When patients meet with a foot and ankle specialist, many have already been dealing with pain in their foot or ankle for months or even years. While some are living with a severe injury or deformity, others may have ongoing nerve symptoms or a loss of function that has not improved with other treatments, and others may have even been told surgery is their best remaining option.
Aaron K. Ruter, D.P.M., is a board-certified, fellowship-trained surgical podiatrist at Lakeshore Bone & Joint Institute (LBJI). His practice includes complex foot and ankle reconstruction, peripheral nerve surgery, limb salvage and foot and ankle trauma. He also serves as a second-opinion resource for patients who want to better understand what may still be possible.
Seeking another evaluation does not necessarily mean the first recommendation was wrong; complex foot and ankle conditions can have more than one reasonable treatment path, with different benefits, risks, and recovery demands. Dr. Ruter focuses on helping patients understand those options and determine which approach best supports their health, function, and personal goals.
When Should You See a Foot and Ankle Specialist?
An evaluation may be appropriate when foot or ankle pain affects daily function, has not improved with previous care, or could require a major treatment decision.
Consider seeing a foot and ankle specialist if you are experiencing:
- Numbness, burning, tingling or electric sensations that may be related to a nerve
- Foot drop, increasing weakness or a change in the way you walk
- A red, hot or swollen foot, especially when there is no clear injury
- A severe injury that changes the shape, stability or function of the foot or ankle
- Pain, deformity or loss of function that continues despite prior treatment
- A recommendation for amputation or fusion that you want to understand more fully before proceeding
During a second opinion evaluation, Dr. Ruter may identify another appropriate treatment path or confirm that the original recommendation remains the safest and most effective choice. Either result can help the patient move forward with greater clarity and confidence.
Evaluating the Whole Foot and Ankle for a Comprehensive Diagnosis
For Dr. Ruter, foot and ankle reconstruction is more than repairing a single bone or joint. The foot and ankle support the weight of the whole body, absorb force, and work together along with muscles, tendons, ligaments, and nerves. A problem with any one of these structures can change how the entire limb moves.
When evaluating a difficult case, Dr. Ruter first considers the patient’s alignment, stability, nerve function, soft tissue, circulation, and the quality of the bones in the foot and ankle. He also reviews the results of his examination with prior treatments, imaging, work demands, and personal goals.
Together, these details help him determine whether nonsurgical care may still be useful before turning to a surgical procedure such as reconstruction.
Symptoms including burning, tingling, numbness, or electric sensations may point to a nerve-related condition rather than a problem involving only a bone, joint, tendon, or ligament. Because these symptoms can overlap with other conditions, identifying the source of the problem is an important first step.
Exploring Options Beyond Typical Foot and Ankle Care
Advances in orthopedic technology have expanded the options available for certain complex foot and ankle conditions. Dr. Ruter considers these specialized approaches when they fit the patient’s diagnosis, anatomy, health, and treatment goals.
One example involves avascular necrosis of the talus. Avascular necrosis occurs when a bone loses its blood supply, causing it to weaken and potentially collapse. The talus is a central ankle bone that helps transfer weight from the leg to the foot. Damage to this bone can significantly affect the stability and function of the ankle.
An ankle fusion can be an effective and appropriate treatment for many patients with this diagnosis. Dr. Ruter took a particular case of avascular necrosis, however, and suggested that a fusion would most likely not join successfully.
After reviewing the patient’s anatomy and individual risk factors, Dr. Ruter planned a reconstruction instead, using a 3D-printed talus implant to replace the damaged bone. Created through imaging, the implant offered this patient another solution to address the damaged bone without relying on the healing process required for a fusion.
A custom implant is not automatically a better option, and it is not appropriate for every patient. Its value is that it may provide another carefully selected approach when a more traditional treatment presents added concerns.
The same individualized thinking applies to limb salvage and complex trauma. When evaluating potential procedures like fusion or amputation, Dr. Ruter thoroughly examines and determines which option provides the individual patient with the safest and most realistic opportunity to preserve function.
Foot and Ankle Surgery is Only Part of the Work
When surgery is part of the treatment plan, Dr. Ruter is direct with patients about what the procedure can accomplish and what recovery will require.
Surgery creates an opportunity for healing. Following the recovery plan helps protect the reconstruction and gives it the best chance to succeed.
Dr. Ruter describes this process as a partnership. He is responsible for planning and performing the procedure, while the patient must be prepared to follow restrictions, follow-up care and appointments, and participate in physical therapy when prescribed.
This allows Dr. Ruter and the patient to establish a realistic goal for recovery. That goal may be walking around the block, returning to work, standing with less difficulty, or remaining independent.
Working Toward a Better New Normal
For Dr. Ruter, success is not defined by using the most advanced procedure or avoiding a particular treatment. Rather, he defines it as helping the patient understand the available choices, establish an honest goal, and work toward the best possible function.
Learn more about Dr. Aaron Ruter or schedule an appointment with the Foot & Ankle Team at Lakeshore Bone & Joint Institute.