Top athletes who have had ankle arthroscopy

Top athletes who have had ankle arthroscopy:

1) Soccer - Cristiano Ronaldo

http://www.theguardian.com/football/2008/jul/07/manchesterunited.ronaldo

2) Soccer - Ruud Van Nistelrooy

http://www.fifa.com/world-match-centre/news/newsid/716/674/index.html

3) Soccer - Michael Ballack

http://www.telegraph.co.uk/sport/football/2321107/Michael-Ballack-faces-third-ankle-operation.html

4) Dr. Neik Van Dijk

http://www.niekvandijk.com/

Top athletes who have undergone ankle ligament surgery

Top athletes who have undergone ankle ligament surgery:

1) NBA - Stephen Curry

http://espn.go.com/nba/playoffs/2015/story/_/id/13019137/2015-nba-playoffs-how-stephen-curry-put-ankle-issues-him

2) NFL - Cam Newton

http://bleacherreport.com/articles/2000678-breaking-down-cam-newtons-ankle-injury-and-surgery

3) Soccer - Robin Van Persie

http://www.theguardian.com/football/2009/nov/28/robin-van-persie-surgery

Recommended aids to help with post-op recovery

1) Breg Kodiak Cold Therapy + Ankle / Foot Attachment / Game Ready / Ossur

Cold therapy + Ankle / Foot Attachment

2) Walking Aids - Crutches / Knee Scooter / iWalk 2.0

Knee Scooter
iWalk 2.0

3) Shower Aids

Cast Cover
Shower Bench

4) Vitamin D drops - 2000 IU / day + Vitamin C + Arnica

Vitamin D Drops
Vitamin C
Arnica

5) Aspirin

If you do not have a contraindication for taking aspirin.  I would recommend you take an Aspirin 81 mg / day for each day that you are in the cast.

Aspirin

6) Foam Bed Wedge to elevate feet

Bed Wedge

7) Advanced healing waterproof band-aids

 

Band Aids

8) Diet.  Make sure you are eating a good well balanced diet with adequate amounts of protein and fruits + vegetables.  No junk food.  No fast food.  No sugar. No smoking. 1-2 eggs per day.

9) ASO Ankle brace

ASO Ankle Brace

10) Long Cast Boot

The Brostrum Procedure

The Brostrum Procedure is the standard procedure used to correct ankle instability.

It has been performed for over 50 years.

Brostrum's original paper was written in 1966.

Below are some links about the procedure.

Recovery is generally 3 to 6 months.

Brostrum Procedure / Wikipedia

Brostrum Procedure / Wheeless

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC164377/pdf/attr_37_04_0458.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC164377/

PXB - Percutaneous X-ray Guided Internal Brace

Ankle instability treated using PXB technique - Percutaneous X-ray Guided Internal Brace.

1) Make an incision and percutaneous identify the fibula

2) Drill hole for 4.75 mm SwiveLock

3) Tap fibula

4) Insert 4.75 mm SwiveLock

5) Mark and drill talus

6) Tap talus

7) Insert 4.75 mm SwiveLock in talus and tension fiber tape appropriately

8) Post-op incisions

Pre and post-op stress X-rays:

Case 1:

Case 2:

Case 3:

Case 4:

Case 5:

Case 6:

Tracking Outcomes - AOFAS Ankle-Hindfoot Scale

In an effort to track outcomes for our patients we will be using the AOFAS Ankle/Hindfoot Scale.  I have attached the AOFAS Ankle/Hindfoot scoring sheet.  If you are a patient it would be appreciated if you could fill out this form on your first and subsequent visits.

AOFAS Ankle-Hindfoot Scale PDF

Clinical Prediction Rules

Darryl Yardley - one of my physiotherapy colleagues asked me if I could list some Clinical Prediction Rules / Indications for Surgery.

My main clinical indications are the following:

1) Ankle pain and instability for greater than 1 year despite non-operative management / physiotherapy.

2) Clear 2+ anterior drawer sign

3) Evident varus / valgus instability with stress testing

4) Palpable crepitus in the ankle (this can be caused by an OCD lesion or Ankle Osteoarthritis).