A Guide to Ankle Arthroscopy (Keyhole Surgery)

 

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At a Glance

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What is ankle arthroscopy?

An ankle arthroscopy is an operation to look inside the ankle joint via keyhole surgery. It can be offered to a patient who has a problem within the ankle joint that would benefit from surgery, and that can be performed through small incisions.

Common examples of procedures that can be done in this way include:

  • Removal of loose bone or cartilage (“floaters”)
  • Removal or shaving of bone spurs
  • Clearance of inflamed soft tissues
  • Decompression of painful bone cysts

It can also be performed as part of a combined procedure, such as ligament reconstruction. It is very useful in assessing the quality of a joint, which may give an indication to the longer-term prognosis.

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What happens during surgery?

It is usually a day case procedure performed under a general or regional anaesthetic. A tourniquet is placed around the thigh to prevent bleeding during the operation and this might cause a mild ache later.

The operation is performed through two small incisions at the front or back of the ankle joint. A camera (the arthroscope) is inserted through one incision to visualise the joint.  The other incision is used to insert the instruments required to treat the problem. Occasionally, an incision may need to be enlarged to allow the removal of large bone fragments.

After the operation, the wounds are covered with surgical dressings and the ankle will be bandaged.

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Benefits of ankle arthroscopy surgery

The outcome of ankle arthroscopy surgery is usually good but it doesn’t mean that all the people who have the  surgery will be completely pain free. In most patients, the main benefits are:

  • Relief or improvement of pain and disability
  • Greater independence and activity levels

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Risks of ankle arthroscopy surgery

As with any surgery, there are associated risks. If you are overweight, smoke or are not active, you are at greater risk of developing complications after surgery and it may take longer to recover.  You may want to discuss this with your GP or health professional what you can improve before surgery.

  • Risks include stiffness or persistent pain in the ankle.
  • Nerves may be damaged in very few cases, which could lead to chronic pain that is worse than the pain before surgery.
  • There is a very low risk of a blood clot forming in the leg, also known as a deep vein thrombosis (DVT). The main danger of this complication is that the clot travels to the lungs, which can be fatal. All patients will be assessed for their risk of developing blood clots, and if you have no risk factors, then generally no specific precautions are needed.
  • Infections will occur in a few patients which can usually be treated by antibiotics. Occasionally, wounds can become more deeply infected and require further surgery.
  • The arthroscopy may find problems that cannot be treated by keyhole surgery. In these cases, patients might not feel any benefit after the operation and require an alternative approach in the future.

It is important to remember that most complications are minor and can be easily and successfully treated.

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How long will I spend in hospital or on treatment after surgery?

Most patients will either go home the same day or spend one night in hospital.

  • You will be expected to be up and mobile the day after surgery, performing normal essential tasks such as walking, dressing and toileting. You will however need to rest and strictly elevate the foot for 10 to 14 days after surgery to minimise swelling.
  • For the first six weeks after your surgery, you may need walking aids such as crutches to help support you.
  • You may start driving again after about four to eight weeks (or earlier if you have an automatic car depending upon which ankle underwent surgery). You must be able to drive safely and perform an emergency stop before resuming driving.
  • Following your surgery, you may be required to complete questionnaires to monitor your progress and improve our knowledge.
  • It may take up to one year to recover fully from ankle surgery and sometimes longer.
  • A small number of patients will continue to experience symptoms after surgery.

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