Arthroscopy of the ankle

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Arthroscopy of the ankle
The ankle joint is where the bones of the hindfoot and lower leg meet. Ankle arthroscopy can be done for fresh injuries (sprain, fracture, cartilage damage), chronic instability, synovitis, "impingement syndrome, loose bodies in the joint, etc. If these problems are present and conservative treatment with exercises, physical therapy, wearing special shoes, orthotics, anti-inflammatory drugs is unsuccessful, ankle arthroscopy may be necessary. During this procedure, the condition of the cartilages, tendons, ligaments and other intra-articular tissues is visible. Tendons are strong elastic structures that attach muscles to bones, and ligaments connect the bones that make up the ankle.

What is ankle arthroscopy?
Ankle arthroscopy may be necessary to remove, heal, or repair intra-articular cartilage, torn ligaments, an unstable joint, arthritic changes, and more. During the procedure, an arthroscope is used to examine the inside of the joint. The arthroscope is a long metal tube with a light camera and a magnifying glass at the end. Mini instruments are used to remove the trauma to the joint.

Ankle arthroscopy is a minimally invasive procedure. It involves the use of mini incisions through which the ankle joint is accessed. Each incision is less than 1 cm and usually at least two incisions are needed. The ankle joint is relatively small, and in order to gain good surgical access to the joint, its dimensions must be temporarily increased by injecting a special fluid under pressure into the joint.

Ankle arthroscopy can be done under general or regional (spinal) anesthesia. After anesthesia, arthroscopic approaches to the joint are made. They are placed in specific locations to minimize the possibility of injury to surrounding nerves, blood vessels, and tendons. Through one of the incisions, the camera is inserted into the joint and other small instruments are used to treat the specific problems.

If you suffer from torn cartilage, an injured tendon or arthritis, ankle arthroscopy allows for their diagnosis and treatment without the need to make a large incision.

Ankle arthroscopy usually takes about 35-40 minutes.

Various diseases in which the technique is used:
-    Ankle arthritis  
-    "Anterior Ankle Impingement"
-    Unstable ankle
-    Lateral tendon reconstruction
-    Pain after ankle fracture
-    Loose fabrics in the ankle
-    Osteochondral defects of the ankle bone (talus)
-    Diseases of the synovium - Undiagnosed ankle pain

Possible dangers:
Risks by ankle arthroscopy (less than 10%) include: post-operative infection or bleeding during or after the procedure. Some nerves or blood vessels may be affected, which usually resolves in 10-15 days. It is possible to develop an allergy to drugs, including anesthesia, which are used during the procedure. A course of physiotherapy and kinesitherapy is often required for faster recovery (10-15 days) after surgery.

Recovery process:
You should be able to go home on the day of surgery, but your surgeon may recommend that you stay a little longer. You will have a bandage on your ankle for two to three days, and it is normal for your ankle to feel slightly swollen for a few weeks after surgery.

The stitches are removed 10-12 days after the operation. Sometimes crutches need to be used (depending on the procedure performed and at the operator's discretion). You may take painkillers, and a physical therapist will make you a program aimed at restoring muscle strength and range of motion in the joint. You probably won't be able to drive after the arthroscopy.

Recovery time from ankle arthroscopy varies depending on the nature of the procedure. If a procedure is performed that does not require a period of immobilization and non-weight bearing, patients can be mobilized reasonably quickly. Such procedures are: removal of free bodies, osteophytes, synovectomy. When it comes to cartilage injury and especially micro fractures, it is often necessary to immobilize the ankle and not put any weight on it for 4-6 weeks. In addition, if there is a procedure on another part of the foot or ankle, such as lateral tendon stabilization, then the patient should be immobilized for the first 6 weeks.

Benefits of ankle arthroscopy:
The main benefit of arthroscopy as a type of procedure is that it is able to show exactly what the problem is and, in many cases, the necessary treatment for it. After the operation, less pain is felt and the ankle recovers faster.