In an event where chronic Achilles tendinitis is present which does not respond to conservative therapy, then surgical interference becomes necessary. Sometimes the condition is present with heel spur in the back of the heel where the achilles tendon inserts into the foot. Debridement (thinning out) of the Achilles is performed under such conditions along with removing the bone spur as needed. In an event of a full rupture of the Achilles Tendon, surgical repair is required. In such instances, the surgeon sutures together the ends of the ruptured Achilles Tendon and performs any adjunct procedures that the surgeon believes are necessary based on each patient’s individual evaluation. Prior to both of these surgical interventions, advanced imaging in form of an MRI is required in most instances.
At times repeated ankle sprains, or initial severe ankle sprains can lead into a rupture of an ankle ligament. At this time surgical intervention is required to achieve ankle stability once again. It should be mentioned that this is full tears of ankle ligaments are rare. In such instances, the surgeon may remove bits of torn ligament, bone and cartilage.
Bone spurs may be present at any part of the foot. The may be hereditary or due to repeated trauma. In instances where bone spurs cause irritation to surrounding tendons and ligaments or cause discomfort during weight bearing and activities, surgical intervention may be required. In such instances, the surgeon excises the Bone Spur and repairs any surrounding soft tissue injuries that are a result of the Bone Spur.
Often times, conservative treatment of Bunions is unsuccessful and surgical intervention is required. In such instances, the surgeon evaluates the Bunion radio-graphically and determines the most appropriate corrective procedure based on each patient’s individual evaluation.
This is a hereditary condition where a toe (mostly the 4th) is shorter than all others on the foot. This is as a result of a short 4th metatarsal bone. Various surgical conditions are available for severe conditions of brachymetatarsia where pain is present and it is resulting in limitation of daily activities. The most used surgical treatment by Dr. Khavari is callus distraction of the bone using a external fixator which allows for lengthening of the bone over a few weeks.
Flat Feet/Fallen Arches
At times, custom orthotics and shoe modification is not enough to relieve all pain and symptoms caused by flat feet. In some cases of severe flat feet, surgical intervention is required. In such cases, the surgeon evaluates the appropriate corrective procedure based on each patient’s individual evaluation. Younger adults/children at times require a small implant in the hindfoot to re-establish an arch in the foot.
Ganglion Cyst/Plantar Fibromas
At times, ganglion cysts are in prominent areas of the foot which are constantly irritated by shoes or by weight bearing in cases of plantar fibromas. They mostly respond to conservative measures, however, should they not, surgical intervention then will become necessary. This is done by removing the cyst/fibroma. At times, a corticosteriod is injected at the site of the cyst to reduce chances of recurrence.
Hammertoes are seen quite frequently at our office. Some are asymptomatic. Often times, conservative treatment of symptomatic Hammertoes is unsuccessful and surgical intervention is required. In such instances the surgeon evaluates each patient individually and determines the appropriate corrective procedure consisting of either excising a small piece of bone, or performing a joint implant or joint fusion procedure.
Plantar Fasciitis/Heel Spur
In some cases, conservative treatments are not effective and surgical intervention is required. In such instances, the surgeon would release the painful contracted tissue from the heel bone.
Should the conservative treatments of Morton’s Neuroma be unsuccessful then surgical intervention is required to alleviate symptoms. In such instances the surgeon removes the inflamed portion of the nerve.
In instances when pain from the osteoarthristis causes disability and does not respond to conservative treatments, surgical intervention is required. In such instances, the surgeon evaluates a variety of each patient’s individual factors, including location of the arthritis and impact of the disease on the joints when determining the appropriate corrective procedure.
Should the sesamoid bones be fractured, surgical intervention is required. In such instances, the surgeon removes the fractured sesamoid bone(s).
Tarsal Tunnel Syndrome
Tarsal Tunnel Syndrome, is very similar to Carpal Tunnel in the hands. In severe cases, surgical intervention is required. In such cases the surgeon decompresses the nerve and relieves it of any impingement that may be causing compression.
In cases in which the tendon is torn, surgical intervention is required. In such instances the surgeon debrides (cleans and “thins out” the degenerative tissue from the tendon, repairs any small tears, and performs tendon transfers should the tendon have lost its mechanical properties.
In severe cases of Turf Toe, surgical intervention is required. In such instances, the surgeon repairs the injured tissue.