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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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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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I was diagnosed with plantar fasciitis. Had a series of shockwave treatments that unfortunately didn't resolve the problem. Mr Ajis suggested a tendon release operation, which has made a tremendous difference I highly recommend Mr Ajis. Great surgeon and a very pleasant man.
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Andy Wooldridge
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After suffering 2 years with plantar fasciitis, I’d been to foot clinics to physio therapy spent a fortune on footwear …. I was told about mr Adam Ajis at goring hospital, he really was my last hope. After an MRI he decided to operate on the back of my knee to realise the calf muscle, I was a bit sceptical but my goodness this really has changed my life, no pain in my foot any more I can walk without limping and no more crying in pain… thank you so much for your care and attention to my needs… to everyone at goring hospital for being so lovely and friendly….. highly recommend this place… thank you again…
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gill baker
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To begin with.. I was naive and didn’t even know an ankle replacement was possible. What a huge success.. the whole process has been faultless.. From the initial consultation of what the options were available to me right through to the in-depth explanation of what the operation, the after care, recovery and follow up entailed. I was back playing tennis 3 months after the operation… I believe that is testimony in itself. I even think Mr Ajis was somewhat surprised! An amazing surgeon. I can’t recommend him highly enough.
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alfie profile picture
alfie
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I have had many problems with flat feet in both legs for a very long time. My mobility was very reduced with walking genuinely painful all the time. Following investigation Mr Ajis recommended a number of surgical solutions. I was surprised at the result on my left foot, it now being more stable and strength improving. Physio and excercise planned for many months before i consider the right foot, of course under the care of Mr Ajis .
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Abhai Pandya
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I am a retired Paediatrician and my wife a retired GP. We had gone to India where my wife twisted her foot and fractured 4 metatarsals in her left foot,. She was given emergency treatment at the local hospital and was advised that the fractures would heal by conservative treatment. We contacted Mr. Ajis and asked for his advice regarding best treatment option for her condition. He advised us to come home straight away and the rest he would take care of. His attitude and his words were very reassuring and we immediately felt relieved as if half the problem was already solved. Back in Worthing, Adam went out of his way and operated on her on his day off. She has had regular follow up with him and on each of these appointments. he has been extremely kind caring and gracious. My wife feels that she made the best decision in her life to be operated by Adam. He is an excellent surgeon and a very kind , caring doctor who takes his time to explain all aspects of the condition , the treatment and its sequalae and complications. The outcome of the surgery has been wonderful. After 3 months she is walking normally and is pain free. We cannot thank him enough and would recommend him as the best orthopaedic surgeon for ankle and foot surgery. Anil Garg Consultant Paediatrician(Retd)
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Anil Garg profile picture
Anil Garg
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My wife saw Mr Ajis as she had become unable to walk due to the build up of significant scar tissue from a former achilles injury a few years ago. He gave her an informed and honest list of the options available. He did not immediately insist on surgery, although my wife opted for surgery despite it being the most expensive option. The operation was carried out to fit in with our plans, and at a price which we thought was reasonable. After 6 weeks she was able to remove the post-operative boot she had been told to wear. The outcome was better than we had possibly hoped for, and she is now able to walk again, entirely pain free and normally, something which she has not been able to do for a very long time. Throughout the entire process Mr Ajis and his secretary were excellent. We would not hesitate in recommending him to anyone needing treatment.
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Adrian Daniels profile picture
Adrian Daniels
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I can highly recommend Mr Ajis, he is a brilliant orthopaedic surgeon .. I had hammered toe surgery in July, which i'm quickly recovering from now .. The my recovery app for physiotherapy is very useful as well ..
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Karen Andrews profile picture
Karen Andrews
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I initially saw Mr Ajis for a broken toe, but on the x-ray he spotted Haglunds Deformity in one foot - this was a revelation, it explained why any time I tried serious marathon training I just ended up with excruciating Achilles pain after a few weeks. Mr Ajis explained how an operation performed with keyhole surgery could remove the extra bit of bone that was aggravating the Achilles. I opted to go ahead, after all the risks were clearly explained by Mr Ajis. The operation was carried out at the Nuffield in Woodingdean under general anaesthesia, the first time I had been under. When I came round, I was given details of how the operation had gone, kept in for a few hours while I was observed and then discharged. Following discharge I had very little pain - I didn't even need to take ibuprofen. I was able to move on crutches the same day and after a couple of days could do without them. Follow up appointments confirmed that the operation had been successful and I am now looking forward to a full recovery (I know it will take time to get back to running competetively). I'd definitely recommend Mr Ajis - throughout the process he has given clear information and the operation couldn't have been smoother.
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Chris Gilbert profile picture
Chris Gilbert
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Just to say I could not have had better care. From start to finish Mr Ajis took time to explain the procedure and recovery as well as ensuring I was kept up to date. His attitude and manner have been exceptional and I am so grateful for his skill
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Simon James
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