What is an ankle arthroscopy?
An ankle arthroscopy is a procedure where the ankle joint is visualised, and a procedure performed, through tiny incisions in the skin. Through one of these ‘portals’ a specialised camera is inserted to directly visualise the anatomy. The 2nd ‘working portal’ is used to pass specialised instruments inside the ankle joint and address the specific condition.
What conditions can be treated with an ankle arthroscopy?
Many of the common ankle conditions are now able to be managed via keyhole ankle arthroscopy.
Reconstruction of the lateral (outer) ligaments of the ankle is frequently combined with an ankle arthroscopy to address any inflammation or chondral (joint surface) damage that may be present.
Ankle impingement is the result of abnormal abutment of excess soft tissues or bone during ankle movement. This can occur at both the front (anterior) and back (posterior) of the ankle joint. An ankle arthroscopy is performed to remove the excess tissue which is causing the pain. With the use of modern techniques, this is routinely performed as a day procedure.
Removal of loose bodies
‘Loose bodies’ can become entrapped within the ankle joint, leading to a painful ‘catching’. These can be directly visualised and removed via this technique.
Treatment of ankle cartilage damage
An ankle arthroscopy allows assessment of both focal and generalised ankle cartilage loss. Several treatment options may be performed via this technique, including ‘drilling’ of the lesion, micro-fracture, and ‘fixation’ of any loose fragments.
What are the benefits of an ankle arthroscopy?
There are many benefits to performing surgical procedures via keyhole techniques. These may include:
Minimal soft tissue dissection
Early discharge home
What happens on the day of the procedure?
When an ankle arthroscopy is performed in isolation, it is typically done as a day procedure.
You will turn up to the hospital 1-2 hours prior to the procedure, and change into theatre attire. The anaesthetist will introduce themselves to you, and discuss the anaesthetic options. Typically an anaesthetic ‘block’ is performed to make you as comfortable as possible following the procedure.
Anterior Ankle Arthroscopy
This is the more common form of ankle arthroscopy and is used to address the majority of conditions affecting the ankle joint.
The procedure involves making two tiny (4-5mm) incisions at the front of the ankle. One ‘portal’ is used to introduce the arthroscopic camera, and the other ‘portal’ is for the passage of tiny specialised instruments. Once the condition has been address, the portals are closed and a bandage is applied. Depending on what condition was addressed, you can frequently commence walking the same day.
When you go home, please keep your dressings on and dry until you next review. Leg elevation of the first week or so is also encouraged and beneficial.
Posterior Ankle Arthroscopy
This procedure is typically reserved for patients with posterior ankle impingement. The lead up to the surgery, and instructions following the surgery are similar to what is outlined above in ‘Anterior Ankle Arthroscopy’. The two incisions that are used are both made at the back (posterior) aspect of the ankle joint alongside the achilles tendon (Heel cord).