28 Oct Ankle Cheilectomy
An ankle cheilectomy is a surgical procedure that involves the removal of a bone spur from the ankle joint, typically from the talus or tibia. Bone spurs, also known as osteophytes are very common and often form where bones meet each other — that is the joints. The most common site of bone spur formation is the spine but they can also form in other sites, such as the ankle. Bone spurs cause joint damage typically associated with osteoarthritis, and can be quite painful. The goal of an ankle cheilectomy is to relieve ankle pain caused by impingement or pinching caused by a bony spur at the front of the ankle.
Not all cases of ankle bone spurs require cheilectomy. Noninvasive options include orthotic support, and physical therapy can provide some symptomatic relief. PT can be especially helpful if there is an associated loss of motion. Of course, these options cannot remove bone spurs. Other symptomatic remedies include ice or cold packs, stretching exercises, massage, etc. Medications typically used here include steroid (cortisone) and NSAIDs, as they provide some pain relief and improve swelling.
Patients who suffer from chronic pain at the front of the ankle (worse on dorsiflexion) that have failed with nonsurgical treatment, are advised to undergo ankle cheilectomy as the curative therapy. An ankle cheilectomy is not indicated if the patient has severe ankle arthritis as the latter is more likely the cause of pain. These patients typically do not find relief from pain post-surgically.
The ankle cheilectomy can be performed arthroscopically or as an open surgery procedure. The arthroscopic approach involves making a small incision and inserting a camera into the ankle joint. The cartilage and soft tissues inside the ankle joint are examined. The bone spur is identified and then removed with a burr or chisel placed into the ankle through a separate small incision. In cases where the bone spur is not easily accessible and/or large in size, open surgery is performed, where the ankle joint is opened, and the bone spur is identified and removed with a chisel.
Post-surgical recovery depends on several factors, such as the size of the bone spur and the degree of swelling or bleeding that occurs during surgery. In addition to pain control, anti-inflammatory agents are prescribed to improve swelling. Weight-bearing is limited for 2-3 weeks. Physical therapy is then typically started to assist tissue healing and regaining muscle strength, and then weight-bearing and activity are generally increased as tolerated.
In addition to the general complication of any surgery, including infection, bleeding/clotting, risks associated with anesthesia, but more specific complications include loss of feeling at the top of the foot. There may be a persistence of pain, and in fact, can be worsened especially if there is underlying arthritis.
We specialize in the full range of ankle and foot-related problems, including the accurate diagnosis and complete management of the bone spurs. We perform cheilectomies when necessary and strive for the best possible clinical results.