Ankle Arthroscopy
An arthroscopy or “keyhole surgery” is an operation that allows a surgeon to look inside a joint using small incisions. Usually 2 small incisions (less than 5mm) are made to allow access for a camera and instrument to treat any abnormalities seen in the joint such as damage to the joint surface, arthritis or ligament problems. The benefit of ankle arthroscopy is that the diagnosis can be made and the problem treated at the same time.
Are there other treatment options?
In most cases patients will have had X-rays or an MRI scan before an operation is suggested. The likely diagnosis is usually made using the X-ray or MRI scan and treatment options, including non-operative treatment, can be discussed including the pros and cons of each option.
What does the operation involve?
The operation is usually performed under a general or spinal anaesthetic and most patients go home on the day of surgery. An ankle arthroscopy takes between 30 and 60 minutes, depending on what the surgery is being performed for. Sometimes an ankle arthroscopy will be performed in combination with another procedure, such as a ligament repair. The small skin wounds are repaired with dissolvable sutures and a bandage is applied.
What are the potential complications?
The surgeon will discuss the risks of the operation when taking your consent. There are general complications that can occur with any operation such pain, bleeding, wound problems/ infection, nerve damage and the possible complications of an anaesthetic (the anaesthetist will discuss these with you). Other complications of ankle arthroscopy include: –
– A blood clot in the leg (DVT) or lung (PE); the surgeon will assess your risk of this before the operation and may prescribe injections if required
– Infection of the ankle joint; the risk is less than 0.5% but if a joint infection occurs it would require another operation to wash out the ankle followed by a long course of antibiotics
– Abnormal pain response; this is known as complex regional pain syndrome and results in excessive pain and loss of function. It is rare.
What happens after the operation?
Most patients are allowed to fully weight-bear after an ankle arthroscopy, albeit with crutches and medication for pain relief. A follow up appointment to remove the bandages and check the wounds will be made at 10-14 days after the operation. Depending on the operation most patients will start physiotherapy at about 2 weeks and be reviewed by the surgeon again at 6 weeks. The surgeon will discuss the timing of return to work/ exercise/ driving before the surgery.