Case history: Total ankle replacement

Graeme Collins, 63, a retired ballet dancer who now teaches, knew he was in dire straits when he first felt his ankle joint getting stiff about 14 years ago. "My left ankle was a mess," he says.

At the time, he was the head of ballet at the Hong Kong Academy for Performing Arts, after a successful 17-year career as a professional dancer in Australia, London, Sweden and South Africa. "I had sprained my ankle a number of times as a dancer," he recalls.

After retiring from dancing, he developed an interest in long-distance hiking and squash, and those activities caused a few more sprains on his now-weary ankle.

About five years ago, Collins felt his ankle becoming increasingly immobile and painful, and he started to walk with a limp. He iced and strapped it, and saw the physiotherapist at the Academy. It didn't help much.

He lived with the pain for a while more, but when it became tougher to demonstrate dance moves in class, he decided to take further action. His general practitioner did an X-ray of the ankle and confirmed it was deformed. The physician referred him to Dr Yeung Yeung, a specialist in orthopaedics and traumatology at Matilda International Hospital.

"Mr Collins couldn't put his left foot flat on the floor because of the ankle deformity. He was walking on the outside of the foot and was in a lot of pain," Yeung recalls of her first meeting with him. "Repeated injury to the outer ligament of the ankle meant it could no longer support the joint."