Foot and ankle surgery: Helping patients reach their goals

Sept. 24, 2019

Mayo Clinic's orthopedic surgeons have the breadth of experience to manage the full range of foot and ankle surgeries, from the repair of routine sports injuries to correction of complex deformities. That expertise, combined with Mayo Clinic's commitment to individualized care, helps to ensure optimal outcomes and, for athletes, a return to play as soon as possible.

"Even a common sports injury, such as a stress fracture or chronic lateral ankle instability, can be devastating to a young athlete or anybody who wants to return to exercise. We work with our patients to help them achieve their goals safely," says Daniel B. Ryssman, M.D., an orthopedic surgeon specializing in foot and ankle procedures at Mayo Clinic in Rochester, Minnesota.

As a high-volume tertiary center, Mayo Clinic has the capability to surgically correct complex deformities caused by trauma or a neurological disorder such as Charcot-Marie-Tooth disease. But patients with more-common sport injuries also benefit from the expertise of an orthopedic surgeon with fellowship training in the foot and ankle.

"An athlete might face certain circumstances — pressure to get back on the team and in shape for the next season — that don't necessarily match a one-size-fits-all approach," Dr. Ryssman says. "Without cutting corners or taking chances, we tailor our approach to the specific patient."

The individualized approach begins with diagnosis. Mayo Clinic starts with a detailed history and physical examination. "The history and physical exam are key. Too often nowadays, there can be an overreliance on the MRI when determining a treatment plan. But what we see on MRI may not precisely correlate with what is causing the patient's pain," Dr. Ryssman says.

Mayo Clinic focuses on the patient's chief complaint. "We ask, 'Where do you hurt?' and 'What's keeping you from doing the things you want to do?' We then use imaging to help us better understand the patient's needs and to plan treatment," Dr. Ryssman says.

Accurate diagnosis might point patients toward physical therapy or other nonsurgical treatment first. If surgery is indicated, Mayo Clinic's orthopedic surgeons have broad experience with surgical procedures to address all types of sports-related injuries to the foot and ankle, including lateral ankle ligament reconstructions, arthroscopy, ankle cartilage procedures, fracture treatment and Achilles tendon repair.

The individualized approach continues through postoperative rehabilitation. Orthopedic surgeons work closely with physical therapists to devise programs, and closely monitor patients throughout the process. "Not all injuries are the same. You have to listen to the patient, watch the patient closely, work with the physical therapist closely and make changes to the program if needed," Dr. Ryssman says. "That's where the experience comes in."

He cites the case of a high school basketball player who had surgery at Mayo Clinic to repair a fractured ankle. The patient was eager to return to play, but his ankle needed sufficient strengthening to avoid a repeat break or other injury.

"We saw him more frequently than usual, so we could accelerate his physical therapy to the extent that it was safe to do so. After he returned to play, he won the state championship," Dr. Ryssman says. "We understand the importance of working with our patients to help them achieve their goals."