Warning Signs You May Need Foot or Ankle Surgery

Patients may develop arthritis or deformities in the foot or the ankle for many reason. Warning signs that you may be developing or have already developed significant arthritis in either your foot or ankle will include pain particularly with weightbearing or walking on an uneven ground, significant deformity to the foot or ankle, difficulty in wearing standard footwear, and decreased performance or increased discomfort during sporting activity.

Although there are numerous causes for all of the aforementioned symptoms and signs, they could be a sign that you have developed significant arthritis in the foot or ankle and it is best to consult with a specialist orthopedic surgeon who will take a full history and perform a physical examination as well as obtain plain film radiographs to determine possible diagnoses that may mean that you require foot and/or ankle surgery.

Who is a good candidate for Foot and Ankle Surgery?

Patients who have developed the aforementioned symptoms and have ideally tried (and subsequently failed) nonoperative treatment strategies such as footwear modification, orthotics or bracing, anti-inflammatory and other over-the-counter pain medications, injections of various types or physical therapy and periarticular strengthening.

Due to the complex nature of the anatomy of the foot and ankle, patients may experience some of the aforementioned symptoms but may not require any foot or ankle surgery at all. Conversely, patients may have more minor symptoms and still be good candidates for surgery.

In order to determine which category you fall into, your treating orthopedic surgeon will need to complete a full and complete history and physical examination and likely obtain special plain from radiographs and possibly even cross-sectional imaging in the form of CT or MRI scans.

Alternatives to Foot and Ankle Surgery

Although many patients who are good candidates for surgery do eventually end up requiring it, this is not the only option for treating numerous complaints within the foot and ankle and, as previously mentioned, there are a number of nonoperative modalities that can be trialed before reaching a point at which surgery is the only remaining effective option.

These include, but are certainly not limited to, physical therapy, over-the-counter analgesics and anti-inflammatories, footwear modification and/or orthotics, taping or bracing of the foot and ankle, intra-articular injections and even manual and massage therapy.

It is important to remember that while the most nonoperative treatment modalities will be at least partially effective for sometime, their effectiveness of any and all of these can diminish over time and patients may have to accept that surgery will be the best option for addressing their symptoms.

Ankle Surgery Procedure

Depending on the exact type and anatomical location of arthritis that the patient experiences, there are a number of different options for addressing this unique and often troublesome medical problem. If the arthritis is confined to the tibiotalar joint, the patient may be considered a good candidate for a total ankle arthroplasty and although this procedure is still in its infancy, it is demonstrating some good results in early research studies. If the patient’s arthritis is predominantly in the subtalar joint then the patient will most likely be a good candidate for a subtalar fusion. If the patient has arthritis in the subtalar and tibiotalar joints then fusion of a different type may be indicated and indeed if the patient has subtalar, tibiotalar, and talonavicular arthritis then the procedure of choice will be what is known as a triple fusion (fusing all three joints in the same procedure).

If you are unsure as to which type of arthritis you have and which is the most suitable procedure for you then consult with any of our orthopedic surgeons who will be able to guide you to the most appropriate procedure for your arthritis.

Foot Surgery Procedure

Foot surgery is quite a bit more complex than surgery in other areas of the body and as such there are a great deal of surgical procedures that a surgeon can choose from to perform depending on the exact nature of the presenting complaint. For example, hallux valgus (more commonly known as bunions) can be treated in a number of different ways depending on the severity of the deformity and whether or not the metatarsophalangeal joint contains any arthritic change. There are a great deal of different types of osteotomy that can be used to correct the bunion deformity and if arthritis is present then fusion at this joint is also a good option.

For more specific information and advice on your foot condition, we recommend that you speak to our specialist orthopedic surgeons who can assess you with a full history and physical examination as well as plain film radiographs and we will be happy to guide you through explanations of your diagnosis and the most appropriate surgical procedure for you.

Foot and Ankle Surgery Success Rates

It is important to maintain clear expectations of each surgery that one is considering having. For the most part, the goal of surgery is to improve pain, correct deformity or even in some cases both. Ultimately success rates for correcting deformity are quite high in foot and ankle surgery with the only major complication that may affect the success rate being recurrence of the deformity. This complication rate is minimized by selecting the appropriate surgical procedure in appropriate patients and this will be explained in more detail by your surgeon.

Ankle surgery also has high success rates, however, a detailed discussion may be needed with patients should they prefer certain surgeries over others. For example, if a patient is keen on pursuing a total ankle arthroplasty as opposed to an ankle fusion for the ankle arthritis, they must be willing to accept that there is a high rate of failure of this procedure in the medium term, and although the advantage to choosing ankle arthroplasty over fusion is maintenance of a good range of motion postoperatively, they may be facing repeated surgical procedures in their lifetime.

More detailed discussion surrounding the pros and cons of each surgical procedure can be had with your specialist orthopedic surgeon and we will be happy to explain success rates specific to each procedure to you in detail as well as the main signs of complications to watch out for postoperatively.

Foot and Ankle Surgery Risks and Complications

Although there are some surgical risks that are common to most procedures in the foot and ankle (for example, infection, neurovascular injury, and bleeding) each procedure carries its own set of specific potential complications that patients need to be made aware of. For example, the most common complication in bunion surgery is recurrence of the bunion deformity after the surgery. Total ankle arthroplasty patients must be counseled with regards to the likelihood of aseptic loosening of the components around the 8 to 12-year mark. Fusion patients must be informed of the risk of nonunion, or failure of the fusion, in each specific type of fusion that exists.

Patient factors will also affect the potential risks and post-op complications – for example, infections post foot and ankle surgery are known to be a particular problem in certain types of patient population (e.g. diabetics, peripheral vascular disease patients) and it is important to remind patients of this when counseling them preoperatively for any types of surgery that they wish to undergo.

Recovery and Timeframe

Each surgical procedure in and around the foot & ankle has its own specific postoperative recovery protocol and as such each procedure comes with its own proposed time frame for recovery. Given that the goal is slightly different in each case – for example, in total ankle arthroplasty patients can be weightbearing much sooner after the surgery than patients who undergo fusion procedures – these need to be stressed to each patient based on the surgery type and as such there is no “one size fits all” rule for every foot and ankle surgery patient.

Given the area around foot and ankle is one of the least well perfused areas in the body in terms of blood flow, infection is certainly an important complication to discuss with patients and every step should be taken to ensure that the risk of this is minimized.

Management of expectations is also very important particularly with fusion patients. Patients may feel they are not fully recovered given that they feel stiffness after the procedure and it should be stressed to them that the range of motion in the fused joints will decrease significantly (and, if the fusion is successful, ultimately be eliminated) and so feeling new areas of stiffness is normal and that the goal of surgery is not to improve or maintain the range of motion but specifically to relieve the pain.

Conclusion

There are a myriad of surgical procedures in the area of foot and ankle surgery and they are each appropriate for different patient populations and done for specific indications that are distinct from one another. For guidance and information on your particular foot and ankle complaint, please contact our office and arrange to see one of our specialist orthopedic surgeons who will perform a full assessment and will be happy to discuss your diagnosis with you and answer any questions you may have, including the most appropriate management and which surgical procedures, if any, are most appropriate in your case.

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Based on 93 reviews
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
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I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

Please take a look at my profile page and don't hesitate to come in and talk.