Foot and Ankle Surgery Unit

Istituto Ortopedico Galeazzi

KEY FIGURES:

CLINICAL SERVICES:

  • Outpatient consultation
  • One day surgery for small foot procedures
  • Hind foot/mid foot/forefoot surgery
  • Traumas

PROCEDURES PERFORMED PER YEAR:

  • 60 Total ankle replacement
  • 120 Paediatric flat foot correction
  • 90 Complex adult foot deformity (flat foot and club foot)
  • 750 Hind foot deformity correction
  • 80 Complex rheumatological feet

Since the foundation in 2013 the USPeC Unit devoted its efforts to a 360-degrees study and treatment of foot deformities and diseases, treating more than 1000 patients on an annual basis.

It has been the leading team in TAR (Total Ankle Replacement) and even now it has the longest follow up of Hintegra TAR.

Open to all innovations, the main area of treatments is foot deformity (flat foot, club foot, arthrosis).

Dr. Alfieri Montrasio, former President of the Italian Foot and Ankle Society, is devoted to teaching at the University of Milan and also offers medical advice to Rugby players of the Italian teams and the National team.

Dr. Boga, co-founder of the USPeC Unit, is the main TAR surgeon and has also developed Arthroscopic AMIC (a technique to resurface large cartilage lesion using a porcine membrane).

Dr. Milani, joined the team in 2014 and his main area of interest is minimally invasive surgery.


TREATMENTS:

Foot Deformities

These alterations of the anatomy of the foot are related to failure in the correct biomechanics of the lower limb, joint might present alteration of the correct function. All these lead to muscular disbalance itself thus affecting the correct foot path.

Main Pathologies Treated:

  • Flat foot
  • Club foot
  • Posterior tibialis tendon alteration or rupture
  • Plantar fasciitis
  • Recurrent ankle sprain
  • Hallux valgus
  • Metatarsalgia
  • Hammer toe
  • Bunionette of m5,
  • Morton’s neuroma

Top Procedures:

  • Subtalar and mid-foot fusion
  • Subtalar fusion simple or with open wedge axial correction
  • Medial calcaneal osteotomy
  • Closed wedge calcaneal osteotomy (Dwayer)
  • Distal m1 osteotomy (Austin, WU)
  • Distal osteotomy of metatarsal to shorten the bone and elevate the head
  • Jimenez procedure

Foot and Ankle Arthritis

The foot and ankle might suffer primary cartilage degeneration or secondary (after traumas or following mechanical disbalance).

In most cases foot and ankle joint arthritis, when severe, is treated with bone fusion in order to prevent any movement which causes pain through receptors not covered by cartilage anymore. Ankle arthritis is treated when the patient is eligible for TAR. TAR’s goal is to reduce pain meanwhile allowing movement.

USPeC is one of the main users of 4th series total ankle implants, this protheses is a resurfacing implant, implanted since 2012 and the first results of the 5-year follow ups are encouraging.

Main Pathologies Treated:

  • Foot and ankle arthritis

Top Procedures:

  • Proximal interphalangeal (PIP) joint fusion
  • First metatarsophalangeal (MP1) Joint Fusion
  • Resection of metatarsal heads
  • C1M1 fusion
  • Miller procedure
  • Lisfranc Fusion
  • Talonavicular fusion
  • Subtalar fusion
  • Total ankle replacement
  • Tibiotalocalcaneal (TTC) fusion with plate or nail
  • Tibiotalar fusion

Cartilage defects

Since 2011 our team decided to start treating cartilage defects with arthroscopic approach, at first stimulating the coverage of the lesion through micro-perforation in order to produce a fibrous scarring tissue covering the lesion.

Dr. Boga, since 2014, has started with the AMIC method, a coverage of the cartilage defect with autologous bone implant and porcine membrane which allows the lesion to be covered by a tissue rich in chondroblast, very similar to the cartilage.

This procedure performed with a mini-invasive technique allowing for a fast recovery of the patients, with no need to wear any plasters as the bone needs to be osteotomized.

At the follow-up the team has recorded very satisfying results especially in high demanding patients (young athletes).

Main Pathologies Treated:

  • Osteochondritis
  • Autologous matrix-induced chondrogenesis (AMIC) Arthroscopy

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT:

  • Personalized arthroscopic set to perform AMIC procedure