Ankle Cartilage Restoration: What You Need To Know

I am Dr. Scott Carrington. I practice in La Crosse, Wisconsin at Gundersen Health System. I did a residency out in Denver, Colorado at the Highlands Institute and followed that with a fellowship in Pennsylvania, Coordinated Health. I've been with Gundersen for about the past two years. I previously practiced in Colorado. So, now part of this group here, and it's been a great experience.

When I look at cartilage restoration, one of the things I focus on in my practice is arthritic conditions of the ankle. And for a long time, we had very invasive approaches to treating cartilage. I think the trend in surgery all over the board, and majority of the specialties, we are seeing a minimally invasive approach. And I think with the technologies and techniques we have now, I think treating cartilage and arthritic conditions in the ankle can really be done through minimally invasive techniques, largely arthroscopic. I have not done any sort of medial malleolar osteotomy in years because I think we can treat these all arthroscopically, which makes better outcomes for the patients.

It's a bridge. The problem with arthritis in the ankle, it's a progressive inflammatory process. And once this cycle starts, we can continue to see degradation within the ankle joint. So the hope is if we have younger patients or even older patients that have the beginning of cartilaginous defects or arthritis in the ankle, if we can restore that in a younger population to prevent having to do more joint destructive procedures, either immediately or the hope is in the future, that's where we should really target our therapies at this point to prevent end-stage arthritic changes developing, or slowing that progression in a way that we can get back to a form of function without pain.

I think recently there's been some new developments in terms of equipment and technologies that we've been using where we can arthroscopically deliver autogenous bone graft to fill large cystic and osseous defects in the ankle, where before those were ones that we had to do osteotomies or larger arthrotomies. But we've got good techniques now that can harvest gold standard, autogenous bone graft and fill these cystic lesions, and then fill them with a cartilaginous graft on top of that. But it can all be approached through small arthroscopic incisions.