Arthroscopic ankle surgery may be a treatment option for certain types of ankle pain. In arthroscopic surgery, a small camera is inserted inside the joint. Through other small incisions, instruments can be inserted to repair or remove damaged structures. Arthroscopic ankle surgery is often called "scoping the ankle" or arthroscopy.
4 Reasons for Surgery
Not all causes of ankle pain can be effectively treated with an arthroscopic procedure. Some of the reasons to perform an arthroscopic ankle surgery include:
1. Restoring Ankle Cartilage Damage
Small, isolated areas of cartilage damage (not widespread ankle arthritis) are commonly found in people who have sustained injuries to the ankle joint. In fact, cartilage damage is estimated to occur in about 5% of people who have a sprained ankle. Left untreated, these cartilage areas may lead to the development of generalized arthritis of the joint.
Ankle arthroscopy is often used to assess these areas of cartilage damage and to try to restore the normal cartilage surface to the joint. Restoring a cartilage surface can be accomplished by either repairing the damaged cartilage, or by trying to stimulate new cartilage growth with a microfracture, cartilage transfer, or chondrocyte implantation procedure.
2. Removing Bone Spurs in the Ankle Joint
Bone spurs can form in the front of the ankle joint, causing the ankle to pinch when the foot is pushed all the way up towards the shin. This condition, properly termed anterior ankle impingement syndrome, has also been called athlete's ankle or footballer's ankle. Ankle arthroscopy can be used to shave down the bone spur on the front of the joint, to allow for improved motion of the ankle joint.
3. Removing Loose Debris/Scar Tissue
Ankle arthroscopy can be helpful whenever there is a condition causing the accumulation of loose debris or scar tissue within the ankle joint. Removing debris or scar tissue may be helpful in restoring motion and decreasing swelling and pain inside the joint.
4. Treatment of Posterior Ankle Pain
Pain in the back of the ankle can sometimes be treated arthroscopically. While there is limited space to perform an arthroscopic procedure in the back of the ankle, there are some conditions that can be helped when people have posterior ankle pain. Certain types of tendonitis and some bone spurs in the back of the ankle may be treated arthroscopically.
Ankle arthroscopy can be done under general or regional anesthesia. After adequate anesthesia, your surgeon will create 'portals' to gain access to the ankle joint. The portals are placed in specific locations to minimize the potential for injury to surrounding nerves, blood vessels, and tendons. Through one portal, a camera is placed into the joint, and through others, small instruments can be used to address the problem.
The length of the ankle arthroscopy procedure varies depending on what your doctor needs to accomplish. After surgery, your ankle will be wrapped in a soft bandage or splint. Most patients will work with a physical therapist to regain motion and strength of the joint. The length of rehabilitation will also vary depending on what procedure is performed at the time of surgery.
The most concerning complication of arthroscopic ankle surgery is an injury to one of the nerves or tendons that surround the ankle joint. Other complications include infection and damage to joint cartilage from the arthroscopy instruments.