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Are there any operations available to realign the ankle joint?

Q) Our son, Terry, has had Still’s disease intermittently since the age of six. He's currently 27 and the condition is being successfully managed with methotrexate. There's only one problem; he has permanent damage to one joint – his left ankle. My wife and I were wondering if there's any intervention, operation or procedure for re-lining the ankle joint. He has discomfort at the end of a busy day and can walk three to four miles at a stretch.
Mike Richardson, Clitheroe, Lancashire (Autumn 2007)

A) There are a number of surgical options available, although resurfacing, such as that available for the hip, isn't one of them. Replacement of the true mortice ankle joint is now possible but the results aren't as impressive as for hip and knee replacement. This will improve in time. If the damage is confined to the lower part of the ankle joint, the sub-talar region, procedures which fuse the joints together are effective and give good pain relief. However, the decision to undergo any joint surgery should be taken together by patient and surgeon. There are risks to any operation and if your son has an exercise tolerance of four miles it might be better to wait until things are worse before proceeding to an operation. Sometimes wearing a support helps and gives a good indication of how successful an operation is going to be.

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