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Orthopaedic & Rehabilitation Institute

A Solution for a Common Ankle Problem

A Solution for a Common Ankle Problem Restores Pain-Free Mobility

Alice McCaffreyWalking is one of Alice McCaffrey's favorite pastimes. For years, she has taken a daily four-mile hike at the Montour Trail in McMurray, Pa.– and has showed no signs of slowing down, despite advancing age. But early in the morning two years ago, Alice woke up to discover a painful and disabling condition that made it difficult for her to walk across the room, let alone stroll through the park.

"I could barely get out of bed," said Alice, 70, a resident of Muse, Pa. "My left ankle was so sore and swollen that I feared I had some sort of structural damage."

A MRI scan confirmed that Alice had a degenerative tear of the posterior tibial tendon – a common problem in women over the age of 50 who stand or walk for prolonged periods of time. When Alice visited Stephen F. Conti, M.D., a foot and ankle specialist at AGH's Department of Orthopaedic Surgery, she learned her injury was so severe that non-operative treatment options would not be very effective. Without surgery, walking would become an increasingly painful ordeal.

"Even though I was facing a complex operation, Dr. Conti assured me that with a tendon transfer and joint fusion, my chances of achieving a successful outcome were very good. I was too young to hang up my walking shoes, so I decided to have the procedure done," said Alice. In late August 2005, Alice had surgery to remove the torn tendon and replace it with another tendon in her foot. At the same time, Dr. Conti fused the subtalar joint (the joint below the ankle) to straighten Alice's foot.

"The procedure is technically challenging because it involves placing the foot in exactly the right position so it hits the ground flat when the patient walks," said Dr. Conti, who also has removed a bunion from Alice's foot and treated her hammer toe. "It is an uncommon procedure for a general orthopaedist, but one which we do at AGH with some frequency and with great success." The two-hour operation went well and Alice began four months of physical therapy. Before long, she returned to work and resumed her four-mile-a-day walk in the park.

"My mobility is as good as ever and I don't experience pain in my ankle any longer," said Alice, who now wears special shoes to provide better arch support for her feet. "Through the masterful care I received from Dr. Conti and his colleagues from the Department of Orthopaedic Surgery, I can walk with ease. There's no stopping me now!"

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