Ankle conditions we treat include:
Ankle Osteoarthritis (Degenerative joint disease)
When cartilage is torn or damaged, the exposed bone surfaces beneath can get worn and rough. This means more friction in your ankle joint – causing pain, inflammation and potential damage to other tissues around it. In osteoarthritis, the exposed bones wear away over time, sometimes leading to bony growths (osteophytes). With an early diagnosis, arthritis can be treated conservatively using physiotherapy and injections to reduce inflammation and enhance healing. More advanced arthritis can be resolved with surgery – either smoothing and trimming the joint surfaces, or replacing damaged bones with prosthetic parts or a fusion.
Osteochondral Defects of the Talus
Damage to the cartilage and the bone underneath (also called chondromalacia). The cartilage and bone beneath can be torn (chondral fracture) or worn away as a result of an impact, through wear-and-tear or sudden twisting movement. The resulting defects can cause pain, stiffness, limited range of motion and damage to other tissues in your ankle. Osteochondral defects are usually resolved using arthroscopic / keyhole surgery – to smooth the cartilage and bone surfaces, and stimulate repair.
Also known as anterior impingement, this pain at the front of your ankle is caused by repetitive movements where your foot is pointed downwards. Over time, the tissues can thicken and bony growths (osteophytes) can appear – which cause pinching at the front of the joint. At Capital Orthopaedics, footballer’s ankle is usually treated using arthroscopic or keyhole surgery. It usually involves removing the bone spurs to smooth the surfaces and repairing any other structures.
Soft tissue gets trapped at the back of the ankle – a common injury for dancers, cricket fast bowlers, footballers or even wearing high heels. It results in inflammation and pain in the back of the ankle, often spreading up the Achilles tendon and into the heel. The Capital Orthopaedics team offers physiotherapy and injections to reduce inflammation and promote healing. If symptoms persist, you may need keyhole surgery to release trapped tissues, to smooth damaged surfaces or to remove loose bodies and torn cartilage.
Achilles Tendon Problems
Your Achilles tendon runs from the calf muscle to the ankle joint. It is most often injured by an explosive motion such sprinting from standing start, or if you land heavily from a jump. It can also be torn as a result of repetitive actions, such as running or basketball. Achilles tendons can be completely torn or suffer micro-tears and become inflamed (tendonitis). We initially provide a physiotherapy programme to help your tendon to heal. In more severe cases, our surgeons will repair the torn tendon using minimally invasive techniques.
Your ankle can be broken in a number of ways. Most often, the slim fibula bone can be fractured where it connects to the ankle joint – particularly if your ankle has been suddenly twisted or you have an impact on the outside of the joint. It usually heals well with a weight-bearing cast or walking boot. More complex fractures can affect two or more of the bones in your ankle, and are often the result of high energy injuries in impact sports. These may require surgical repair, as they often involve displaced bones, damage to the soft tissues and instability.
Peroneal Tendon Problems
The peroneal tendons run under the bony lump on the outside of your ankle – connecting your Achilles tendon to your midfoot. Peroneal tendonitis is inflammation in the tendon due to repetitive use, with symptoms of pain and swelling. A peroneal tear – which can also be caused by overuse or trauma – also has symptoms of weakness or instability. They can be treated conservatively with physiotherapy and anti-inflammatory injections, or may need keyhole surgery to repair the tendon and any other damaged tissue.
This is when the tendons that run under the outside of your ankle bone slip out of place, as a result of acute or chronic twisting injuries (such as a sprain). This can lead to weakness and instability, and other problems in the structure of your ankle. Initial treatment usually includes physiotherapy and anti-inflammatory injections. Ongoing subluxation may need surgery to repair the tendon and any other damaged tissues – returning them to their correct position.
The Anterior Talofibula Ligament attaches the fibula to the outside of your ankle bone (talus). It stabilises the joint and is usually damaged when you twist or roll your ankle (sprain). If the ATFL is badly stretched, it can become partially or completely torn, leading to weakness, instability and swelling. Rest and physiotherapy can aid recovery, but severe ligament damage usually requires repair and reconstruction.
Posterior Tibial Tendonitis
The posterior tibial tendon provides support to the arch of your foot. It attaches your calf muscle to the bones of the inside of your foot and runs under the bony lump of your inner ankle. It helps you to invert or turn your foot in and can be damaged due to overuse or direct trauma. Tibial tendonitis causes pain and instability and can lead to other disorders of your foot. We can treat it with physiotherapy and provide orthotics – shoe inserts – to take the strain off your tendon. If symptoms persist, you may require surgery to prevent other problems developing such as arthritis.