Procedure Relieves Arthritic Ankles

A new external-fixation procedure for arthritic ankles applies tension to expand the joint and leave room for new cartilage to form, thereby eliminating painful bone-on-bone pressure without taking away the overall movement and function of the joint.

Although new for treating ankle arthritis, minimally invasive, external-fixation techniques are widely used by foot and ankle surgeons to repair fractures. Bones are immobilized with pins, screws, or wires, which are secured outside the skin with clamps and rods that form an external frame.

For treating arthritis, wires inserted through the skin are attached to a frame, and the resulting tension pulls apart the ankle joint, creating space for new cartilage to replace what was destroyed by arthritis. Prior to applying the fixators, the foot and ankle surgeon may perform ankle arthroscopy to clean out arthritic tissue and bone spurs. Most surgeries are performed in less than three hours, and the risk of infection is minimal. The patient can walk with the frame in place the day after surgery and the fixators remain in place for about four months until new cartilage is in place.

"While fusion surgery has been a mainstay for many years and works very well for pain relief, fusing the ankle joint makes it immobile and permanently stiff,” stated Brad Lamm, DPM, a foot and ankle surgeon affiliated with Sinai Hospital in Baltimore (MD, USA). "Ankle joint distraction with external fixation preserves the joint, eliminates pain, and increases function.” Dr. Lamm made an oral presentation on the procedure at the annual conference of the American College of Foot and Ankle Surgeons in New Orleans (LA, USA) in March 2005.





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