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Ankle Arthroscopy

Background

Recent advances have permitted surgical procedures to be performed inside joints without opening the joints by traditional methods. Using a fibre-optic device called an arthroscope, orthopaedic surgeons are able to inspect the inside of a joint by direct vision. This can be done to make a diagnosis or carry out surgical procedures.


The ankle arthroscope in place during the procedure.

The arthroscope is inserted through a small hole on the front of the ankle whilst fine instruments are inserted through another one or two holes. Video equipment is used so your doctor can view the entire procedure on a TV monitor in the operating theatre. The ankle arthroscopy usually takes between 45 and 60 minutes.


A small camera inserted into the ankle joint allows your doctor to view the entire procedure
on the TV monitor.

Common Conditions Treated

Ankle arthroscopy is most often performed to remove scar tissue and inflammation or to remove small detachments of bone and cartilage.

  • Scar tissue – following an ankle sprain some patients develop inflammation and scar tissue within the ankle joint. This leads to continued pain, most often felt on the outer aspect of the front of the ankle.

    In some cases this can be resolved with anti-inflammatory tablets and physiotherapy but frequently it requires surgery to remove this abnormal tissue.

  • Loose bone/ cartilage – sometimes spontaneously and at other times after a sprain, pieces of bone and/or cartilage can be detached within the ankle joint. This often leads to pain in the ankle.

    Plain x-ray is often normal and a bone scan and CT scan is usually needed for accurate diagnosis. These cases frequently require arthroscopy to remove fragments and smooth off surfaces.

What to Expect

Patients are routinely admitted to hospital on the same day as the procedure. In most cases the patient is fit to leave hospital later the same day. Sometimes, depending on the type of surgery and the needs of the patient, an overnight stay is recommended.

Following surgery you will have just a crepe bandage around the ankle. For the first 1-2 days, you will be required to use crutches after which you will be allowed to weight bear as tolerated.

Sometimes, if more extensive surgery is carried out you will be instructed to remain on crutches for 7-10 days.

For the first few days at home it is important to keep your foot elevated above the level of the heart as much as possible.

This will greatly reduce the amount of pain and swelling. In addition, applying a cold pack to the area during the first 48 hours will decrease any discomfort.

It is important that the dressings remain undisturbed until the first visit with your doctor.

This will require the use of plastic bags to keep the dressing from becoming wet during bathing.

The first post-operative visit is scheduled for 7-10 days following surgery. The wounds are checked and the stitches removed. Photographs are generally taken to document the state of the ankle joint and copies are provided for the patient at their first post- operative visit.

Another review is then scheduled usually for 6 weeks post surgery.

It usually takes 2-3 weeks for the majority of swelling and discomfort to resolve. It usually takes 6-8 weeks before the level of function is better than before surgery.

Each patient’s recovery will de different. Your Doctor will discuss the best time for you to return to work and return to sport.

Caution

Post-operative infection is very uncommon with arthroscopy, but if it does occur, it needs to be treated promptly to avoid serious ill effects.

If you experience increased swelling, pain, persistent temperature, or purulent discharge, please call your doctor or see your local medical officer immediately.

 

This material has been produced as a reference guide only and should not be used in place of a consultation with a qualified medical practitioner.