Ankle Arthroscopy

Information

The ankle joint is where the bones of the hindfoot meet the lower part of the lower leg. Ankle arthroscopy can be performed for fresh injuries (sprains, fractures, cartilage damage), chronic instability, synovitis, impingement syndrome, loose bodies in the joint and others. If these problems are present and conservative treatment with exercises, physical therapy, wearing special shoes, orthoses, and anti-inflammatory medication has failed, ankle arthroscopy may be necessary. During this procedure, the condition of the cartilage, tendons, ligaments and other intra-articular tissues can be seen. Tendons are strong, elastic structures that attach muscles to bones, while ligaments connect the bones that form the ankle.

What is ankle arthroscopy?

Ankle arthroscopy may be necessary to remove, treat or repair intra-articular cartilage, torn ligaments, a "loose" joint, degenerative changes and others. During the procedure, an arthroscope is used to examine the inside of the joint. The arthroscope is a long metal tube with a small camera and a lens at the end. Miniature instruments are used to address the injury within the joint.

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

Ankle arthroscopy can be performed under general or regional (spinal) anesthesia. After anesthesia, the arthroscopic access points to the joint are made. They are positioned at specific locations to minimize the possibility of injury to the surrounding nerves, blood vessels and tendons. Through one of the incisions, the camera is inserted into the joint, and the specific problems are addressed using other small instruments.

If you are suffering from torn cartilage, an injured tendon or arthritis, ankle arthroscopy makes it possible to diagnose and treat these conditions without the need for a large incision.

Ankle arthroscopy usually takes about 35-40 minutes.

Various conditions in which the technique is used:

• Ankle arthritis
• "Footballer's ankle" (Anterior Ankle Impingement)
• Unstable ankle
• Lateral tendon reconstruction
• Pain after ankle fracture
• Loose tissue in the ankle
• Osteochondral defects of the talus
• Synovial disorders
• Undiagnosed ankle pain

Possible risks

The risks of ankle arthroscopy (under 10%) include: postoperative infection or bleeding during or after the procedure. Some nerves or blood vessels may be affected, which usually resolves within 10-15 days. An allergy to medications, including the anesthesia used during the procedure, may occur. A course of physical therapy and kinesitherapy is often needed for faster recovery (10-15 days) after the operation.

Recovery process

You should be able to go home on the same day as the surgery, but your surgeon may recommend staying a little longer.

You will have a bandage on your ankle for two to three days, and it is normal to feel your ankle slightly swollen for several weeks after the surgery. The stitches are removed 10-12 days after the operation. Crutches are sometimes needed (depending on the procedure performed and at the surgeon's discretion). You may take painkillers, and a physical therapist will create a program aimed at restoring muscle strength and range of motion in the joint. You will likely not 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 include: removal of loose bodies, removal of osteophytes, synovectomy. When it comes to cartilage injury, and especially microfractures, the ankle often needs to be immobilized and kept non-weight-bearing for 4-6 weeks. In addition, if a procedure is performed on another part of the foot or ankle, such as lateral tendon stabilization, the patient must then remain 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 precisely what the problem is, and in many cases, the treatment needed for it. After the surgery, less pain is felt and the ankle recovers faster.