Mumbai: 58-year-old Army man with ankle pain successfully undergoes surgery

In a medical relief a Mumbai army man has successfully undergone ankle arthroscopy for a damaged cartilage at a city hospital A team led by Dr Saikat Jena conducted a twohourlong ankle arthroscopy on a 58yearold retired army man from Mumbai to address his pain while avoiding ankle replacement surgeryKallappa Dhule a resident of Mumbai had pain in his ankle while walking for a year He consulted many other doctors who tried conservative treatments with medications and exercises but there was no relief The pain deteriorated further and he was unable to walk Finally he approached Wockhardt Hospitals in Mira Road for a second opinionDr Saikat Jena consultant orthopaedic surgeon Wockhardt Hospitals Mira Road said ldquoOn arrival three months ago the patient was in severe pain and was unable to walk After a detailed clinical examination the patient was sent for Xrays which showed some abnormalities in the ankle joint MRI scan of the ankle joint was done next which showed loss of cartilage over the Talus bone which forms the ankle joint and it was causing the pain These are known as Osteochondral defects which can lead to joint damage and pain The cartilage of the joint gets damaged spontaneously in a lot of patients in the knee due to no specific reason He adds However it is believed to get damaged due to the hampered blood supply and steroid use which makes it difficult to pinpoint one causative agent This damage can also be seen in other joints such as the Talus bone which is the ankle joint The symptom that one will experience is pain while walking Normally cartilage is smooth but under pressure it can cause immense ankle pain In this patient damage to the bone beneath the cartilage led to joint surface damage when Arthritis occurred That is why there is bonetobone grating due to friction The lesion was largely affecting the entire medial half of the Talus If action is not taken at the right time the joint will be completely damaged and the patient will require an ankle replacement which in itself is a complex and fairly uncommon surgery Ankle replacement is not a common procedure in the country as of now Knee and shoulder Arthroscopy is done in many patients Ankle Arthroscopy is a minimally invasive surgery to treat a damaged ankle and is not performed that widely in India as compared to knee and shoulder Arthroscopy ldquoDr Jena added ldquoAlthough Knee and Shoulder Arthroscopy are common surgeries today Ankle Arthroscopy is uncommonly performed despite being used to treat conditions like ligament injuries bone impingement and cartilage damage The frequency of the surgery has increased over recent years due to its minimally invasive nature shorter recovery times and advancements in arthroscopic technologyAn Arthroscopy keyhole surgery allows the surgeon to view inside your ankle using a camera inserted through small cuts on your skin After detecting the cartilage damage the unstable part was identified the lesion was opened and we took grafts from the patientrsquos own body which is an Osteochondral graft a tissue that replaces damaged cartilage and underlying bone in a joint from the knee Now the cartilage is been taken from the patientrsquos knee Later the damaged bone was removed with special instruments and then the harvested ones from the knee The uneventful procedure lasted for two hours The patient was discharged on the second postoperation day Kallappa was advised nonweightbearing ambulation with walker support for a month Exercises and rehabilitation were also done This is how his joint was preserved avoiding the need for replacement Now the patient is painfree and walking without any supportldquoI found it difficult to take even a few steps because of severe pain in my ankle Completing my everyday tasks became quite a struggle I had to rely on my family for assistance which I wasnt comfortable with As an army officer we are trained to be independent and resilient in the face of challenges Thanks to the prompt care provided by Dr Saikat Jena and his team I am now able to walk without restrictionrdquo concluded Mr Kallappa Dhule patient