Beijing 23 August 2006

Mr. Paul Carr

Paulcarr2005@hotmail. com
Dear Mr. Carr,
Name: Paul CARR File Code: C09741
Diagnosis: 1. OLT left ankle
2. Footballer s ankle left
3. Pronated feet
I am writing to record our consultation today. You twisted your left ankle avoiding a
car about 7 years ago. You were given a cast at the time. About 6 years ago the ankle
became painful. On 18 July 2006 you had an MRI in your native Ireland, which
showed an osteochondral lesion of the talus (OLT) i.e. damage the articular
cartilage and underlying bone but you were unable to arrange treatment as you were
coming to Beijing.
The ankle is not unstable - in other words - it does not feel weak and give way .
The other ankle is OK.
On examination: pronated (flat) feet. Left ankle is tender at the antero-medial joint
line. Both ankles are stable. You have generalised ligamentous laxity.
MRI 18 July 2006: as stated. In addition there is small anterior tibial osteophytes
which represent footballer s ankle i.e. extra spikes of bone which have grown on
the front of the joint and can cause pain.
Recommendation: arthroscopic (keyhole) treatment of the ankle by performing a
simple debridement (clean up) of the damaged cartilage and underlying bone on the
OLT and removal of any impinging osteophytes (footballer s ankle) at the same time.
This surgery can be performed in Hong Kong, and you will be able to leave hospital
the same other next day and return to Beijing a few days later. You will be able to
walk with minimal assistance immediately after the operation.
Footwear recommendation: I suggest motion control shoes (see www.sp.hk
product section on types of running shoes) as your flat feet may be contributing to
your ankle pain.
Yours sincerely,

Jason Brockwell, FRCSEdOrth FHKAMOrth Pg Dip Sports Med

Sports Medicine & Arthroscopy
cc Nurse Linda Fung (linda.fung@sportsphysicians.hk)