Kochi: VPS Lakeshore Hospital in association with the Indian Foot & Ankle Society (IFAS) on Saturday successfully performed a live surgical workshop on Osteochondral Lesion of the ankle joint – known as Osteochondral Lesions of the Talus (OLT) in medical parlance – with Episealer Implant imported from Episurf, Sweden. The rare feet surgical procedure was conducted by noted surgeon Dr Rajesh Simon, Senior Consultant and Foot & Ankle Surgeon at VPS Lakeshore Hospital and current President of IFAS along with Prof. Niek van Dijk, former head of the Orthopedic Department of the Amsterdam University Hospital, and founder of the Orthopedic Research Center Amsterdam and the Amsterdam Foot & Ankle School. Prof. Niek, who led the surgical procedure, is currently working at the FIFA Medical Centers of Excellence in Madrid. The patient was a 28-year-old native of Kochi, perusing PhD in IIT, Goa. This is the first time that such a surgery was performed in Kerala.

“The patient had met with an accident few months back. His ankle was seriously injured. This was Osteochondral Lesion of Talus. That is the cartilage injury to the ankle joint. If it is a small injury, we can do it as a Keyhole surgery. But it was 1.5-centimetre-deep injury and talus had damages. So, we opted for the open surgery using latest technology which is most advanced option available today to cure this particular injury. The surgery was done using a virtually created 3D model of the damaged talus. This 3D model helped identify the and define the lesion. The individualized design of the implant was customized based on MRI and CT Scan images and data. The surgery went on well and the patient is recovering fast. If the patient’s wounds heal within one and half months, then we are expecting to make him walk within that time.”, Prof. Niek van Dijk said.

“The goal of the surgery was to restore the ankle function and reduce the pain significantly, as well as stop or delay the need for a joint replacement surgery or ankle fusion”, Dr Rajesh Simon, said. The individualized design of the Episealer Talus implant and Epiguide are based on images generated from MR and/or CT scans. “By processing the data, a virtual 3D model of the damaged talus surface was created and the lesion was defined. Subsequently, the Episealer and instruments were designed to remove the damaged tissue as well as to restore the area with a perfectly fitting implant. Using the Epiguide during surgery increases the precision of the surgical procedure for optimal positioning of the implant”, Dr Rajesh Simon said adding “no superior treatment to OLT is available as of now.”

The Episealer is made of cobalt-chrome alloy. The part of the Episealer that is countersunk in the bone and cartilage is covered with a titanium undercoating and a hydroxyapatite outer coating, ensuring a quick and lasting fixation to the bone. Personalized treatment option that replaces the affected area of the joint surface was developed by Episurf Medical.

Episurf Medical is a Swedish surgical and medical instrument manufacturing company that endeavors to bring people with painful joint injuries a more active, healthier life through the availability of minimally invasive and individualized treatment alternatives.

OLT is a medical condition with patients who met with an accident develop deep ankle pain during or after weight-bearing activities after six month or one year of the incident. Physical examination and imaging are paramount in the diagnosis of OLT. The lesion size and morphology, surgeon and patient preferences, and individual patient aspects guide treatment options for individual patients. Optimal surgical management depends on primary or secondary nature of the lesion, size, morphology, fixability, and presence of a fragment.