Dr Bali has carefully curated a list of recommended educational videos for his patients. Watching these videos will help you get a better understanding of what happens during your orthopaedic surgery.
Lateral ligament repair with internal brace augmentation is used for patients with recurrent ankle sprains. The ligament is anatomically repaired and a fibre tape reconstruction with the internal brace strengthens and reenforces the repair to quicken rehabilitation and return to work and sports
For straight forward fractures we only need to fix the outside of the ankle and occasionally need to put a tightrope between the 2 bones above the ankle. For more complex fractures screws and plates are needed on the inside and/or back of the ankle bones
This technique utilises a small incision, so reducing wound complications whilst still achieving excellent repair strength
There are several techniques for ACL reconstruction. A more modern and widely adopted technique is the graft link, which is a double suspensory fixation method that allows accurate intraoperative tensioning of the graft
This technique is often combined with ankle fixation plates when there is an associated ligament injury between the 2 bones of the ankle. This technique is a preferred option than the traditional long screw across the 2 bones as it doesn’t need a second stage removal and is a permanently stabilising implant.
Ankle arthritis can be managed keyhole or open. Open procedures are done when there has been an existing plate for an ankle fracture that needs removal, for a revision procedure, or for more complex deformity correction. For an open procedure this anterior plate is a great option for providing durable stable fixation and good joint compression to increase the chance of a successful fusion.
There are several techniques to repair cartilage damage in the ankle, from simple shaving of cartilage flaps all the way to open deliberate fractures of the ankle to allow access and graft harvesting from the knee into the ankle. More recent technology has allowed less invasive techniques with biological grafts. Whilst the long term data is awaited, the early results are promising.
Big toe or 1st MTPJ arthritis has always had the gold standard surgery of fusion, where the joint is sacrificed and stuck together. Its satisfactory but not perfect as it limits shoe choice and often a rocker sole is needed to roll the foot when pushing off with every stride. Big toe replacements have been tried but with limited success and high mid term failure rates with large areas of bone loss needing complex second stage fusions. The Cartiva is a relatively new research award winning implant with good mid term results, and is a good option for those with moderate to advanced arthritis and well aligned toes.
The infinity prophecy total ankle replacement is a modern ankle replacement that has a combination of preoperative computer generated cutting blocks and intraoperative X-rays to ensure well aligned implants. Ankle replacements dont have the same success rates as hip or knee replacements, and depending on which paper you read have a success rate of 80-85% at 10 years - lower than the 90-95% for knees and hips. Patients selection is a key component, and is best suited for lighter patients with lower levels of activity. For people that have a higher level of activity an ankle fusion is a more reliable option.