Surgical Overview
Ankle arthroscopy is an outpatient surgical procedure that is minimally invasive and used to treat various problems in the ankle joint. It uses a thin fiber-optic camera that magnifies the images of the ankle onto a video screen. Two or three small incisions are used during the procedure which allow excellent visualization of the entire ankle joint.
Some of the more common ankle problems that ankle arthroscopy (scope) is used for are (but not limited to):
Anterolateral impingement – scar tissue may form after an ankle sprain/injury and cause subtle pain and inability to return to prior level of function without pain
Loose bodies – free floating tissue (bone, cartilage, scar tissue) in the joint can be a source of pain and mechanical locking/catching
Synovitis – the soft tissue lining of the joint (synovial tissue) can become inflamed after an ankle sprain or repetitive overuse/trauma
Osteochondral defects (OCD) – these are areas of cartilage and bone damage in the ankle joint that may result from an ankle sprain or fracture.
Ankle instability – patients with chronic injuries to the ankle may develop ligament instability which can affect either the medial or lateral side of the ankle.
Ankle arthritis – patients with good alignment of bone structure can usually undergo an arthroscopic ankle fusion. Using a scope for a portion of an ankle fusion surgery can avoid larger incisions.
ankle arthroscopy
Any patient who fits the above criteria of injuries may benefit from an ankle scope. Most patients can recover 100% from an ankle sprain but patients who have failed conservative treatment options such as physical therapy, bracing, immobilization and who may have gotten temporary relief from a cortisone injection may benefit from this type of surgery.
Initial treatment for ankle pain after an ankle sprain or overuse injury may include rest, ice, anti-inflammatories. Other conservative options are immobilization in a walker boot, ankle bracing, physical therapy, cortisone injections or PRP injection.
You will wake up from surgery with a sterile dressing on the ankle and a medical boot on the lower leg. Usually you are weight-bearing as tolerated using crutches right after surgery. You can expect some pain and swelling so we recommend elevation of the limb and resting for the first 1-2 weeks. Oral pain medications will be supplied to you prior to your surgical procedure.
Ankle arthroscopy with a debridement (clean out of scar tissue, synovitis or loose body) is a fairly quick recovery being weight-bearing as tolerated in a medical boot for about 2-3 weeks post-op then starting physical therapy. Full recovery and return to activities is usually around 6 weeks post-op.
If another procedure with an ankle arthroscopy is required then the recovery may be altered. One more common procedure (a microfracture) that is done for a specific type of OCD requires non-weight-bearing for 6 weeks after surgery. This will be clearly discussed at time of booking surgery.
As with any surgical procedure complications can occur but with an ankle scope they are quite rare. Some possible complications may include, but are not limited to:
Download the Ankle Arthroscopy Post-Operative Guidelines for full details.
Your surgery generally takes place in an outpatient setting.
You will have sedation and possibly a nerve block.
Yes. You will get a dose of antibiotic before surgery.
No. Bleeding is minimal with use of a tourniquet during surgery.
Read carefully the handouts in your surgical folder. The Mayo Clinic on-line patient information section is also an excellent source as well as FootCareMD on AOFAS.org.
Discuss this with your rheumatologist, but it is generally recommended that you stop immune suppressive modulators (eg. Methotrexate, Enbrel, Humira) for two weeks before and two weeks after surgery.
Small spots may appear on the bandage. You may reinforce the dressing with an ace wrap obtained from a pharmacy. While highly unlikely, excessive bleeding through the bandage is of concern and you should call the office to be seen.
You can drive once off narcotics if it is your left ankle. If it is your right ankle then you can drive once out of walker boot after 2 weeks post-op.
That depends on what you do and the procedure performed. Sedentary desk workers may return as soon as one week. You will be provided out of work notes, or restricted duty notes, as necessary during your recovery.
