UPMC Video Rounds - Approaches to Foot and Ankle Injuries

MaCalus Hogan, MD, chief, Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery: 

The treatment of ankle cartilage injuries in athletes does vary across the spectrum of their sport, their activity level, and particularly, as it relates to whether they are a high-impact athlete with a considerable amount of running and jumping versus low-impact athletic activity.

And in either case, we work to optimize the environment for cartilage healing, so that they can span their length of their athletic career as well as being active in their later years in life.

We have a foot and ankle injury research group, which focuses on in vivo kinematic work, as well as cadaveric assessment of ankle cartilage injuries, ankle joint injuries, as well fixation techniques.

In addition, we are working with even at the stem cell, in the cellular level, and how we can improve biologic healing around cartilage injuries and other injuries of the ankle.

There are a number of novel approaches that we're using for ankle cartilage injuries. We are looking closely into biologics, which include bone marrow aspirate as well as discussions around platelet-rich plasma, both of these being autologous options that come from the patient.

And we're looking into combining those or using in isolation additional augmentation materials that are commercially available such as cartilage cell, juvenile cartilage cells, as well as minced cartilage cells, and using those for augmentation of repair.

A number of very active patients have Achilles problems as they are a result of usually overuse. And we are taking approaches to these injuries to include orthobiologics as well as augmentation techniques and the different fixation techniques we utilize for reconstruction of the Achilles when needed. With the goal being to get individuals back to their very active lifestyles that they hope to lead.

Here at UPMC, we have a number of orthopaedic foot and ankle surgeons within our Foot and Ankle Division, as well as our Foot and Ankle Center. And we utilize, as a group, a validated patient report outcomes platform that allows us to track our patients' outcome, how they're doing in real time.

And we are very confident that this will allow us to learn, evolve, and utilize the data that we have to improve our treatment for ankle injuries across our patient population.

Learn more about the Department of Orthopaedic Surgery at UPMC.