Arthroscopy of the Ankle

Ankle arthroscopy is a minimally invasive surgical procedure that allows doctors to diagnose and treat various conditions affecting the joint. Ankle arthroscopy allows the surgeon to examine the ankle with a camera through small incisions. This minimizes post-operative pain and speeds up patients' recovery . The surgery is performed under day hospitalization conditions due to its minimally invasive nature.

Ankle arthroscopy can be used to treat various conditions such as:

- Ligament injuries: treatment of damage or instability in the ligaments, such as those caused by ankle sprains.

- Cartilage damage: Repair or removal of damaged cartilage, including osteochondral damage.

- Arthritis: Treatment of inflammation of the synovial membrane of the joint.

- Bone debris: removal of bone spurs or loose bodies that may cause pain or restrict movement.

- Arthritis: Treatments for arthritic changes in the joint.

- Morton's neuroma: Although usually treated at the level of the foot, some nerve entrapments can also be visualized or manipulated through arthroscopy.

- Minimization of scars: Smaller incisions lead to less visible scars.

- Reduced pain and recovery time: Patients often experience less post-operative pain and can return to normal activities more quickly than with traditional open surgery.

- Direct imaging of the joint structures: This allows for accurate diagnosis and treatment.

Ankle arthroscopy may be recommended for various conditions and situations where the benefits of a minimally invasive approach outweigh the options available through open surgery or non-surgical treatments. It is usually performed to control and treat persistent ankle pain, swelling, bouncing sensation, blockage or a feeling of joint instability.

Some common indications for ankle arthroscopy include:

- Chronic ankle pain: When persistent ankle pain cannot be diagnosed or adequately treated with conservative measures (such as rest,physical therapy or medication), arthroscopy can help visualize and treat the underlying problems.

- Recurrent ankle sprains: In cases where patients experience recurrent ankle sprains due to loose or unstable ligaments, arthroscopy can be used to repair or reconstruct the ligaments.

- Osteochondral lesions: This is damage to the cartilage and underlying bone in the ankle, which can lead to pain and joint dysfunction. Arthroscopy is often indicated to repair or rehabilitate these lesions.

The procedure is usually performed under general anaesthesia, although in selected cases, epidural anaesthesia may be preferred. The use of a tourniquet is encouraged, while joint distension is not mandatory.

The method of arthroscopy begins with a thorough examination of the patient and diagnosis of the condition. The way in which the technique is performed is quite reminiscent of laparoscopic surgery. In particular, a micro-camera is placed in the anterior part of the ankle through 2-3 holes, just a few millimetres in diameter, in the skin.

In this way, the orthopaedic surgeon has a complete picture of the condition of the joint and can identify peripheral intra-articular lesions with great precision. Once the existing lesions are fully detected, the process of diagnosing the condition is completed. The surgeon then decides what steps to take to treat them.

Some of the actions that can be implemented through ankle arthroscopy are:

- The repair of damage to the articular cartilage

- The removal of inflamed articular tissue; and

- The implantation of chondrocytes and the infusion of growth factors and germ cells to enhance the healing of certain lesions.

Once the patient has recovered from the anaesthesia, he is encouraged to be active and move around to avoid complications such as stiffness, deep vein thrombosis. As long as he is mobilized without problems, he is discharged from the clinic the same day or the day after surgery with a simple leg dressing, pain medication for pain control, bacteria to help with walking and no restrictions on diet. Over a period of 6 weeks the patient will work on improving mobility and range of motion through physical therapy and gradually increasing daily activities and walking distance. Return to work depends on the progress of rehabilitation. Patients should expect continued improvement for 6 months.

Depending on the patient's physical condition, you can walk on the leg immediately or you may need to wait several months before putting weight on the leg. This will also depend on the type of surgery performed and the recommendations of your surgeon. Your surgeon will determine when activities such as range of motion and ankle exercises are allowed. Physical therapy is also necessary.