Ankle Treatment

The ankle joint is made up of three bones: the shinbone (tibia), the smaller bone next to the (fibula) and the bone that fits into the socket formed by the tibia and the fibula (talus).

The talus sits on top of the heel bone (calcaneus), forming a secondary joint. On either side of the talus is a small bony protrusion – in some people, the outer one of these lumps is naturally separated, forming a separate bone (the os trigonum).

Strong ligaments on both sides of the ankle hold the bones together – helping to stabilise the joint and to control the range of movement.

Criss-crossing the ankle joint are many tendons, which connect the muscles to the bones of the foot, enabling movement. The large Achilles tendon in the back of the ankle connects the calf muscles to the heel bone and gives the foot the power to walk, run and jump.

Inside the joint, the bones are covered with a slick, smooth material called articular cartilage, which enables smooth movement.

Common ankle problems:

Anterior impingement (footballer’s ankle)

This is when the two bones at the front of the ankle, namely the distal tibia and talus, impinge as the foot is extended/dorso-flexed. This can either be a soft tissue impingement or more normally a bony impingement. This is common with kicking sports and in dancers. Patients who have pain at the front of their ankle joint, have restricted movement and pain exiting or kicking.
Most commonly performed arthroscopic surgery is debridement of impinging soft tissues and removal arthroscopically of the bone spurs on the tibia and talus respectively.

Posterior impingement

This is when soft tissue at the back of the ankle joint gets pinched between the bones, causing pain, inflammation and swelling.
Most commonly performed arthroscopic surgery: os trigonum exision.

Ankle instability

A sprain can stretch or tear the ligaments in the ankle, making them loose and unable to stabilise the joint. Symptoms are instability, pain and swelling.
Most commonly performed arthroscopic surgery: ligament tightening procedure.

Osteochondral defects

During a sprain, the shinbone and anklebone can bang into each other, resulting in cartilage damage or a cyst forming in the bone. Symptoms are pain, swelling and catching.
Most commonly performed arthroscopic surgery: debridement and micro fracture.

Ankle osteoarthritis

Bones in the joint become misshapen and misaligned due to degenerative arthritis. This results in pain, stiffness, swelling, instability and difficulty walking.
Most commonly performed arthroscopic surgery arthroscopic debridement, ankle fusion.

Achilles tendon problems

The Achilles tendon is the thick cord running from your calf to your heel. It can get injured through overuse, and the degeneration leaves it at risk of rupturing. Inflammation, weakness and pain are the result. Over 90% of patients with Achilles tendon problems can be treated non-operatively.
Most commonly performed arthroscopic surgery: debridement and tendon reconstruction.