Ankle Arthroscopy
Ankle arthroscopy is the medical name for keyhole surgery of the ankle. It is suitable for many problems inside the ankle such as ankle impingement lesions, bone spurs, loose bodies and unstable cartilage flaps (osteochondral lesions).
Why have the surgery?
If you have developed pain inside the ankle joint, then you might struggle to stand and walk. The cause of pain can arise from problems relating the soft tissues, bones or the cartilage that lines the joint. Visualisation and then treatment through a minimally invasive key-hole technique may be the appropriate answer to curing the problem.
How is surgery performed?
The operation is typically performed under a general anaesthetic. Two keyhole incisions are made on either side of the front of the ankle. One of these portals allows a small camera to look inside the ankle, whilst the other portal allows small instruments to enter the ankle.
What are the benefits?
The type of surgery performed varies according to the underlying problem. In most ankle arthroscopies, any excess bone or soft-tissue is taken away. This may be couple with techniques to stimulate a healing response known an bone marrow stimulation, where stem cells are released inside the ankle joint to form new and healthy tissue.
What are the risks?
All operations have risks, but the commonest and most concerning for this surgery are: - Recurrence, meaning that the problem comes back. - Nerve damage, since the incision on the outer aspect runs in close proximity to a nerve known as the superficial peroneal nerve. Damage to this nerve can result in pain, number or a pain syndrome known as CRPS. - Blood clots, which can form in the leg and travel up to the lung where they can be fatal. This list is not exhaustive and Mr Patel can talk you through them all in more detail during a consultation.
What recovery is involved?
Recovery depends upon whether any ligament stabilisation surgery is performed at the same time as the arthroscopy. Ankle arthroscopy on its own will typically permit patients to bear weight fully after surgery. If ligament stabilisation is needed too, then a plaster cast is used for between two and six weeks, and thereafter a pneumatic boot or brace for up to two months.
Any other considerations?
Not all patients with problems that are seen on a scan need surgery. Arthroscopy is only indicated if non-surgical means have failed, and symptoms are severe enough to stop everyday functional tasks.