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The ankle joint is where your lower leg bones and the bone on the top of your foot meet. Ankle arthroscopy may be done to check an injured, unstable, stiff, or painful ankle. If you have these problems after treatment with exercises, special shoes, a splint or other measures, you may need an ankle arthroscopy. This procedure shows the condition of your bones, cartilage, tendons, ligaments, and other tissues. Tendons are strong elastic tissues that connect muscles to bones. Ligaments connect one bone to another.                   

What is an ankle arthroscopy?

Ankle arthroscopy may be used to remove, repair, or rebuild part of the ankle. It may be done to fix broken bones, ligament tears, loose tissue, or other problems. During the procedure, an arthroscope is used to see inside the joint. An arthroscope is a long metal tube with a light, camera, and magnifying glass on the end. Small tools will be used to fix your ankle problem.

Also known as key hole surgery or minimally invasive ankle surgery.   Ankle arthroscopy involves using very small incisions to gain access into the ankle joint.  Each incision is less than 1cm and usually two incisions are required. The ankle joint is relatively small and to allow good surgical access to the joint, its dimensions need temporarily to be increased. This is done using a combination of distraction across the joint together with having a stream of pressurized fluid circulating through the joint which distends it.

Ankle arthroscopy can be done under general or regional anesthesia. After adequate anesthesia, your surgeon will create 'portals' to gain access to the ankle joint. The portals are placed in specific locations to minimize the potential for injury to surrounding nerves, blood vessels, and tendons. Through one portal, a camera is placed into the joint, and through others, small instruments can be used to address the problem.

If you are suffering from a torn cartilage, ligament damage or arthritis, an ankle arthroscopy allows your surgeon to diagnose and treat common ankle problems such as these without needing to make a large cut in the skin.

The various disorders in which the technique is useful :

- Ankle arthritis

- Footballers ankle (Anterior Ankle Impingement)

- Unstable ankle

- Lateral ligament reconstruction

- Ankle pain following fracture

- Loose bodies within the ankle

- Osteochondral defects of the talus

- Diseases of the synovium

- Undiagnosed ankle pain

Risks

Risks of having an ankle arthroscopy (under 10%) include getting an infection or bleeding during or after your procedure. Nerves, blood vessels, or ligaments in your ankle may be damaged during your procedure, which goes away in 10-15 days. Your ankle may become more stiff, numb, or painful after the arthroscopy. You may not be able to move your ankle as well as you could before your procedure. You may be allergic to medicines, including anesthesia, used during the procedure. Often a course of physiotherapy is required for faster recovery (10-15 days) after surgery.

Recovery

You should be able to go home on the same day as the operation, however your surgeon may recommend you stay a little longer.

You will have a bandage on your ankle for two to three days, and it is common for the ankle to feel slightly swollen for a few weeks after surgery. Stitches are removed 10-12 days after the surgery. In some cases you may have to use crutches (depending on the procedure and the opinion of your surgeon). You may need painkillers and your physiotherapist will show you exercises to help you regain your muscle strength. Probably you won’t be able to drive after an arthroscopy.

The recovery time from ankle arthroscopy varies depending upon the nature of the procedure. If a procedure is performed that does not require a period of healing following the surgery, then patients can be mobilized reasonably quickly. These procedures would include simple shavings of the synovium, or removing basic osteophytes [bone spurs] in the front of the ankle. If an osteochondral injury is addressed, and particularly of micro fracturing occurs, then it is often necessary to keep the patient relatively immobilized for 4-6 weeks in order to allow healing. In addition, if there is a procedure to another part of the foot or ankle, such as in a lateral ligament stabilization, then the patient will need to be kept relatively immobilized during the first 6 weeks.

Benefits of ankle arthroscopy surgery

The main benefit of this ankle surgery is being able to confirm exactly what the problem is, and in many cases, treat the problem at the same time. After ankle arthroscopy surgery you should feel less pain and recover more quickly.