Ankle Cheilectomy

An Ankle cheilectomy (bone spur removal) is used to treat anterior ankle impingement resulting from certain injuries such as ankle arthritis. Anterior ankle impingement causes a pinching, painful sensation at the front of the ankle joint. Bone spurs or other soft tissue swellings can sometimes be felt beneath your skin. X-rays, bone scans, or 3-dimensional imaging (CT scan or MRI) will help to show the ankle joint and the bone spurs clearly. The bone spurs may be on the tibia, the talus, or both. Ankle cheilectomy may be offered if non-surgical treatment is not effective.

Conditions

If you have anterior impingement you may experience symptoms when walking uphill or when squatting (when the front of the shin moves toward the foot). Sometimes, you will feel weakness or instability in your ankle due to pain, or you may feel that you are “walking with your feet turned outward.”

Ankle cheilectomies are most effective for you when you have mostly healthy ankle joints, with pain specifically at the front of the ankle. If most of the joint are healthy, and only the front of the joint shows narrowing or bone spurs, then removing the prominent impinging bone spurs and/or anterior soft tissue can help symptoms considerably.

If there is evidence of injury to other parts of your ankle (from fractures or sprains) or if you have more significant ankle arthritis, then sometimes only partial relief of symptoms can be expected from removing bone spurs and scar tissue from the front part of the ankle.

Surgery

Doctors perform surgical treatment by removing the prominent bone spurs and/or soft tissue or scar tissue from the front of your ankle. This is done either arthroscopically, or by opening up your ankle joint with a wider incision. An ankle cheilectomy for small areas of spurs/tissue can usually be performed arthroscopically. However, if your bone spurs are large, it is often more efficient and effective to make a larger incision, open up the ankle joint, and remove the bone spurs.

In some instances, surgery to remove the bone spurs can contribute to an unwanted increase in your symptoms since the surgery is designed to allow the ankle joint to move more, and more movement may irritate the other damaged areas of your ankle.

Rehabilitation

Recovery requires limited activities for 6-8 weeks, during which time your ankle will be swollen and painful. However, you may be able to weight-bear immediately after surgery if an ankle cheilectomy was the only procedure performed. Crutches and/or an air walker brace may be prescribed to enhance your comfort after the procedure. Physical therapy to gradually mobilize the joint safely and comfortably will often be prescribed as well. It is important to recognize that your ligaments and tendons may be tight before surgery. You should expect an improved, but not fully normal, range of motion, even after surgery and rehabilitation.

Your bone spurs themselves often tend to ‘grow back’ gradually over time; therefore, recurrence of symptoms is possible. Athletes may continue to experience mild or moderate symptoms in the long term.