Ankle Arthroscopy
Introduction
Ankle arthroscopy is a surgical procedure that uses a fiber-optic viewing camera and small surgical tools to operate in and around the ankle joint through small incisions. Ankle arthroscopy is performed for the surgical evaluation and treatment of a variety of ankle conditions. Arthroscopic surgery can have a quicker recovery time than traditional open surgery.
- You may need ankle arthroscopy if you have debris in your ankle from torn cartilage or from a bone chip. Also, if there is ligament damage from a severely sprained ankle, a bone surgeon may choose to do an arthroscopy to evaluate the extent of damage and possibly to repair it.
- For some people, arthroscopy means a speedier recovery, less scarring, and fewer complications than open surgery.
Risks of Ankle Arthroscopy
Ankle arthroscopy is a relatively safe procedure with low complication rates.
- As with any procedure involving the introduction of instruments to a normally sterile area, infection is a risk.
- Bleeding from cut blood vessels may also occur.
- Some people may have local nerve damage from the procedure making the overlying skin numb.
- There are risks in using any kind of anesthesia, depending on the type that is chosen.
Ankle Arthroscopy Preparation
In general, you should refrain from eating or drinking the day of the surgery. Check with your surgeon regarding prescription medications and herbal medications that you may be taking. The surgeon may ask you not to take blood-thinning agents such as aspirin or warfarin (Coumadin) for a few days prior to the surgery. Arrange for transportation home after the procedure if it is an outpatient procedure.
During the Procedure
You will be brought to the operating room and prepped for anesthesia and surgery. An IV line will be started. The ankle, foot, and leg will be exposed, cleaned, and sterilized. Depending on the type of anesthesia chosen, a tube may be placed in your throat to assist with breathing, once you are asleep. The ankle will be numbed locally or with a regional anesthetic block. Once you are anesthetized, small incisions will be made for the portals.
The portals, or small tubes, will be placed in different areas around the ankle for the instruments and camera to be placed in. The surgeon will then perform the procedure. Afterward, the instruments and portals will be removed. The small incisions will be stitched closed and bandaged.
After the Procedure
You will be taken to the recovery room for monitoring while waking up from the anesthesia.
- Some people may be allowed to bear weight with crutches.
- Others may be placed in an immobilizer for as long as six weeks. The type of repair made during the procedure and the surgeon’s preference will determine how your ankle may be immobilized.
- If extensive surgery or remodeling of the ankle is performed, the surgeon may choose to put your ankle in a cast to prevent you from moving it too early and to promote healing.
- If you had an arthroscopy only to establish a diagnosis, the surgeon may put a simple splint or air splint on your ankle.
- In general, the area should be kept clean and dry while the incisions are healing.
- Pain medicine may be prescribed.
- The ankle should be elevated and iced to minimize swelling and to help control pain
Next Steps
After leaving the hospital, you should follow the rehabilitation instructions your surgeon gives you. You should not rush the rehabilitation without consulting the surgeon. Follow-up visits should be arranged.
When to Seek Medical Care
Watch for signs of infection or compartment syndrome (see below). Both are emergencies. Seek immediate medical care by calling your doctor or the surgeon immediately.
If signs or symptoms of an infection occur, call your doctor. Signs of an infection include
- Fever
- Pus draining from the incisions
- Red streaks from the incisions
- Redness of the skin around the incisions
- Increasing pain more than two days after surgery
Watch for signs of compartment syndrome, a rare but dangerous condition. Compartment syndrome occurs when the pressure of the tissues in a compartment, in this case, in your ankle or calf, is higher than the blood pressure of the vessels supplying that area. The swelling could be responsible for causing this condition. Or a cast or wrapping that is too tight could also result in this condition. The tissues of the ankle are not receiving adequate nutrition, which impairs the ability of the body to heal. Ultimately, this could lead to death of the tissues involved. Things to watch for include the following:
- Pain or swelling in the leg, more than at the incision sites
- Numbness or tingling in the leg
- Change in skin color compared to the other leg
- A cold leg or foot
If you suspect you have an infection in the ankle or compartment syndrome, call your doctor or surgeon immediately for instructions on where to go for treatment. If instructed to do so, or if you are unable to contact your doctor, go to an emergency department.