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Goa's First Total Ankle Replacement Sets New Standard
Goa recently marked a significant milestone with the first-of-its-kind Total ankle replacement surgery, led by a dedicated team of doctors. Dr Mahendra Kudchadkar, Chief of Orthopaedic Surgery department at Healthway Hospitals, who spearheaded the surgery, shares insights into the surgery’s purpose and the circumstances under which it becomes necessary.
Dr Mahendra Kudchadkar, Chief of Orthopaedic Surgery, Healthway Hospitals, Old Goa
Total Ankle Replacement surgery is a transformative procedure for patients suffering from ankle arthritis, offering a longterm solution and restoring optimal function to the affected joint. This surgery marks a significant advancement in orthopaedic surgery in Goa and is the 10th of its kind in India.
Ankle replacement surgery is the replacement of a damaged ankle joint with a prosthetic implant. The ankle joint, known as the tibiotalar joint, is where your shinbone (tibia) rests on top of a bone in your foot, the talus.
Arthritis, a degenerative condition, can afflict this joint over time as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away.
This can result in pain, inflammation, stiffness and swelling of your joint, which can lead to difficulty in walking.
The ankle joint can get damaged even with a simple sprain or a traumatic fracture. An extended period of time spent in pain and suffering might result from arthritis caused by the cartilage’s gradual deterioration. Movement and even climbing stairs become impossible as a result.
Ankle pain is a complex condition, particularly in the areas around joints and soft tissues. This may result in movement instability and deformity, which can complicate problems. The patients’ social and professional lives are affected by this.
For individuals with mild to moderate arthritis, healthcare providers typically suggest various treatments such as pain medications, specialised shoe inserts, physical therapy or injections (an anti-inflammatory medication).
In cases where severe symptoms significantly impact daily activities, ankle replacement may be recommended by your healthcare provider.
This surgical procedure is distinctive for several reasons. Firstly, the implant required for the surgery must be pre-ordered, since it is not readily available, making the surgery a rare and specialised option. Secondly, the associated costs are high and only a select few doctors in India can provide this level of expertise.
Total Ankle Replacement surgery is a complex procedure that demands specialised implants, careful planning and a high degree of surgical proficiency. The collaboration with Dr Beat Hintermann and Dr Roxa Ruiz, both esteemed foot and ankle surgeons from the Clinic for Orthopaedics & Traumatology at Baselland, Switzerland, has played a pivotal role in ensuring the success of this surgery in Goa.
Hintermann is a pioneer in ankle replacement surgery, having performed surgeries since 1996. His technique involves installing the implant in a manner that can last for approximately 15 years or more. Hintermann emphasises the importance of not only using the best implant but also balancing it correctly; otherwise, it could fail within a few weeks or months. The implant utilised in the recent surgery was designed by Hintermann himself, who possesses an in-depth understanding of its functionality.
The planning and execution of this surgery is intricate and demands meticulous attention to detail. Gathering clinical and radiological data, along with the necessary paperwork for preordering the implant and instruments, poses significant challenges. Hintermann and his team have offered to establish Goa as a Centre of Excellence in Total Ankle Joint Replacement Surgery and other foot and ankle complex surgeries. This surgery is just the beginning of a new era in orthopaedic care in Goa, where healthcare providers strive to provide the highest quality of care and technology to patients, ensuring more successful outcomes and improved quality of life
Box 1: Types of Ankle Arthritis
Osteoarthritis: This is ‘wear and tear’ arthritis that develops in older adults
Rheumatoid arthritis: This is a system-wide autoimmune disease that affects the joints
Arthritis: This can happen because of a past injury of your joint
Box 2: Sign You May Need Ankle Replacement Surgery
Severe Pain: Pain that does not improve with conservative treatments
Limited Mobility: Difficulty walking or performing daily activities due to ankle arthritis
Bone Spurs: Development of bony growth around the ankle joint
Joint Stiffness: Persistent stiffness in the ankle joint, affecting mobility and flexibility.
Box 3: Impact of Ankle Arthriti on Daily Life
Mobility Limitations: Pain and stiffness in the ankle joint hinder walking, climbing stairs and performing routine tasks.
Social Implications: Reduced mobility may lead to social isolation and impact participation in recreational and social activities
Occupational Challenges: Individuals with ankle arthritis may experience difficulties in performing job-related tasks, potentially affecting career opportunities and financial stability.
