Advanced Food & Ankle Specialist for Ankle Prosthesis

Prótesis de Tobillo

An ankle prosthesis means that the ankle joint is replaced with artificial material. Pain in osteoarthritis is the most common complaint leading to ankle prosthesis.

Pain caused by osteoarthritis of the ankle lead to:

  • Limited walking distance
  • Disturbed sleep
  • Walking stairs is difficult
  • Swollen ankle
  • Dis-alignment of the ankle may be an "O" or "X" position; using an ankle prosthesis is not possible
  • Obstruction in bending of the Ankle


The procedure is as follows:

  • The operation is performed under general anesthesia or spinal anesthesia
  • Once the damaged bone has been removed, the artificial parts can be inserted and with the bone prepared to fit and stabilize the ankle
  • With the parts inserted, the Ankle joint performance is examined and finally placed in position.
  • The wound is applied with a drain for excess of blood and/or fluid disposal, local anesthesia and closed with stitches
  • After 14 days the wound is inspected and stitches removed
  • A  plaster cast is needed for 6 weeks after surgery
  • We use the latest techniques to minimize tissue damage so that recovery is progressing at a fast pace after surgery.

To undergo an ankle replacement is not a daily matter. An Ankle replacement is major surgery with an extended recovery period. It is important to consider all consequences. The better your physical condition before your treatment, the better your recovery after surgery.

Frequent asked questions (FAQ)

How long takes an Ankle replacement procedure?

The average duration of an ankle replacement is between 60 and 90 minutes.

How long will an Ankle replacement last?

Research shows 15 years but each individual has potential differences such as heavy use can shorten the lifecycle.

Is an Ankle revision possible?

Replacing the replacement Ankle is usually more complicated and a longer procedure than the original surgery. There is no set limit to the number of times you can have revision surgery, but it is widely accepted that the artificial Ankle joint becomes less effective each time it is replaced.

What are the consequences of an infection of the Ankle replacement?

When a total joint replacement becomes infected, it may loosen, become painful, and need to be removed. When infections occur within 6 weeks after surgery it is treated by extensive rinsing of the Ankle and giving antibiotics. Unfortunately, even if the implant is washed clean during surgery, most types of infections require removal of the implant to cure the infection.

My Ankle makes clicking noises. Why is this and can it hurt?

In Ankle replacement, the ends of the bones that make up the Ankle joint are “resurfaced” with metal and plastic components. Because there is almost always some laxity in a replaced Ankle, clicking can sometimes be heard as a result of contact between the metal and plastic components during activity.  Often it is heard during a transition from low or non-weight bearing to weight bearing.  For example, a patient may hear the click while walking as the leg comes out of swing phase and makes contact at heal strike.  For the most part, the clicking is usually not associated with any adverse conditions

Should I take antibiotics for treatment by the dentist if I have an Ankle replacement?

Patients who have joint replacement surgery are at risk for developing infections of the implanted joints. Once bacteria that have traveled through the bloodstream find implanted joints, the body's immune system has a difficult time fighting the infection.

How old do I have an Ankle replacement to get?

For young people with arthritis (usually under age 40-50) it is desirable to avoid a joint replacement if possible, since patients in that age group are very likely to outlive the joint replacement. In those individuals, who represent a very unusual circumstance, there are other surgical options available. For people in "middle age" or older, an Ankle replacement is usually the best choice to relieve the pain of Ankle arthritis, and restore a reasonable level of function.

Will I ‘beep’ at an airport, with Ankle prosthesis, as I go through the gate?

Not common but especially in thin patients or multiple implants it can happen.

Foot and Ankle Podiatrist in Houston for treat the Laser Therapy

Terapia Láser

  • When a physical illness or injury affects mobility or quality of life, there is a goal: a rapid return to daily activities.

    Rivera Foot & Ankle is proud to be at the forefront of medical technology, offering Laser Theraphy MLS. We have invested in the best technology as a key component of our ongoing quest to provide the utmost in health services.

    Laser therapy has been FDA approved and proven successful as evidenced by a thorough and reliable study conducted in the best institutions of our country, including Harvard University.

    • Managing Pain
    • Reduce inflammation
    • Regain mobility
    • It helps speed recovery


    • Tendon and ligament injuries
    • Arthritis
    • Soft tissue injuries
    • Muscle strains
    • Muscle and joint pain
    • Degenerative joint conditions
    • Neuropathic pain
    • Chronic nonhealing wonds
    • Overall pain
    • Musculoskeletal disorders
    • Pre and post surgical treatment


    • Nonsurgical treatment
    • No patient sedation
    • Very safe, no side effects
    • Immediate results
    • Accelerates the healing process

    Ask us how laser therapy can help!

  • 1. Anti-Inflammatory:

    MLS® Laser Therapy has an anti-edema effect as it causes vasodilation, but also because it activates the lymphatic drainage system which drains swollen areas. As a result, there is a reduction in swelling caused by bruising or inflammation.

    2. Analgesic:

    MLS® Laser Therapy has a beneficial effect on nerve cells. It blocks pain transmitted by these cells to the brain which decreases nerve sensitivity. Also, due to the decreased inflammation, there is less edema and less pain. Another pain blocking mechanism involves the   production of high levels of pain killing chemicals such as endorphins and enkephalin from the brain and adrenal gland.

    3. Accelerated Tissue Repair and Cell Growth:

    Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. The laser light increases the energy available to the cell so that the cell can take on nutrients faster and get rid of waste products. As a result of exposure to laser light,  damaged cells are repaired faster.

    4. Improved Vascular Activity:

    Laser light will significantly increase the formation of new capillaries in damaged tissue which speeds up the healing process, closes wounds quickly and reduces scar tissue. Additional benefits include acceleration of angiogenesis, which causes temporary vasodilation and increase in the diameter of blood vessels.

    5. Increases Metabolic Activity:

    MLS® Laser Therapy creates higher outputs of specific enzymes, greater oxygen and food particle loads for blood cells.

    6. Trigger Points and Acupuncture Points:

    MLS® Laser Therapy stimulates muscle trigger points and acupuncture points on a noninvasive basis providing musculoskeletal pain relief.

    7. Reduced Fibrous Tissue Formation:

    MLS® Laser Therapy reduces the formation of scar tissue following tissue damage from cuts, scratches, burns or surgery.

    8. Improved Nerve Function:

    Slow recovery of nerve functions in damaged tissue can result in numbness and impaired limbs. Laser light speeds the process of nerve cell reconnection and increase the amplitude of action potentials to optimize muscle healing.

    9. Immunoregulation:

    Laser light has a direct effect on immunity status by stimulating immunoglobulins and lymphocytes. Laser emissions are absorbed by chromophores (molecule enzymes) that react to laser light. Upon exposure to the laser, the enzyme flavomononucleotide is activated and starts the production of ATP (adenosinetriphosphate), which is the major carrier of cell energy and the energy source for all chemical reactions in the cells.

    10. Faster Wound Healing:

    Laser light stimulates fibroblast development in damaged tissue. Fibroblasts are the building blocks of collagen, which is the essential protein required to replace old tissue or to repair tissue injuries. As a result, MLS® Laser Therapy is effective post surgically and in the treatment of open wounds and burns.

    • Treatment for arthritis with laser theraphy
    • Treatment for bursitis with laser theraphy
    • Treatment for sports Injuries with laser theraphy
    • Treatment for Sprains and strains with laser theraphy
    • Treatment for occupational injuries with laser theraphy
    • Treatment for Repetitive motion injuries with laser theraphy
    • Treatment for Post-surgical swelling with laser theraphy
    • Treatment for plantar fasciitis with laser theraphy
    • Treatment for tendonitis with laser theraphy
    • Treatment for wounds with laser theraphy
    • Treatment for bruising with laser theraphy
  • What is laser therapy?

    Laser therapy is the use of certain wavelengths of light for the treatment of painful and debilitating conditions.

    How does it work?

    Light energy enters damaged cells and stimulates intercellular activity. This reduces pain in the area and speed recovery of damaged cells. Once the cells are recovered, the healing process is complete.

    What I can expect during treatment?

    Laser therapy is a painless treatment that usually lasts several minutes. The patient may experience a sense of comfort at the point of application.

    What I can expect after treatment?

    Most patients are positive in treatments 1-3 weeks. The swelling is greatly reduced and there is a rapid pain relief. Chronic conditions can be controlled with regular treatments. Acute conditions typically refer quickly, usually within a series of treatments.

Foot and Ankle Podiatrist in Houston for treat the Anatomic Insole

Plantillas Ortopédicas


Usually used for people suffering pain from flat feet or spurs condition. Templates designed by Dr. Orlando Rivera have been designed under the highest strict quality controls, and its design has been carefully adapted in different types of bone architecture, every human being has a different foot type, and the traditional footwear does not provide adequate support for our feet to support the weight of the body.

Therapy templates have the automolding technology, which allows to be used by the patient, these take the shape of your foot, providing more support in those places where the pressure is greater.

In its construction is used for the bottom layer plastazote offering custom molding, and the top layer a thick layer of genuine cowhide.


  • PVC base material
  • Poliurethane midlayer
  • Cow lining Footbed layer


  • Put on the insoles into shoe with the Plastazote layer above.

Instructions of maintenance:

  • Clean with a light wet soft cloth
Base material with Arch Support and heel cup: extending from heel cup to just behind the metatarsal heads to provide outstanding fit and relief.
Poliurethane mid layer: resist bottoming out of the upper Plastazote layer.
Cow lining footbed layer: provide the right temperature while allowing the foot to breathe.
Accomodate insole: high surface of contact.


Podiatrist in Houston to treat the Not Invasive Treatments for lower extremity

Tratamientos no invasivos de la extremidad inferior

  • A support, brace or splint to support, align, prevent or correct the function of movable body parts. Shoe inserts are orthotics that are designed to correct an abnormal or irregular gait pattern, by altering slightly the angles at which the foot strikes a walking or running surface.
  • Some therapeutic uses

    • Arthritis
    • Bursitis
    • Sports Injuries
    • Sprains and strains
    • Occupational injuries
    • Repetitive motion injuries
    • Post-surgical swelling
    • Plantar fasciitis
    • Tendonitis
    • Wounds
    • Bruising

Advanced Food & Ankle Specialist for Reconstructive Foot and Ankle Surgery

Cirugía Reconstructiva de Pie y Tobillo

  • The foot and ankle surgery has evolved significantly in recent years due to several factors: the technological advancement of materials such as screws and plates, with anatomical designs and better biomaterials (titanium alloys, etc.), improved surgical techniques and computerization of gait studies (biomechanics, baropodometry electronics, video-assisted laboratory gear, etc).

    It is now possible to combine open surgery techniques, mini-invasive, percutaneous and arthroscopic. As a result have shortened periods of treatment and recovery and improved the short-, medium and long term.

    Foot surgery or percutaneous MIS surgery (by its Spanish acronym, minimal incision surgery), is a method to perform surgical procedures through small incisions, without direct exposure deep levels, reducing the risk of tissue injury soft and surgery times and promotes bone healing.

    Reconstructive surgery is performed primarily to restore foot function. It is indicated in a myriad of diseases.
  • SURGERY forefoot

    • Bunion
    • Claw toes, hammertoes and other deformities of the lesser toes
    • Complex deformities of the forefoot
    • Total Prosthesis first finger
    • Surgery metatarsal
    • Surgery nail (polish)

    SURGERY middle and hind foot

    • Adult flatfoot surgery
    • Flat Foot Surgery Children
    • Tarsal Coalitions
    • Heel Spurs


    • Plantar fasciitis
    • Tarsal tunnel syndrome
    • Excision of soft tissue tumors


    • Ligament reconstruction
    • Achilles tendon lengthening
    • Liberation gastrocnemius

Foot and Ankle Podiatrist in Houston for treat the Physical Therapy for lower extremity

Terapia Física para la Extremidad Inferior

  • A branch of rehabilitative health that uses specially designed exercises and equipment to help patients regain or improve their physical abilities. Physical therapists work with many types of patients, from newborns with musculoskeletal birth defects, to adults suffering from sciatica or the after-effects of injury, to elderly post-stroke.
  • Ankle sprains are one of the musculoskeletal injuries more common. Sprains are injuries to the ligaments of the ankle, causing them to break partially or completely as a result of sudden stretching. They can occur in one or both of the inner and outer parts of the ankle joint. Ankle sprains are the most common when there is a preexisting muscle weakness in the ankle area or a history of previous ankle injuries. The typical injury occurs when the ankle is suddenly "twisted" in a sport or down an uneven surface. The pain is initially severe and can be associated with a "popping" sensation. Immediate swelling in the area of the injury is more common in damaged blood vessels leak fluid into the local tissue. Examination of the area can cause pain when the ankle moves. The degree of pain does not necessarily indicate the degree of damage to the ligament (s). Ligament injuries are graded from I to III, ranging from partial to complete tears. partial tears maintain a certain stability of the ankle, while complete tears become unstable, because the reinforcement strips ligaments longer ankle joint. After an examination, significant ankle sprains are commonly evaluated with an X-ray test. X-rays can determine if there is a rupture of accompaniment (fracturing) the bone.

    Acute ankle sprains are initially treated with ice, rest, and limiting the amount of walking and bearing weight on the injured ankle. The leg can be elevated to reduce swelling, and crutches are often recommended to prevent further trauma to the injured ligaments. Nonsteroidal anti-inflammatory can be taken to reduce local inflammation. Ice packs to further decrease the inflammation in the area and can reduce pain. Patients with serious injuries are placed in immobilization casts. Surgical repair of grade III injuries is considered, especially for patients who covers sports participation in the future. physical therapy programs are part of the rehabilitation process, incorporating strengthening exercises of the calf muscles. Fractures are repaired with frame to immobilize the bone during healing. Depending on the severity, fractures may require orthopedic casting, surgical procedures, including fixation, and open repair of the fractured bone

Foot and Ankle Podiatrist in Houston for treat the Lower Extremity Nerve Decompression Surgery

Cirugía de Descompresión del Nervio de la Extremidad Inferior

  • What causes foot pain?

    Foot pain can be caused by many different conditions or injuries. Acute or repeated trauma, disease, or a combination of both are the most common causes of foot pain. Trauma is the result of external forces the body, either directly affect the body or force the body into a position in one or a combination of forces on the result of damage to body structures. Misalignment can result in biomechanical foot pain. Wearing shoes that are too tight or high heels can cause pain in the toes and the bones in that area. Shoes that are tied too tightly can cause pain and bruising on the top of the foot.

    Injuries such as ligament sprains, muscle strains, contusions and fractures usually occur suddenly (acute). Sprains, contusions and fractures may result from a single or a combination of tensions in the foot. A sprained foot or ankle occurs when the ligaments that hold the bones are overstretched and the fibers tear. The looseness of the ligaments of the joints of the feet can lead to foot pain.
    The bag muscle and fascia of the foot can be strained by overstretching, overuse, overloading, bruising, or cutting (eg stepping on a sharp object). Achilles tendonitis is a common injury to the tendon that attaches to the back of the heel.

    Injury to the bones and joints of the foot can be caused by a blow or strain on the foot, or also by repetitive trauma that can result in a stressfracture. A blunt force injury such as someone walking on your foot can result not only in a bruise (contusion) injury, but also damage to the muscles and ligaments of the foot. a direct blow to the foot can cause bruising, skin breakdown, or even broken bones. Metarsalgia is irritation of the joints of the ball of the foot toe Turt. is a common injury in athletics that sneaks into the tendon of the joint at the base of the big toe. Trauma to the toenail can cause the accumulation of blood under the nail and the temporary or permanent loss of a toenail. Repetitive trauma to the bones, muscles, ligaments and can result in extra bone growth known as spurs or exostosis.

    The lesions in both the leather cover and internal structures can also be caused by multiple small repetitive trauma. micro-trauma injuries can be caused by running on uneven surfaces, surfaces that are too hard or too soft, or shoes that have poor absorption qualities of force or incorrectly. repeated stress of the same foot structure can cause stress fractures, tendonitis, plantar fasciitis, and acute and chronic osteoarthritis.

    The arches of the feet absorb and restore strength and body to the outside world when you are standing on your feet. Plantar fascia injury is a common cause of arch pain. The plantar fascia is a tough fibrous sheath that extends the length of the bottom of the foot and supports the arc. When the plantar fascia is damaged, the resulting inflammatory response can become a source of pain arc. feet tall and under flat arches can cause pain because of the stress on your feet.

    Footwear can contribute to foot pain. maladaptive shoes in the short term can cause blisters, calluses, bruises and a source of athlete's foot. The long term effects can bebunions, corns, irritation of the nerves and joints, misalignment of the toe, and the origin of microtrauma injuries in the foot.

    Diseases, viruses, fungi and bacteria can also be sources of foot pain. Diabetes, Hansen disease, and gout are common diseases that affect the feet. Disorders of the nerves of the feet can cause numbness and burning sensation in feet neuropathy asperipheral know.
  • How to relieve foot pain?

    Information on foot pain, arthritis, conditions, causes, diagnosis, symptoms, pain relief, prevention, surgery and other treatment options. Each foot consists of 33 elements. Foot pain is often difficult to avoid because of the large weight-bearing load are given.

    Normally, the heel pain lasting several days if not will give you rest. Naturally, it is impossible to give complete rest to his feet. So massage is a great alternative. Different procedures massage will give you a dose of relaxation and eliminate daily stress. The massage technique is also known as control tissues. That's why many experts as consultants foot pain or podiatrist recommended this technique.

    There are some special massage techniques. The advantages of this type of treatment.

    When you get tired after a long day at the workplace, which require some type of relaxation. After returning home, you may want to take a nap, but you find that there is something else you need to calm down. Usually people suggest getting a massage, which is actually an effective therapy to reduce pain in muscles and joints. Massage provides special comfort and a feeling of freshness. It energizes your body and relax your mind.

    Oil is the main staple and a massage. When the feet or any part of the body is massaged with oil deposits there. These oil droplets get inside the foot. In an instant, the person feels relaxed and quickly gets into a very calm position. Oil is a herbal agent and massage is the form of herbal treatment. That's why many doctors say is a herbal cure for pain anywhere in the body.

    The pain is basically the result of what you did. There are many cases when people go with severe foot injury due to an accident or otherwise. Allow the injury worse and if not consult a specialist for treatment becomes a chronic problem. This neglect can cause more damage than you can imagine. In these cases there is the possibility that the end face stitches people on their feet. First aid is the primitive measure to be taken into account to avoid painful tissue damage.

    There are some other reasons why people have foot pain. Stress is the most common cause of this result. When you are stressed, your body will suffer if you do not learn to relax and the result is pain in the back or feet. The massage is the manipulation of body tissue, but adjusts the tissue disorder. When tissues are back in their normal position, the swelling has gone and feel relieved.

    Try applying the normal patterns of massage, is a permanent solution for chronic pain. No side effects, the procedure is completely herbal and natural. Massage is the recommendation of many medical professionals. Muscle pain is the main reason for the concern and discomfort.