Ankle Arthroscopy
Introduction
Ankle arthroscopy is a minimally invasive procedure performed to treat various problems of the soft tissue and bone involving the ankle joint. It involves gaining access to the ankle joint by use of an arthroscope (a small flexible tube consisting of a light source and a video camera) and special instruments. These instruments are inserted through tiny incisions in the front of the ankle which helps the surgeon to diagnose and treat various disorders of the ankle joint.
Indications and contraindications
Ankle arthroscopy is indicated for the diagnosis of ankle problems associated with swelling, unexplained pain, joint stiffness and instability, hemarthrosis (bleeding within the joint spaces) or locking of the ankle joint. Other indications include treatment of soft tissue injuries, arthrofibrosis (restricted joint motion due to scar), fractures, bony outgrowth, inflamed synovial membrane, and bony impingement.
Ankle arthroscopy is contraindicated in the following conditions:
- Localized soft tissue infection
- Severe degenerative ankle joint disease
- Severe ankle edema
- Weak blood supply to the ankle joint
Procedure
Ankle arthroscopy is mostly performed under the effect of general anesthesia, or occasionally under spinal or local anesthesia depending on your condition. Your doctor will clean the skin over the ankle joint with an anti-bacterial agent and make 2-3 small incisions in the front of the ankle. An arthroscope is inserted through one of the incisions and an examination probe or other special instruments are inserted through the other incisions. A sterile fluid is injected to make the joint easily visible to the surgeon. During the procedure, your surgeon will repair the damaged area and remove any unwanted tissue. At the end of procedure, the arthroscope, other instruments and excess fluid will be removed. Your surgeon will close the incisions and cover them with a sterile dressing.
Post-operative care
After the ankle arthroscopic procedure, you will be advised to keep the operated leg elevated to reduce swelling. The area of your ankle will be covered with a crepe bandage with a layer of wool and small dressing over the wounds. You will be prescribed medications for pain relief. Apply ice packs to help reduce swelling. Keep the wounds dry for up to 2-3 weeks following the procedure. Exercise may be recommended for increasing the mobility of the joint and strengthening the ankle. Limit walking for a few days and if required use crutches for support. Avoid vigorous sports activities and driving for a few days. Recovery takes about 3-6 weeks for soft tissue procedures and double the time for bony procedures.
Risks and complications
As with any surgery, ankle arthroscopy involves certain risks and complications. They include:
- Bleeding and infection inside the joint
- Scars
- Numbness due to nerve damage
- Deep vein thrombosis
