Description of patient (type of occupation, indication of age, intensity of sport):
female, 40 years-old. she has pain in her left ankle for 5 years. no trauma
History and previous treatment:
2007 : ankle arthroscopy performed Pridie with Kirschner. she hadn't improvement.
2011: second ankle arthroscopy. cartilage lesion resection with burr. she didn't present clear improvement.
Currently she presents anterolateral and anteromedial pain in her ankle, with a good articular balance, without stifness, but pain in weigth bearing. she can't practise any sport.
Additional investigation (CT/MRI):
osteochondral defect in talus, operated two times before
Question(s) to this case:
what is the next step for you? thanks a lot for your expert opinion
can you make a standard AP weightbearing X-Ray of the ankle:
It is important to see if there is joint space narrowing on weightbearing. It is also important to judge the alignment on this X-Ray.
Does she have a hindfoot varus?
Finally I could add the x-ray in charge. I wait for your expert opinion.
patient haven't a hindfoot varus. -> Picture 2
My advice would be to perform a hemicap procedure.