Osteoarthritis of the foot and ankle, Paul Hecht, MD

The function of foot and ankle is to help you get from place to place. Problems most often occur as the result of accidents, abnormal stresses, congenital deformities or when the joint doesn't fit together anymore. Dr. Hecht reviews of the complex anatomy of the foot and ankle. It is challenging to treat arthritis in the foot because of the many joints and limited effective treatment options. The big toe is a common place for arthritis. Tend to have pain ith activity and stiffness which can impede your activity. Swelling, tenderness, deformity and a limp are common symptoms. Dr. Hecht always like to have x-rays that shows weight bearing to tell the real story. CT scans and MRI scans give a lot more detailed information for this complex part of the body. Treatment options would be considered to relieve pain, restore function and prevent or correct deformity. Our providers always start with non-operative treatments -- medicines, injections, cane, brace, physical therapy, exercises and other anti-inflammatory options. Shoe modifications (such as a rocker shoe) help to propel the body forward, reducing motion needed from the ankle. Orthotics, braces or a walking boot can also help to relieve pain by reducing motion. Surgery options include debridement (taking out extra pieces), arthrodesis (fusion) and arthroplasty. Debridement -- done with arthroscopy -- is for mild to moderate arthritis. During this procedure lose bits are removed such as pieces of bone that may be grinding at cartilage. Arthroplasty is done to replace toes or the ankle (though there is a lot of improvement needed for ankle replacement prosthetic parts; they often fail). Fusing an ankle joint, called arthrodesis, helps to relieve pain and improve function but this is only for patients who do not benefit from non-surgical treatment or who have a severe deformity. The procedure works well, is durable and still offers the patient a lot of function. The downside is that the patient loses normal joint motion and some function and there can be increased stress on nearby joints. Dr. Hecht reviews the positives and negatives of the various procedures and who is the right candidate for each. Main messages are that you should try non-surgical options before you do surgery. Begin with a simple intervention, then move to medications then consider injection. Move to surgery only if symptoms can't be controlled and you fit the criteria for surgery.

Learn more at: http://bit.ly/dh-osteo

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