Contents
Arthroscopic Surgery
Endoscopic Surgery
MIS (Minimally Invasive Surgery)
Bone Fracture Repair
Arthritis Surgery
Foot and Ankle Reconstruction
Arthrodesis (Fusion) Procedures
Bone Grafting
Hardware Removal
Soft Tissue Repairs
Soft Tissue Mass Excision
Revisions
General Surgical Info
When Should I See a Podiatrist?

Our focus at Chugach Sports Foot and Ankle is on return to sport or physical activity and return to function. We specialize in the following surgical procedures, when necessary, to help achieve those goals:

Arthroscopic Surgery

 •  Arthroscopy is surgery inside of a joint performed with a lighted camera and small instruments through small minimally invasive incisions.
 •  Examples would be ankle joint arthroscopy with debridement, soft tissue impingement excision, bone spur excision, cartilage defect repair and grafting (talar dome lesion repair), and ankle fusion (arthrodesis).

Endoscopic Surgery

 •  Endoscopy is surgery outside of a joint performed with a lighted camera and small instruments through small minimally invasive incisions.
 •  Examples would be endoscopic gastrocnemius recession, endoscopic plantar fascial release (EPF), and endoscopic os trigonum excision.

MIS (Minimally Invasive Surgery)

 •  Minimally invasive surgery is done through small incisions with specialized tools. Potential benefits are decreased scarring, faster healing, and decreased pain.
 •  Examples would include the endoscopic and arthroscopic procedure listed above, as well as some bunion repairs, some fracture repairs, and tenotomies.

Bone Fracture Repair

 •  ORIF (open reduction with internal fixation) is the process realigning a displaced fracture and holding the bone fragments together with screws and plates while the fracture heals.
 •  Examples would be ankle, metatarsal and toe fracture repair.

Arthritis Surgery

 •  Arthritis surgery includes joint clean outs, bone spur excisions, cartilage repair and grafting, joint realignment, and fusions (arthrodesis).
 •  Arthritis can affect all joints in the feet  and ankles. Common targets of surgical repair are the great toe joint (first metatarsophalangeal joint), the subtalar joint, and the ankle joint (tibiotalar joint).

Foot and Ankle Reconstruction

 •  Reconstructive surgery is procedures used to fix structural problems and improve foot and ankle alignment. This is often done through bone cutting (osteotomies), fusion (arthrodesis), and tendon repair.
 •  Examples would be bunion repair and realignment, hammertoe repair, flatfoot repair, cavus (high arch) foot repair, tarsal coalition repair, ankle stabilization, and non-union repair.

Arthrodesis (Fusion) Procedures

 •  Fusion / arthrodesis procedures are often done on arthritic, unstable, or misaligned joints.
 •  Fusion means no more motion at the joint being operated on. Patients can often be more active following a fusion procedure than before as the joint’s alignment is improved and there is no longer any painful motion in the joint.
 •  Examples of common fusion procedures would be the great toe joint (first metatarsophalangeal joint), the Lapidus procedure for bunion correction, the tarsal joints, and the ankle joint arthrodesis.

Bone Grafting

 •  Bone grafting is inserting healthy living bone tissue into a surgical target site which has been harvested  from a separate location on the lower extremity, typically the calcaneus (heel bone) or tibia (main lower leg bone.
 •  This is often an ancillary procedure done for revisional cases, non-unions, or other situations where healing is likely to be delayed.

Hardware Removal

 •  Sometimes the plates and screw used for osteotomies (bone cutting with realignment), arthrodeses (fusions), or ORIF (fracture repair) procedures can be painful, prominent, and problematic. Occasionally patients will have allergies to metals used in the implants. In these situations, taking out the hardware is recommended once it has accomplished its purpose and the bone is healed.
 •  Most of the times hardware removal is not necessary.

Soft Tissue Repairs

 •  Soft tissue repairs are procedures fixing damage to tendons, ligaments, nerves, and muscles.
 •  Examples of common soft tissue repairs are ankle stabilization, Peroneal tendon and Achilles tendon repairs, tendon transfers, tendon lengthening, and neuroma decompression or excision.

Soft Tissue Mass Excision

 •  Soft tissue masses include many different lumps and bumps.  These are generally benign. Biopsy of the excised mass is performed to confirm the lesion is benign and to assist in identifying the lesion.
 •  Examples of common soft tissue mass excision are ganglion cysts, fibromas, and neuromas.

Revisions

 •  Revisional procedures are exactly what they sound like, follow up or repeat surgical procedures.
 •  Revision is often necessary when there is recurrence, re-injury, poor outcome, poor healing, non-healing, infection, complications, or continued pain.

General Surgical Info

Most foot and ankle surgical procedures are done as an outpatient (you go home the same day) at one of the local surgery centers or hospitals.

MAC sedation (Monitored Anesthesia Care) or LMA (laryngeal mask airway) sedation with an anesthetic block in the foot or leg is usually sufficient for foot and ankle surgery. MAC and LMA sedations are generally lighter than an intubation anesthetic, and the patient is breathing independently on their own without assistance. General sedation is usually (generally) not needed which means patients recover from anesthesia quicker with less nausea, vomiting, and risk.

Surgery is not without risk, and there are no guarantees. When the benefits of surgery outweigh its risks and downsides, then surgery often makes sense. The goal of surgery is improved function, decreased pain, not perfection. Surgery will not restore your foot to when you were 18 and indestructible.

When Should I See a Podiatrist?

You know your body, and you know when something does not feel right. The big question is, when should you actually get it checked out? You should see a sports foot and ankle specialist and podiatrist for an evaluation if:

•     You have had a significant injury.
•     It has been a week or two after an injury and it is not calming down or improving, or if it is getting worse. These are clear signs it is time for an evaluation.
•     You are dealing with ongoing swelling, limited movement, or pain which is affecting how you walk, run, or play.
•     A joint feels unstable, or like it might give out. Do not try to push through it.
•     Conservative treatment measures such as custom orthotics and supportive shoes do not provide adequate relief.
•     You are having persistent pain or discomfort.
•     The condition is limiting physical activity or affecting function.
•     The condition is affecting your quality of life.
•     You would like to discuss the appropriate treatment options for your foot.
•     It is time for surgery.

At Chugach Sports Foot and Ankle, we work with athletes and active individuals of all levels. We specialize in return to sport or physical activity and return to function. Schedule an evaluation and consultation today and let us help get you back on track!

Contents
Arthroscopic Surgery
Endoscopic Surgery
MIS (Minimally Invasive Surgery)
Bone Fracture Repair
Arthritis Surgery
Foot and Ankle Reconstruction
Arthrodesis (Fusion) Procedures
Bone Grafting
Hardware Removal
Soft Tissue Repairs
Soft Tissue Mass Excision
Revisions
General Surgical Info
When Should I See a Podiatrist?