Ankle Arthroscopy: Conditions, Recovery & Risks
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Key Takeaways
- An ankle arthroscopy is a minimally invasive surgical procedure to treat damage or injury to your ankle.
- Ankle arthroscopies can help to treat various conditions affecting the ankle, including ankle instability and ligament injuries.
- The procedure involves inserting specialised instruments through small incisions around the ankle to examine the joint structures.
- Recovery from ankle arthroscopy typically yields positive outcomes if you follow your doctor’s post-surgery instructions.
What is Ankle Arthroscopy?
An ankle arthroscopy is a minimally invasive surgical procedure that allows doctors to examine your ankle in the event of an injury or medical condition. The procedure involves inserting an arthroscope, equipped with a light and camera, through small incisions made on your ankle. The arthroscope allows the medical team to view the ankle’s structures and perform the necessary surgery to treat your injury or condition.
Ankle arthroscopies are only recommended when nonsurgical treatments have not relieved symptoms or complications affecting the ankle. For some people, symptoms from an ankle injury may not be experienced until much later, while others may feel them almost immediately after the injury occurs.
When is Ankle Arthroscopy Performed?
Your ankle is a joint located at the lower end of your leg where it meets the foot. It primarily consists of the shinbone, fibula (the smaller bone of your lower leg), and the talus. The ankle joint itself is a hinge that only bends forwards or backwards. This joint also keeps you stable and maintains your balance while standing or moving. Other structures, including ligaments, muscles, and cartilage, enable the ankle joint to move and provide support.
If you have ankle pain that is not responding to nonsurgical treatments, ankle arthroscopy may relieve symptoms and help you restore your mobility. Injuries to the ankle can occur due to falls, accidents, or other incidents that can cause fractures or damage to the ankle’s structure, including the ligaments.
Here are some of the more common conditions that will generally require an ankle arthroscopy.
Ankle Pain
Ankle pain can occur due to various reasons, ranging from structural injuries to fractures involving the bones connected to the ankle joint.
Ankle Instability
Bone deformities may develop in your ankle joint, making it difficult to maintain balance and potentially leading to pain or discomfort when walking or moving.
Impingement
Overuse of the ankle can cause the surrounding tissue to become swollen and sore. This inflammation can restrict and limit the ankle’s range of motion.
Ligament Injuries
Ligaments connect the bones that form the ankle joint. Tears or other injuries can cause significant pain and discomfort, and may impair the ankle’s ability to move or provide support.
Scar Tissue
Injuries may lead to scar tissue, which can impede the ankle’s mobility and potentially affect stability.
Loose Bone Fragments
Some injuries may result in loose bone fragments, also known as floaters, that can cause the joint to “lock up”, reducing range of motion and affecting your balance.
Essential Considerations for Ankle Arthroscopy
Before undergoing an ankle arthroscopy, your doctor will inform you of what you can expect before, during, and after the procedure.
Recovery Outcomes for Ankle Arthroscopy
Compared to other surgical techniques, ankle arthroscopy typically requires smaller incisions for the insertion of the arthroscope and other surgical tools needed for the procedure. In most cases, a successful ankle arthroscopy may result in a shorter hospital stay, depending on your doctor’s assessment of your recovery. However, you may need to use crutches to move around independently during the initial recovery.
Your doctor will schedule follow-up appointments at specific intervals to assess your recovery. These sessions will allow them to evaluate your condition and suggest adjustments to support your recovery further, including reviewing your prescriptions and whether you still require mobility aids to move around.
Risk Factors of Ankle Arthroscopy
Like any medical procedure, ankle arthroscopy carries potential risks. Take the time to understand these risks and speak to your doctor if you have any questions about the procedure. Some risk factors include:
- Nerve or tissue damage
- Blood clots, such as deep vein thrombosis
- Bleeding or swelling
- Risk of infection
- Numbness or tingling around the surgical site
- Additional symptoms that may require additional treatment
Preparations for Ankle Arthroscopy
During the initial consultation, your doctor will review your medical history and may perform additional diagnostic tests to determine whether ankle arthroscopy is suitable for you. They may ask further questions to better understand your condition, which helps them to develop a suitable treatment plan for your ankle.
Your medical team will explain the ankle arthroscopy procedure and provide general guidelines to help you prepare for surgery. Be sure to discuss your condition, potential risk factors, and how you can prepare for treatment with your doctor.
Before Ankle Arthroscopy
The consultation session gives you time to find out more about what to expect from your ankle arthroscopy and how to prepare for it. Here are a few essential pointers to keep in mind before your procedure.
- Current health: Certain medical conditions can increase the risk of complications after surgery. A comprehensive health screening helps your doctor plan your surgery. If you are currently on any medications, especially blood thinners, you may be advised to switch to other alternatives or stop taking them temporarily.
- Illness: If you are feeling unwell on the day of your surgery, notify your doctor. The procedure may be postponed depending on your condition.
- Fasting: You may be required to avoid food and drink for at least 6 hours before surgery, though small sips of water are often allowed up to 2 hours prior to the procedure.
- Health evaluations: If you have any dental or urinary procedures scheduled before your surgery, it may be advisable to reschedule them to reduce the risk of infection.
- Post-surgery support: Once you have been discharged, it may be helpful to have someone assist with daily activities or accompany you when going out.
- Lifestyle changes: Avoiding smoking, reducing alcohol intake, engaging in regular physical activity, and attending follow-up appointments may support your recovery and overall health.
On the day of surgery, a final medical check and a review of your anaesthesia needs are typically conducted. After this, you will change into a surgical gown and wait for the procedure to begin.
During Ankle Arthroscopy
You will first be sedated or placed under general anaesthesia before the procedure begins. Small incisions are made around the ankle to insert the arthroscope and other surgical tools required for the procedure. The arthroscope’s camera and light provide a clear picture of your ankle joint and nearby structures, which is transmitted to a monitor for the surgical team. In some instances, they may need to move nearby tissue, muscles, and other structures gently to the side to reach the affected area.
The surgeon will perform a thorough examination of your ankle joint to identify any other warning signs that may require attention and treat them accordingly. For example, if loose bone fragments are present, the surgeon will carefully remove them using surgical tools inserted through the incisions. Bone spurs and other abnormalities on the ankle may also require debridement to remove any impingements that could impair the ankle’s flexibility and mobility. The incisions may need to be enlarged to extract larger bone fragments, damaged tissue, or other debris.
Once the procedure is complete, the surgeon will close the incisions with stitches. The medical team will then take you to the recovery room for observation before you can return to the ward.
After Ankle Arthroscopy
You may need to be monitored for a period to ensure your recovery proceeds smoothly. However, depending on your condition, you may be discharged earlier. Your doctor will guide you on how to support your recovery at home, including how to minimise placing pressure on the healing ankle. Caring for your surgical wound and keeping it clean will also contribute to your recovery. You may also be prescribed pain medications if you experience any discomfort after surgery.
Ensure that you also follow your doctor’s postoperative care instructions to facilitate a smooth recovery with minimal complications.
- Avoid strenuous physical activities, including weight-bearing, that could impede your ankle’s recovery.
- Use crutches to reduce the pressure placed on your ankle while moving around. You may need them for several weeks or months, depending on your recovery rate.
- Keep your ankle elevated while resting, and apply ice regularly to help manage pain, swelling, and other discomfort.
- Engage in regular home exercises to support your recovery and help prevent gradual muscle degradation. Be careful not to overexert, as this may strain your ankle.
- Attend physical therapy sessions to support your ankle’s gradual recovery and help improve your ankle’s range of motion and flexibility. Your physiotherapist will recommend various exercises to encourage your ankle’s healing.
- If your doctor provides prescriptions for your recovery, take them at the specified times and according to the recommended dosage. If you experience any sudden side effects, stop taking the medications and notify your doctor immediately.
- Have someone who can help support you when you need to walk around the house and assist with activities of daily living.
Our Orthopaedic Doctor and Surgeon for Ankle Arthroscopy
Dr. Ramesh Subramaniam
MBBS (NUS, SG) | MRCS (Edinburgh, UK) | M Med (Ortho) (NUS, SG) | FRCS (Ortho) (Edinburgh, UK)
Dr Ramesh, a fellowship-trained orthopaedic surgeon, focuses on shoulder, knee, and arthroscopic sports surgery.
Dr Ramesh obtained his MBBS and Master’s in Orthopaedic Surgery from the National University of Singapore and completed Advanced Surgical Training. He earned his Fellowship from the Royal College of Surgeons of Edinburgh in Trauma and Orthopaedics. He was awarded the HMDP scholarship for a clinical fellowship in Shoulder and Knee Surgery in Dublin, followed by the Tan Tock Seng Scholarship for a Sports Fellowship in Knee Surgery in Barcelona. He also completed a Shoulder Surgery Fellowship at Hospital Del Mar and was trained in arthroscopic joint reconstruction and joint replacement surgeries.
Frequently Asked Questions
No, you should have someone to drive you to and from the hospital after your ankle arthroscopy to avoid placing pressure on your healing ankle. Avoid using your ankle too frequently in the early stages of recovery to prevent complications.
In most cases, recovery from ankle arthroscopy typically takes several months, depending on various factors such as how quickly you regain strength and mobility and your overall health. Your doctor will monitor your recovery during follow-up visits.
You may be able to return to work within a few weeks after surgery if your job doesn’t involve any significant physical activity (such as manual labour). You should consult your doctor first to ensure that you are fit enough to resume work, and continue to be mindful of your ankle’s condition.
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