Arthroscopy of the Ankle

During ankle arthroscopy consultation, woman talks to surgeon

Arthroscopy of the ankle is a surgical procedure that utilizes a small, tube-like camera, or arthroscope, to generate clear images of the inside of the ankle. This is accomplished by fishing the arthroscope through small incisions in the ankle or foot and performing the surgery with tiny, arthroscopic instruments. The orthopedic surgeon performing this surgery uses a monitor displaying the visual from the arthroscope to increase surgical precision and improve patient outcomes.

The burgeoning popularity of this treatment is largely due to the fact that arthroscopy of the ankle is a minimally invasive surgery, which means the incisions required to perform the surgery are tiny, typically a half-centimeter in length. This cutting-edge surgery has helped countless patients overcome pain and soreness in their ankles stemming from torn cartilage, bone chips, ligament damage, or other ankle-related issues. Best of all, this surgery has a high success rate and minimal complications, making it a suitable treatment option for most people.

Who's a Good Candidate For This Surgery?

Arthroscopy of the ankle can be performed to treat a variety of ankle-related conditions, including torn cartilage, bone chips, and ligament damage. One of the most interesting aspects of this surgery is the how it can be used to both evaluate and treat those with ankle-related injuries or conditions. Due to the variety in the applications of this treatment, just about anyone can be a candidate. Some examples of ankle conditions treated with this procedure include:

  • Ankle Fractures
  • Anterior Ankle Impingement
  • Arthrofibrosis
  • Infection
  • Loose Bodies
  • Osteochondral Defect of the Talus
  • Posterior Ankle Impingement
  • Synovitis
  • Tibiotalar Arthritis
  • Unexplained Ankle Symptoms

Restoring ankle cartilage, removing bone spurs, clearing out loose debris or scar tissue, and treating posterior ankle pain are arguably the most common reasons individuals undergo arthroscopic ankle surgery. Cartilage damage is prevalent in as many as 5% of people who have experienced a sprained ankle. If left untreated, this cartilage damage can lead to arthritis. Bone spurs, which develop in the front of the ankle joint, can be shaved down using arthroscopic instruments. This condition is also known as athlete’s ankle, so it comes as little surprise that athletes are candidates for this surgery.

Individuals experiencing limited range of motion in the ankle joint are also good candidates for arthroscopy of the ankle. Arthroscopic instruments can clear away accumulated debris and scar tissue that restricts movement of the joints. Finally, various types of posterior ankle pain can be treated through arthroscopic procedures.

As previously mentioned, the myriad of ways arthroscopy can be applied to ankle-related conditions makes it an effective treatment option for a broad range of patients. Individuals with severe peripheral vascular disease, peripheral neuropathy, reflex sympathetic dystrophy/complex regional pain syndrome, and edema, as well as those who suffer from severe arthritic changes may not be ideal candidates for this surgery.

What Happens During the Procedure?

Patients will be administered general anesthesia to ensure that they are comfortable throughout the course of the procedure. The ankle, foot, and leg will be sterilized to minimize the chance of infection after the procedure has been completed.

Once the patient is asleep, small incisions, approximately one-half centimeter in diameter will be made. These incisions will allow the orthopedic surgeon to access the inside of the ankle and perform any necessary evaluations or procedures. The arthroscope will be fished through one incision to give the surgeon a clear view of the surgical site. The other incisions will provide access to the arthroscopic instruments utilized to complete the procedure. These incisions are placed in areas that provide relatively direct access to the damaged region.

The orthopedic surgeon doesn’t want to aggravate the surrounding nerves, blood vessels, and tendons during surgery as this can lead to complications. Once the procedure has been completed, all instruments are removed and the incisions are stitched closed.

What Are the Risks?

Arthroscopy of the ankle is considered a safe procedure with a low chance of complications. As a type of minimally invasive surgery, there’s nothing very alarming about this procedure. As is the case with most surgeries, there is a chance of infection following surgery if the surgical site is not sterilized properly or contaminated instruments are introduced through an incision. In some cases, blood loss may lead to further complications, especially if a blood vessel is lacerated.

Other common risks include local nerve damage and side effects commonly linked to the use of anesthesia. Patients who experience uncontrollable pain (unaffected by pain medication), nausea, vomiting, fevers, chills, inflammation, or numbness following surgery should speak with their medical provider immediately. Keeping up with all follow-up appointments is the only surefire way to identify serious complications before they get out of hand.

What's Recovery Like After Surgery?

After surgery, the path to recovery will largely depend on the type of procedure performed. Pain and swelling are commonplace, and patients are usually instructed to get plenty of rest and keep the affected leg elevated to aid recovery. Putting weight on the ankle is unadvised, so crutches may be utilized to assist with movement. The ankle may also be placed in a splint to keep it still and prevent aggravation.

Ultimately, the orthopedic surgeon who performed the surgery will have the last say on how a patient should proceed with the recovery process, so it’s absolutely vital that patients heed their words closely and follow them without err.

For example, patients should leave their bandages in place until they attend a follow-up with their surgeon. As the ankle regains strength, physical therapy will be used to gradually reintroduce the affected joint to full range of motion and, eventually, the full weight of the body.

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Dr. Frank Cannon

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