Case Study: Arthritis and Capsulitis

Home/Case Study: Arthritis and Capsulitis

Patient History

This 80 year-old gentleman presented for a two month follow up appointment
for right ankle arthritis and capsulitis.

Assessment taken during this appointment showed the patient had the following:

  • Primary osteoarthritis of right ankle M19.071 (primary)

  • Pain in right ankle and joints of right foot – M25.57

  • Capsulitis of right ankle – M77.51

  • Equinis deformity, right ankle joint

The patient was given multiple surgical and conservative options as proposedtreatment plans.


Due to the significant nature of the deformity and that the patient had exhausted conservative measures, total ankle implant arthroplasty and Achilles tendon lengthening were identified as the best course of treatment.


The patient underwent general anesthesia and was admitted for two days following the surgery. Adjunct procedures, such as an Achilles tendon lengthening, or ligament/tendon balancing, are methods which are sometimes required to address inherit deformities often seen in cases of developmental abnormalities, DJD, or post-traumatic arthritis. What makes this particular total ankle replacement product  truly exceptional is the fact that it employs pre-made template cutting guides, fabricated from the patient’s preoperative CT study. This foregoes the need for traumatic template guides, typically required with these operations. Often times,
such traumatic guides must be pinned in place just below the knee joint, requiring more sites of invasive surgery. With the current system we utilized in this procedure, the prefabricated guides allowed for less surgical trauma, faster operation time, and more reproducible results. Patients, including this subject, tolerate the procedure well, and operative time is usually less than 2 hours.


The patient remained non-weightbearing for 6-7 weeks and was advised to keep the area clean, dry and intact. No post-operative injections were needed and there were no complications.

Ted P. Couluris, DPM, FACFAS

Dr. Couluris has been in practice since 2003 at Foot & Ankle Specialists.Dr. Couluris is Board Certified by the American Board of Foot and Ankle Surgery in Reconstructive Rearfoot/Ankle Surgery. He is one of a select list of surgeons certified to perform ankle joint replacement.