Ankle Arthroscopy
What is arthroscopy ?
This is "keyhole" surgery, where a joint is visualised using small (4.5mm or 2.7mm) 'telescopes' (fibreoptic cameras) inserted through very small incisions or 'portals'. Using 'keyhole surgery' a wide variety of procedures can be performed, from minor operations on cartilage to major joint reconstruction and fusion.
What types of procedure are available in the foot and ankle ?
Ankle Arthroscopy
This usually performed through two small incisions at the front of the ankle, though may occasionally be performed through the back of the joint. It is commonly performed for chronic ankle symptoms following a sprain or injury.
Subtalar Arthroscopy
This is to treat problems in the joint beneath the ankle joint and is performed through two incisions on the outside of the ankle, though may occasionally be performed through the back of the joint. The sural nerve may be injured, leaving a patch of numbness at the side of the hindfoot.
Metatarsophalangeal Joint Arthroscopy
This is arthroscopy of the 'big toe' joint and is performed for damage to the articular cartilage (OCD). It is performed through 2-3 incisions around the joint.
What are the risks of surgery ?
Nerve Damage
There are two small nerves (superficial peroneal and saphenous) either side of the ankle joint, near where the portal incisions are made. There is a small risk (5%) that one of these nerves is damaged. This will leave a patch of numbness over either the inside border of the foot or over the back of the foot. Usually this is temporary, but may be permanent.
Infection
Deep infection due to Arthroscopic surgery is extremely unlikely. Published results show a risk of 1 in 25,000. If this does happen, further surgery to wash out the joint will be needed, and a course of antibiotics. Minor wound infections are also rare, but can normally be treated with oral antibiotics.
Stiffness & Swelling.
Arthroscopic surgery causes much less soft tissue trauma than more open surgery. Thus stiffness/swelling tends to settle rapidly. Generally weightbearing can be commenced as soon as pain allows and most can perform full activities by 6 weeks.
What happens after the operation ?
You will need to keep your foot elevated for 3 days. The dressing would normally be replaced at your GP practice after 3-4 days. A simple occlusive dressing can be used after this.
How much time do i need to take off work ?
You would usually need to take 2 weeks off work for sedentary/standing/walking jobs.
Article written by
Mr Henry Atkinson
Consultant Orthopaedic Surgeon
North London Sports Orthopaedics
Last updated 16/3/10
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