Ankle injuries: Q&A with Scripps orthopedic surgeon Jacob Braunstein

As more people return to their active lifestyles, especially as pandemic-related public health restrictions have receded, the risks for foot and ankle injuries increase. In a Q&A, Scripps orthopedic surgeon Jacob Braunstein, who lives in Encinitas, discusses his first year with Scripps, ankle surgeries and other aspects of being an orthopedic surgeon. This interview has been lightly edited for clarity and conciseness.

Dr. Jacob Braunstein

(Courtesy of Scripps)

Q: What is your background and what brought you to Scripps?

Braunstein: I had been on the East Coast my entire life before moving out here. I did undergraduate at University of Georgia, and I went on to do my medical school training at Georgetown University in D.C., and then after that I did my residency in Charleston, South Carolina. I was there for five years. And most recently I did a fellowship in foot and ankle surgery at Duke University, which is really kind of a mecca for foot and ankle surgery. Basically, how I ended up out here was my now current partner reached out to the faculty at Duke, where I was doing my last year of training, to see if I’d be interested in the position. It piqued my interest. I know Scripps has just an amazing reputation when it comes to orthopedic surgery. I took advantage of that opportunity, came out here and was kind of blown away with the opportunity.

Q: What are some of the common injuries or other conditions you see?

Braunstein: I see a variety of conditions. I treat a lot of patients who have traumatic injuries, like broken ankles, especially with such an active population as we have here in San Diego. On the other end of the spectrum, I see a lot of people who have degenerative conditions, such as arthritis of the ankle. So, we’ve been able to offer different treatment options for those different types of populations with different types of concerns.

What we’re seeing now is people who have been somewhat sedentary and they’re getting back into their previous level of activity or maybe trying new things they haven’t tried previously, and they’re not really taking the proper precautions before getting into these activities. So I think it’s important for people to ease into whatever activities they’re trying to get into. And then they need to wear the appropriate shoes, use the appropriate equipment, stretch beforehand, because you’re seeing a lot of people who are jumping in headfirst. It’s great they’re getting out there, but at the same time we’re seeing a lot of injuries.

Q: Your specialty is total ankle replacement?

Braunstein: A big reason why I was brought out here was total ankle replacement. It’s not as commonly provided on the West Coast. It’s more so on the East Coast. Scripps is known as a center of excellence for joint replacement surgery. That’s predominantly hip and knee replacement, so what they want me to bring on to Scripps is now total ankle replacement to make that part of the program.

Q: Why do people typically need a total ankle replacement, and what do they have to undergo?

Braunstein: The reason people need joint replacements in general, whether it’s knee, hip or ankle, is that they have advanced arthritis. So basically they’ve worn away the cartilage that lines the joints, and then as a result they have pain and loss of function. And so for ankle arthritis, unlike hip and knee arthritis, which is usually a wear and tear phenomenon, most people with ankle arthritis have had some type of injury, whether they have repetitively sprained their ankle or they have had a bad ankle fracture in their past and they go on to develop arthritis. And so we offer these patients as much nonoperative treatment as we can to allow them to live their lifestyle. When they’re really impacted as far as their quality of life, that’s when we start talking about the different options, including ankle replacement.

Q: When did you know you wanted to be an orthopedic surgeon?

Braunstein: It was something I was interested in early on in my teenage years. My mom was a physical therapist and a few of our good family friends are orthopedic surgeons. So I was exposed to it early on and it met a lot of my interests. As time went on, I found out that it was a really good fit for me. I just enjoy having the ability to help people get back to the level of function that they’re seeking. We have really good outcomes, which in medicine isn’t always the case. We have the opportunity to fix their issue and put their problem behind them, which is really satisfying.

Q: Is there anything in particular you want North County residents to know about orthopedic care at Scripps?

Braunstein: Part of them bringing me on board at Scripps is they were opening a new facility for Scripps Medical Center Jefferson in Oceanside, and so it’s really our largest clinic that they’ve opened in North County. We’re able to offer not only orthopedic surgery, but there’s also family practice, there’s cardiologists, there’s oncologists, we have a fully operational surgical center where I’m doing all my outpatient surgeries. Hopefully we’re able to get that out there and get all the folks in North County to realize that they don’t have to travel down to San Diego proper to get top-notch care.