This is the type of surgery my surgeon wants to do on me. But I can’t see injuring another area of the body (hamstring muscle) to fix the first problem (Achilles tendon rupture). What do you think?

There are many different ways to approach the problem of a chronic Achilles tendon rupture. Surgery is usually necessary when there is a large gap between the tendon “stump” (end of tendon that ruptured and pulled away) and the bone where the tendon is supposed to attach. After an acute […]


I had a very bad ankle injury when I was a teenager and now in my early 30s, I’m starting to have some significant pain and loss of motion in that ankle. Could this be early arthritis? (I hope not…)! What should I expect now?

Ankle osteoarthritis (OA) is not as common as hip or knee OA but it still occurs. And the people affected most often are indeed individuals who had a previous injury or trauma of some sort. Most are younger like yourself who were not expecting such a decline in function so […]


I’m doing some looking on-line about stress fractures and how they should be treated. My situation is a little bit more complicated than a simple stress fracture because I have an ankle joint replacement and the fracture is in the bone around the implant. What can I expect when I see the orthopedic surgeon about this?

It doesn’t happen very often but as you have discovered, an ankle fracture after a total ankle replacement (TAR) is possible. Treatment depends on multiple factors such as your age, your activity level, the location of the fracture, the stability of the implant, and the presence of damage to other […]


My cousin went all the way to Switzerland to have her ankle replacement done. She complains all the time about the pain still continuing and having limited motion on that side. Could she have gotten a better result having the surgery here in the USA?

In Switzerland, orthopedic surgeons have been working for years to develop and perfect a total ankle replacement referred to as the Scandinavian Total Ankle Replacement (STAR). This is a fairly new system and very favorable early to mid-term results have been published. But according to a recent report from a […]


I suspect my sister may be suffering an ankle fracture that actually occurred during surgery (she had an ankle replacement) but nobody’s talking. Should I say something before she goes back to this same surgeon? Maybe she should be seeing someone else for her follow-up care.

It doesn’t happen very often but ankle fracture during (or after) a total ankle replacement (TAR) is possible. Every effort is being made to reduce the number of these cases. For example, in a recent study from Germany, surgeons reported that their own work improved over time. There were a […]


I am a dedicated long-distance runner with a slight problem. I sprained my ankle in the last marathon really badly and ended up with an OLT lesion. If I have microfracture treatment and it works, will it hold up so that I can run long distances again?

Many people who sprain (or even break) their ankle end up with an additional injury known as an osteochondral lesion of the talus (OLT). Osteochondral refers to the layer of cartilage over the bone. The talus is one of the ankle bones between the heel and the lower leg bone. […]


I may be having buyer’s remorse in a weird way. I had an operation called microfracture to help heal a hole in my ankle bone. But now I’m regretting doing it and thinking it could have just healed on its own if I waited a bit longer. And I’m worried that after spending all this money, the repair won’t last. What do you think?

Microfracture is a way to treat defects, lesions, or ‘holes’ that go all the way through the protective cartilage to the bone. In this procedure, tiny holes are drilled around the lesion through the bone to the bone marrow. Breaching the bone in this way releases stem cells from inside […]


I think I’m probably not a good person to have a knee replacement but maybe you can tell me for sure. I have what they call fear avoidance. I’m afraid to do much because if I do, the pain shoots up from a three to a 10 immediately. My husband thinks if I just have the knee replaced, I’ll be fine. But I’m secretly worried I won’t be any be any better off after surgery than before. You probably know about these things. What can you tell me?

Before reaching the point of needing, wanting, and accepting a total knee replacement for joint arthritis, like you, many people become fearful of movement (kinesiophobic). Their level of pain causes them to start avoiding certain movements and activities at home and work. As you have found out for yourself, this […]


I am looking at putting an end to my chronically cranky and very painful ankle. The surgeons says according to the X-rays and CT scan I have end-stage osteoarthritis. She is recommending an ankle fusion using the newer arthroscopic method. Call me old-school but I’m not always convinced new is better. In this case, is it?

In this case, the term “new” may not be exactly the right word to use. Arthroscopic ankle arthrodesis (fusion) has been around for 30 years. That’s long enough to have gathered enough data from studies to track short-, mid-, and long-term results. What we don’t always have are comparative studies […]


I’m scheduled to have an ankle fusion next week. The surgeon I’m seeing didn’t answer all my questions today. He says “don’t overthink this.” But I would still like to know what kind of problems I could potentially run into after surgery. I did read the patient disclosure form with all the usual blood clots that can kill you kind of stuff. What about the actual ankle? Will it work? Will I be better?

When ankle pain from osteoarthritis is severe, function is low, and conservative care isn’t helping, surgeons turn to a fusion procedure known as an arthrodesis. There are two ways to do this surgery: open ankle and arthroscopic. As the names suggest, open ankle involves large incisions. Arthroscopy can be done […]


After tearing my Achilles tendon, I’ve been put on a special program of wearing a removable brace and gently moving my ankle through part of the motion twice a day. I feel really apprehensive about the movement. I’m worried I’ll retear the healing tissue. The surgeon assures me I’ll be fine if I follow his instructions exactly. What do you think?

You have been put on a program referred to as functional rehabilitation. This involves early range of motion to stimulate tendon healing and bracing to protect the healing tissue. This type of conservative care offers the best of both approaches. Instead of putting the lower leg in a cast for […]


I am reading conflicting reports about how to treat an Achilles tendon rupture. Even on your website there are some studies that say surgery is better and others that recommend a nonsurgical treatment plan. What’s the overall big picture view?

You are correct that there are some conflicting results published in the medical literature about the treatment of Achilles tendon ruptures. Some of the differences depend on the type of treatment applied. Not all surgical treatment and not all nonsurgical care are the same. For example, surgical repair can be […]


Well, it’s getting near the end of the year. Time to make a decision about my poor ankle before my insurance runs out and I have to start my deductible all over again. The surgeon says I have a chronically unstable ankle from a dozen sprains and resprains. It’s all been on the outside of the ankle. Lucky me. But really I guess I am fortunate because this surgeon does something new called a hybrid ligament reconstruction. What do you guys know about this operation? Should I go with it?

Two million ankle sprains a year have led surgeons to develop a wide range of treatment possibilities. Most of these injuries occur along the lateral (outside — away from the other leg) portion of the ankle. Conservative (nonoperative) care works well for many people. But when the ankle keeps giving […]