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The ankle joint is a complex hinge joint that provides stability to the extreme body weight which means up to eight times the body weight during running. The muscles, tendons, and ligaments that support the ankle joint work together to support and drive the body.

An ankle sprain is a common injury which results when the ankle is twisted or inverted. The term sprain signifies injury to the ligaments of the ankle. In more severe injuries a fracture might occur too. The treatment could be either conservative or operative depending on the severity of the injury.

Ankle impingement occurs when soft tissues around the ankle are pinched or compressed during the dorsal of plantar flexion and it is usually associated with previous ankle sprains, or irritation due to overuse. When conservative treatment fails surgical options include arthroscopic debridement of the joint, loose bodies and osteophytes removal, os trigonum excision (posterior impingement).

Ankle Chondral lesions and Osteoarthritis

Ankle joint injuries are very common. Though ankle fractures and ankle sprains can heal, injuries in the articular cartilage of the joint cannot heal spontaneously. Several biological treatment options are available in order to repair the injured cartilage such as microfracture, autologous osteochondral, chondrocyte or mesenchymal stem cell transplantation, similarly to the knee joint chondral lesion treatment.

If chondral lesions left untreated, degenerative changes might occur in the ankle joint and osteoarthritis will be developed, leading to persistent pain and functional impairment of the joint. Conservative treatment with the use of anti-inflammatory agents, hyaluronic acid injections and growth factors might be helpful in order to reduce pain and improve function. A rehabilitation program should be always followed up, either along with the conservative treatment or after surgery.


Arthroscopic BMAC surgery for Osteochondral lesion of Talus video link


Pathology of the Achilles tendon

The Achilles tendon is a strong, fibrous band that connects gastrocnemius (calf) muscle to the heel. This powerful muscle group causes plantar flexion of the foot and acts to rise on the toes, sprint, jump, or climb. Several different problems can occur that affect the Achilles tendon, some rather minor and some quite severe. Problems that affect the Achilles tendon include tendonitis, tendinopathy, bursitis that affects athletes most often, but they are also common among both active and sedentary adults. Physical therapy along with biologic therapies with growth factors might provide pain relief and improve in function. Severe cases may result in a rupture of the Achilles tendon that should be treated surgically. The addition of biologic factors can enhance tissue healing after surgical repair of the tendon.