High heels and painful, damaged ankles do not go together. And wearing heels after an ankle-replacement surgery is usually ruled out.
Not any more. The old technique of fusing damaged joints with cement that led to a stiff gait has been replaced with mobile ankle implants made using metal caps and high-density polyethylene. The new implant makes ankle movement as close to normal as possible.
“The new implant makes ankle movement as close to normal that you can not only wear heels but also dance wearing them after an ankle-replacement surgery,” said Dr SKS Marya, chairman of orthopaedic surgery at Max Healthcare, who used the STAR (Scandinavian total ankle replacement) implant last week on a 28-year-old doctor from Baroda (name withheld on request) with Dr Selene G Parekh, an orthopaedic surgeon from Duke University in Durham, North Carolina, US.
The patient had damaged the lower end of the tibia (leg bone) and the ankle joint. Despite the fracture being fixed, the young doctor suffered from post-traumatic arthritis that made the ankle painful and swollen, restricting movement. He was advised total ankle replacement using the new implant.
“Outcomes have been very good and patients can expect a lot of relief from pain and restored mobility,” said Dr Ashok Rajgopal, chairman, bone and joint institute at Medanta, Medicity, who has done five total ankle replacements over the past three years.
“It is a technically demanding surgery and should be undertaken by surgeon with adequate training. Extensive post-operative rehab and physiotherapy are needed to assure good results,” added Rajgopal.
A new technique to India, it was introduced globally a couple of years ago. About 2,500 ankle replacement surgeries using this implant have been done in the US.
“The new implant is a superior alternative to fusing the joints using cement, which is the conventional method to fix a damaged ankle. This technique is quicker and gives more agility to the ankle,” said Dr Maninder Shah Singh, who heads the new Foot and Ankle Unit at Indian Spinal Injuries Centre.
Dr Singh has done 40 surgeries using the STAR implant at the Royal Orthopaedic Hospital in the UK. “New-generation implants such as this one last for up to 15 years, after which they may need to be replaced,” he said.
This means that a 28-year-old with an ankle implant will need to go for revision surgeries at least three times in his lifetime.