Ankle arthroscopy describes surgery using keyhole incisions and a small telescope. The surgeon then operates viewing the video projection of the inside of the joint with specific shavers, burrs and graspers.
An ankle arthroscopy can be performed to address multiple issues in the joint.
Impingement. Patients often describe a jamming or tightness in the front of the joint. This can be due to chronic joint inflammation (synovitis) and scar tissue after an ankle injury or from chronic bony spurs from previous injuries. Arthroscopic treatment removes the tissue or spurs.
Cartilage injury. The Ankle bone (talus) can develop a tear in it’s covering cartilage. The bone underneath can then form a cyst. These are termed Osteochondral defects (OCDs). This is usually due to an injury such as a sprain. These often cause swelling and pain, and occasionally catching or sharp intermittent pain in the ankle. In general an OCD has a natural history of not healing and progressing to more advanced cartilage and leading to arthritis. A small number may heal with rest and protection.
Arthroscopic surgery involves trimming the loose torn cartilage and the drilling the bone to stimulate healing. Around 85% of injuries have a good prognosis. Some cases still progress to a degenerative ankle joint.
Arthritis. The goal is to remove spurs, loose bodies and loose cartilage. This is not curative and the arthritis will still be present and the condition is likely to gradually worsen. Around 70% will experience an improvement in symptoms but in around 2% of patients, the procedure may accelerate the deterioration. This may mean that further surgery is required sooner than initially expected. The duration of symptomatic improvement is unpredictable.
This is a day case procedure with a relatively rapid recovery (6-12 weeks).
Arthroscopy is a day procedure with a relatively rapid recovery. Usually weight bearing and range of motion is possible immediately. There is a 2 week period of rest, followed by gradual motion and strengthening activities. (6-12 weeks).
There is a small chance of stiffness, wound issues, numbess and infection.