Arthroscopy of the ankle is surgery undertaken by an orthopaedic surgeon, which allows for diagnosis and treatment of problems within the ankle joint. It is often referred to as a “key hole” surgery. Small incisions around the ankle joint allow the surgeon to use an arthroscope connected to a camera, which allows visualisation of the structures within the ankle joint. Small incisions mean a faster recovery after surgery and often this sort of surgery can be performed as day surgery.
Arthroscopy can only be undertaken after your surgeon has conducted a thorough history and examination of your ankle, often supplemented by further investigations such as X-rays or MRI scans. Following this a decision will be made whether to proceed to surgery. Surgery can be undertaken for either further diagnosis of an ankle problem or treatment of this problem.
Arthroscopy not only allows faster recovery from surgery, but also better visualisation of the joint than can often be seen even with a large incision.
Common problems within the ankle joint which can be dealt with by arthroscopy include:
- Synovitis (inflammation of the joint lining);
- Damaged joint surfaces;
- Loose fragments of bone or cartilage;
- Bone spurs / impingement.
The synovium is the lining of the ankle joint. This can become inflamed and scarred after a previous injury. This inflammation causes swelling and pain throughout the lining of the joint. It can also cause the lining of the joint to catch with ankle movement causing pain. Arthroscopically this swollen lining of the joint can be removed to improve symptoms.
Damaged Joint Surfaces
The bearing surfaces of the ankle joint can be damaged at the time of an injury or by wear and tear. This can cause fraying of the surfaces and inflammation, as well as swelling and pain throughout the ankle joint. With arthroscopy these damaged surfaces can be smoothed. If the cartilage is damaged all the way through to the underlying bone, this is commonly known as osteoarthritis.
Loose Fragments of Bone or Cartilage
Sometimes after injuries to the ankle joint damage is caused to the weight bearing surfaces and fragments of bone or cartilage may be loose within the joint. These can cause pain and block movement within the joint. These can be removed with arthroscopy.
Spur / Impingement
Bone spurs can develop at the edges of the joint surfaces. With movement these can impinge (catch) and make contact with other bones or the synovium (lining of the joint). This can cause pain with certain movements and certain sporting activities. With arthroscopy these bone spurs can be removed to allow more clearance within the ankle joint and possibly even a greater range of movement.
What are the advantages of ankle arthroscopy?
Arthroscopy is generally a safe procedure that can often be performed as a day surgery procedure. Arthroscopy lessens the discomfort and risks associated with procedures performed through large incisions. It allows for a quicker return to work and sporting activities. Most patients will return to work or school within 2 weeks of their surgery. It will take at least 6 weeks to return to sports.
What are the risks?
Complications from arthroscopy are uncommon. These include infection, swelling of the ankle / bleeding within the ankle, only minor improvement of symptoms, damage to blood vessels or nerves.