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Consultant Orthopaedic Surgeon

Frequently Asked Question

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When you come for your appointment remember to bring the following:

  • Insurance information
  • Referral Letter (if required)
  • Copies of results, X-rays, MRI’s, CT scans etc and any other relevant information
  • List of medications (if any)
Arthroscopy is a surgical procedure during which the internal structure of a joint is examined for diagnosis and treatment of problems inside the joint.

Arthroscopic examination of joints is helpful in diagnosis and treatment of the following conditions:

  • Inflammation: Synovitis, the inflammation of the lining of the knee, shoulder, elbow, wrist, or ankle.
  • Acute or chronic injury: Injuries to the shoulder, knee and wrist joint such as cartilage tears, tendon tears, carpal tunnel syndrome.
  • Osteoarthritis: A type of arthritis caused by cartilage loss in a joint.
  • Removal of loose bodies of bone or cartilage that becomes logged within the joint.
During arthroscopic surgery, a general, spinal, or a local anaesthesia will be given depending on the condition. A small incision of the size of a buttonhole is made through which the arthroscope is inserted. Other accessory incisions will be made through which specially designed instruments are inserted. After the procedure is completed, arthroscope is removed and incisions are closed.
Some of the possible complications after arthroscopy include infection, phlebitis (clotting of blood in vein), excessive swelling, bleeding, blood vessel, or nerve damage and instrument breakage.
It may take several weeks for the puncture wounds to heal and the joint to recover completely. A rehabilitation program may be advised for a speedy recovery of normal joint function. You can resume normal activities and go back to work within a few days. You may be instructed about the incision care, activities to be avoided, and exercises to be performed for faster recovery.
Getting a full range of motion, strength, and flexibility back after surgery usually takes time. That is where pre-operative exercise, education, and post-operative physical therapy programs come in – to ensure you are physically and emotionally prepared for surgery and to maximize your recovery after surgery.
Plantar fasciitis, an inflammation of the plantar fascia, is a common problem that causes pain under the heel bone often with lengthy walks and prolonged standing.

Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to heel bone. It is used when you walk, run and jump.

A high force or stress on the Achilles tendon results in rupture which can happen with activities that involve running, pivoting, and jumping. Recreational sports that may cause Achilles rupture include tennis, racquetball, basketball and badminton.

Bunion, also called a hallux valgus, is an enlargement of bone or soft tissues around the joint at the base of the big toe that results in the formation of a bump. The bone that joins the big toe with the first metatarsal bone thickens and enlarges, tightening the tendons, which in turn causes the base of the big toe to angle out resulting in a painful bony deformity.

Yes, ill-fitting shoes can contribute to the formation of bunions. Prolonged wearing of high-heeled or narrow shoes compresses the toes into unnatural positions.

WHAT SYMPTOMS AND PROBLEMS ARE CAUSED BY BUNIONS?

  • Pain with ambulation when wearing shoes
  • Swelling with red, calloused skin at the base of the big toe
  • Decreased mobility in the big toe
  • Inward turning of the big toe toward the second toe
  • Bulging of a bony bump at the base of the big toe
  • Formation of corns and calluses at the overlapping of the big toe and second toe

Initially, your doctor will recommend conservative treatment measures that include wearing properly fitted shoes with specially designed shoe inserts, padding, and taping of bunions.


Physical therapy and certain medications may be prescribed for relieving pain and inflammation.

 

If the above conservative measures fail to treat the bunion pain, then Mr Ajis may recommend a surgical procedure to remove the bunion.

An ankle replacement is a procedure where the damaged ankle joint is replaced with an artificial joint (prosthesis). The aim is to reduce pain from arthritis and improve mobility, while preserving as much natural movement as possible. Unlike ankle fusion, which permanently stiffens the joint, ankle replacement allows the ankle to keep moving.

Modern ankle replacement surgery often uses patient-specific instrumentation (PSI). This means that before surgery, a detailed CT scan of your ankle is taken. Specialised software is then used to design 3D-printed cutting guides that are unique to your ankle’s anatomy.

Benefits of this approach include:

  • Higher accuracy in implant placement
  • Tailored surgery that matches your unique bone structure
  • Reduced operating time in some cases
  • Potentially better long-term results because the replacement is aligned precisely

Not all centres use this technology, but it represents the most advanced and personalised approach to ankle replacement available today.

Ankle replacement is most often considered for patients with:

  • Severe ankle arthritis (often after an injury or wear and tear)
  • Daily pain that does not improve with non-surgical treatments
  • Reduced mobility and quality of life
  • A need to maintain joint movement rather than fusion
Most patients spend one night in hospital and go home the next morning. In some cases, it can even be performed as a day case procedure, meaning you go home the same day.

Recovery after ankle replacement is a step-by-step process:

  • First 2 weeks: You will be in a plaster cast and must remain non-weight bearing (no standing or walking on the operated leg).
  • Weeks 2–6: You will transition into a special boot. During this period you can walk full weight bearing in the boot.
  • After 6 weeks: Most patients are able to come out of the boot, walk in normal shoes, and gradually return to daily activities.
  • 3–6 months: Ongoing improvements in walking and function.
  • 12 months: The ankle continues to settle and strengthen for up to a year after surgery.

Modern ankle replacements have very good success rates. The majority of patients experience:

  • Significant pain relief
  • Improved walking and mobility
  • Preservation of ankle movement compared to fusion

Like any joint replacement, the implant may wear out over many years, but current designs are lasting longer with excellent outcomes.

  • Desk-based work: often possible after 4–6 weeks
  • Driving: usually after 8–10 weeks (depending on which ankle and your recovery)
  • Manual work or sports: may take 3–6 months or longer, depending on activity levels

As with all surgery, there are risks, although serious complications are rare. Potential risks include:

  • Infection
  • Blood clots
  • Nerve or blood vessel injury
  • Loosening or wear of the implant over time
  • Need for revision surgery in the future

Your surgeon will discuss these risks with you in detail before your operation.

Preparation often includes:

  • A pre-operative assessment and medical checks
  • Stopping or adjusting certain medications if needed
  • Planning for support at home in the first few weeks (as you will not be able to walk without aids initially)
Both operations can relieve pain from arthritis. Ankle fusion eliminates movement by fusing the bones together, which may reduce flexibility and put stress on nearby joints. Ankle replacement aims to preserve ankle movement, which can make walking more natural. The best option depends on your age, activity level, and the condition of your ankle.

Patient Stories

TESTIMONIALS
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Adam Ajis Web 42 scaled

Private Patient

Mr Ajis was extremely efficient. He informed me of the condition I had with clarifity and any addititional more extensive treatment I may require in the future. He immediately dealt with my small needs when he found the hospital had inadvertently made me nil by mouth, and came back to check afterwards. I would highly recommend him.

NHS patient

Listened to everything I said about the problems I was having with my ankle. He explained clearly and concisely what procedure was needed. What tests were needed. Visited me on day of operation both pre and post surgery to check that I was alright and if I had any questions plus post op to tell me his findings. Excellent care

Bognor Regis

I had pain in my ankle and over the last 3 years Mr Adam Ajis has looked after me. I saw him many times and he has always been very professional, kind and helpful. He takes the time to explain things in detail which, as a patient, is very helpful and reassuring. Both my operations were successful and I am truly grateful to him.
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