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Ankle Arthroscopy / Ankle Scope

    Also called ankle arthroscopy, this is a less invasive way of doing surgery. Rather than openly cutting into the problem area, the surgeon uses small incisions to navigate the joint and fix the pain or other symptoms with a camera and microscopic instrumentation.






    What is an Ankle Scope?

    The surgeon uses two small incisions and a thin fiber-optic camera to view the problem area in the ankle joint on a screen during surgery as they repair it. This results in less healing time and faster return to activity.

    Who should have an Ankle Scope?

    An ankle scope is generally recommended if conservative treatments like rest, physical therapy, medications, injections or other treatments do not effectively treat a condition or injury. Ankle scopes are often used to treat the pain caused by sports injuries, scar tissue, inflammation, fractures, loose cartilage and more.

    Does an Ankle Scope work?

    Ankle scopes work very well when done for the right reasons. The small incisions greatly reduce the risks of pain or infection and allow for recovery and rehabilitation much sooner. According to the American Orthopedic Foot and Ankle Society and the American College of Foot and Ankle Surgeons, about 70- 90% of patients undergoing ankle arthroscopy for the most common problems achieve good to excellent results.

    What can I expect when I have an Ankle Scope?

    You will need a pre-surgical physical to make any necessary accommodations based on your health history. When you arrive at the hospital, you’ll speak to your surgeon and anesthesiologist. You are likely to put to sleep (general anesthesia) for this surgery.

    Afterward, a physical therapist will help show you how best to get around, likely using crutches. You are very unlikely to be kept in the hospital overnight, and you will need to have someone drive you home. Crutches or a knee scooter may be necessary for most day-to-day tasks for a few weeks. Your physical therapist will help you progress.

    Time off from work will be based on your mobility, but for office workers, 1-2 weeks is average.



    Below is a sample video in animation of the procedure:





     

    Minimally Invasive, Cutting-Edge Procedures

      These breakthroughs in foot and ankle surgery have benefits which include a rapid return to weight-bearing, faster recovery, decreased wound complications and lower infection rate.


      Make an appointment at 626-517-0022 to discuss if you would be a good candidate for minimally invasive procedures.



      Tenex

      ...A minimally invasive cutting edge technology for Achilles Tendonitis and Plantar Fasciitis

      Read the article on Tenex for more detailed information.


      Call Pasadena Orthopedics at 626-517-0022 to see if you would be a good candidate! You may also read the article on Tenex for more detailed information.


       

      Bunion Surgery

        ...not the same painful surgery grandma had.


        Technology and bunion surgery has changed quite a bit in the last 5-10 years. Pasadena Orthopedics offers minimally invasive procedures that allow you to get back on your feet as soon as a few days.



        Also called hallux valgus, or hallux abductovalgus, a bunion is an enlargement of bone and/or soft tissue around the first metatarsal phalangeal joint. The bone that joins the big toe with the first metatarsal bone thickens and enlarges, tightening the tendons, which in turn causes the base of the big toe to angle out resulting in a painful bony deformity.

        What causes a bunion?

        A common cause of a bunion is prolonged wearing of ill-fitting or flexible footwear that compress the toes into unnatural positions and lack proper support. This can include high heeled shoes, narrow shoes, shoes that are too small or pointy shoes with a narrow toe box. Genetics which determine our foot type and certain disease conditions such as arthritis or polio also increase the risk of developing a bunion.

        Bunions are much more prevalent in women than men, which may be associated with the use of heels or non supportive shoes.

        Signs and symptoms

        The signs and symptoms associated with bunions are as follows:

        • Pain with ambulation when wearing shoes

        • Swelling with red, calloused skin at the base of the big toe

        • Decreased mobility in the big toe

        • Inward turning of the big toe toward the second toe

        • Bulging of a bony bump at the base of the big toe

        • Formation of corns and calluses at the overlapping of the big toe and second toe

        Diagnosis

        The diagnosis of a bunion by an podiatric surgeon includes taking a medical history, and performing a physical and biomechanical examination to assess the extent of misalignment and damage to the soft tissues. Your doctor will order X-rays to help determine the extent of damage and deformity of the joints, as well as plan for surgery.

        Treatment

        Your surgeon initially will recommend conservative treatment measures with the goal of reducing or eliminating foot pain.

        Such measures include wearing properly fitted supportive shoes with custom or over-the-counter shoe inserts, padding, or taping of bunions. Physical therapy and certain medications may be prescribed for relieving pain and inflammation.

        If conservative measures fail to treat the bunion pain, then your surgeon may recommend a surgical procedure to address the bunion.

        There are many surgical options to treat a bunion but the common goal is to realign the joint, correct the deformity, and to relieve pain and discomfort.

        Bunion surgery entails surgical cutting and realignment of the joint. The podiatric surgeon selects the appropriate surgical procedure based on the patient's presentation and severity of the bunion.


        This before & after x-ray below is of the Lapiplasty Procedure which uses small linear plates- however there are many different types of bunion procedures. This is another type of bunion procedure performed.

        This is another type of bunion procedure performed below:





        Risks and complications

        As with any surgery, complications can occur. Complications after bunion surgery are rare with a board certified surgeon with experience. However, risks include:

        • Infection

        • Recurrence of the bunion

        • Nerve damage

        • Unresolved pain

        • Non-union or mal-union

        • Painful scar

        In rare cases, a second surgery may be necessary to correct the problem.

        Post-operative care

        Patients should follow all instructions given by their surgeon. Common post-operative instruction includes:

        • Ask your surgeon if you will be getting a nerve block, which will help cut down on narcotic pain medication post-operatively.

        • Keep your dressing dry and in place until your follow up appointment- usually 2 weeks after your procedure.

        • Avoid bearing weight on the foot by using crunches or knee scooter for 4-6 weeks

        • Elevate the foot above heart level to minimize swelling.

        • Exercise and physical therapy may be prescribed for strengthening and restoring range of motion to the foot once you are able to ambulate.

        • Eat a healthy diet and quit smoking to facilitate healing.

        Conclusion

        A bunion is an enlargement of bone or soft tissues around the first metatarsal phalangeal joint. Bunions result in pain and impaired movement of the foot, making it difficult to find properly fitting shoes. If conservative treatment measures are unsuccessful, surgery is an option to consider.


        Make an appointment with Dr. Sara Shirazi to discuss further!


        (626) 517-0022



         
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