At Home with Dr Christian Jessen - 357

| PROMOTION|

MEET THE EXPERT

Mr Derek Robinson BSc (Hons), MB ChB(Hons),
FRCS (Trauma and Orthopaedics) is a consultant
orthopaedic foot and ankle surgeon

Mr Robinson is based in Bath at the Royal United Hospital and also
holds clinics at the Royal National Hospital for Rheumatic Diseases. He
bases his private practice at the new CircleBath hospital. After surgical training in
Nottingham and Bristol he performed advanced training in Vancouver. He is also a
member of the British Orthopaedic Foot and Ankle Society.
Mr Robinson has extensive experience in the diagnosis and management of
the whole spectrum of both foot and ankle conditions. His specialist interests include
bunion correction, foot and ankle arthritis, tendon problems and other sports injuries.

Ankle fusion

This has been the treatment of choice for
severe ankle arthritis for many years. The pain
of ankle arthritis is due to the movement of the
joint. If this movement is prevented then the
pain should disappear. It involves completely
removing the damaged cartilage from the
ankle and then holding the bones together by
screws until they naturally fuse.
Many patients are concerned that if they
can't move their ankle they will walk very
badly. Surprisingly, this is not the case. The
rest of the foot has movement that, to a degree,
can take over the mobility that is lost from the
ankle. In fact, it's often difficult to even tell that
someone has had the procedure. It is the
operation of choice for patients with severe
arthritis who are young and active and also
for older patients with significant deformity.
Previously, ankle fusion was a major
open procedure but it's now almost always
performed with a keyhole technique. This
has several advantages - the incisions are
very small, the risk of infection is low, the
bones heal more reliably and pain is minimal.
	

Ankle replacement

This procedure has been undertaken for many
years. The initial designs, in the 1970s, were
not very successful, however surgeons now
have a much greater understanding of the
ankle joint and better designed implants using

force across the ankle is up to seven times
the body weight during day-to-day activities.
SURGERY OPTIONS
There are several operations for ankle arthritis.
Choosing the most appropriate for you is best
decided by a specialist foot and ankle surgeon
with the expertise to perform all the different
procedures. Factors to be considered include
the severity and type of arthritis, age, activity
level and whether other joints are stiff. For
early arthritis, the ankle is washed out and
cleaned up by a keyhole technique. The loose
cartilage and excess bone are removed.
For more severe arthritis, the options are
either an ankle fusion or replacement.

2110104829 DerekRobinson DPS.indd 49

'THE OPERATION
CHANGED MY LIFE
- I'M SO GRATEFUL'

Mrs Inge Cross, 80, chose to have
an ankle replacement
'Seven years ago, I had my ankle
replaced by Mr Robinson. He changed
my life completely. I wasn't able to walk
properly, but here I am, so many years
later, walking everywhere.
'I went on a five-week cruise to the
Caribbean recently and I danced every
single night! It was quite wonderful.
I am forever grateful to Mr Robinson,
he really has changed my life.'

'WALKING IS A JOY,
I'VE NO PAIN AT ALL'

Mrs Mavis Ratcliff, 81, underwent
an ankle fusion
'Mr Robinson, yesterday, I spent
the whole day sightseeing in London,
walking miles, going up and down stairs
and escalators, jumping on and off Tube
trains and having a lovely time.
'I tell you this because two years ago
today you fused my left ankle and gave
me a whole new life. I'm over 80 now
and walking is again a joy, I can keep up
with all the family and walk fast over
three miles. There is no pain at all. So
please accept my heartfelt thanks.'

modern materials mean results have improved
greatly over the past 40 years. The new ankles
have excellent outcomes in appropriately
selected patients and consultant orthopaedic
foot and ankle surgeon, Mr Derek Robinson,
expects that 90% of ankle replacements will
be successful for at least five years and often
much longer. The aim of surgery is to relieve
pain and allow retention of ankle movement.
The patients that are considered most
suitable for replacement ankle surgery tend to
be less active, usually over the age of 60, or
diagnosed with rheumatoid arthritis. Patients
with rheumatoid arthritis are particularly able to
benefit, as they may have other stiff arthritic
joints in the foot. Because of this, it is important
to retain some movement in the ankle.
Young, active individuals may wear out
the ankle and be better served with a fusion.
If there is severe deformity, this may put extra
strain on the replacement causing it to fail early.

FOR MORE INFORMATION
Visit www.sportsmedsw.com
www.circlebath.com
email bathfootandankle@hotmail.co.uk
or call Katy Keen, Mr Robinson's PA
on 01225 851185.
CircleBath, Foxcote Ave,
Peasedown St John, Bath BA2 8SQ

23/01/2015 12:11
http://www.sportsmedsw.com http://www.circlebath.com
At Home with Dr Christian Jessen

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