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- Talk
- 11/03/2021
- UK
BOFAS Interactive Instructional Case 3 Questions and Discussion: 59 Year Old with OA Ankle with 16 Degree Deformity, Mild ST Degeneration
Description
In this engaging and informative dialogue led by Rick Brown, three orthopedic specialists, Rick, Jim Carmichael, and Paul Haliwell, discuss a range of clinical and surgical challenges related to ankle joint diseases, particularly focusing on asymptomatic subtalar joint disease and the appropriateness of total ankle replacements versus ankle fusions.
Rick opens the session by prompting Jim to elaborate on his evidence-based remarks regarding asymptomatic subtalar joint disease, inviting insight into the clinical definitions used to identify patients without symptoms. Jim acknowledges the complexity in defining asymptomatic, stressing the importance of a thorough clinical examination combined with patient discussions to gauge their experiences and reactions.
Paul interjects with questions about the thresholds for deformities in the hindfoot and the complexity of assessment due to multifactorial issues, including the need for possible multi-staged surgeries based on individual patient conditions and preferences.
As they dissect specific case scenarios, they emphasize patient-centric approaches where pain relief remains a primary objective for treatments, regardless of the procedure chosen—be it a fusion or a replacement. Intriguingly, they discuss how patients often report feeling less 'stiff' post-surgery, despite the actual mechanical restrictions that may actually be present.
Faced with a hypothetical patient case, they navigate their decision-making processes regarding the surgical options available, ultimately leading to audience engagement through a voting session on potential treatment paths.
Closing the discussion, Rick summarizes the audience vote, revealing a preference for ankle fusion, which highlights the ongoing debates in orthopedic strategies and underlines the necessity for collaborative discussions among medical professionals.