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What Is Ankle Arthroscopy?
Arthroscopy is a minimally invasive surgical procedure that is used to diagnose and treat problems in the foot and ankle joints. The word “arthroscopy” comes from the Greek words “arthro” (joint) and “skopein” (to look).
This surgical procedure involves making very small incisions in the skin around the affected joint and inserting a tiny camera, called an arthroscope. The images from the scope are then projected onto a television screen, so that the surgeon can see them.
Arthroscopic surgery of the foot and ankle is becoming increasingly popular because it offers several advantages over traditional “open” surgery.
These advantages include less pain, less swelling, shorter hospital stays, and quicker recoveries.
Arthroscopic surgery is less invasive and lowers the risk of complications and infections.
What Conditions Does Ankle Arthroscopy Treat?
Ankle arthroscopy is used to treat many different conditions that cause ankle pain. Listed below are the main indications.
Scar Tissue Removal
Over time, scar tissue can form within the joint, leading to discomfort and limited mobility. Ankle arthroscopy can remove this excess tissue, improving joint function.
Ankle Ligament Repair
In the case of ligament tears or laxity, arthroscopy can be employed to repair and tighten the ligaments, thereby stabilizing the ankle.
Ankle Impingement Syndrome
Impingement syndrome occurs from repetitive stress in the ankle joint. This causes abnormal contact between the bones of the foot and ankle. Arthroscopy can help alleviate the pain and restore normal movement.
Arthroscopy is effective in treating ankle arthritis, where joint stiffness and inflammation is present. Inflamed tissue and loose bone fragments in the ankle joint can be removed to provide relief
Osteochondral Lesions of the Ankle
Osteochondral (OCD) lesions occur due to injuries to the cartilage of the ankle bone. Arthroscopic surgery can treat these lesions, thereby reducing pain.
Tendon tears can impair movement in the ankle. Ankle arthroscopy can be used to repair these tears. This will help restore strength and mobility of the ankle.
How Can You Prepare for the Surgical Procedure?
Preparing for an ankle arthroscopy involves several steps listed below.
A comprehensive assessment of your overall health is essential prior to surgery. You will need to see your family doctor before the surgery to ensure that you are healthy enough to proceed with the surgery.
Your doctor will conduct a thorough examination, which may include blood tests, imaging studies, and other diagnostic tests. This identifies any potential risks and complications that could affect the procedure or recovery.
It may be necessary to modify or discontinue certain medications before the surgery. For example, non-steroidal anti-inflammatories (NSAIDS) should be stopped a week prior to surgery. Certain blood thinners should also be stopped a few days before the surgery due to risk of bleeding.
You will need to avoid eating and drinking for 8 hours before the surgery.
Plan For Post-surgery
Following surgery, you will need time to recover and may need assistance with everyday tasks. Plan for someone to drive you home from the hospital, and consider arranging extra help at home for the first few days after surgery.
If you have stairs inside your home and your bedroom is upstairs, it would be advisable to bring needed supplies to the first floor to help limit excess weight-bearing activities in the first few weeks after surgery.
What Does the Ankle Arthroscopy Procedure Entail?
The ankle arthroscopy operation is a surgery that takes place in the operating room. The patient is put to sleep with anesthesia for comfort.
To start the operation, the surgeon makes small cuts, also known as “portals”, near the troubled ankle joint. These cuts act like doors for the surgical tools. Next, the surgeon injects a clean solution into the joint, which helps it expand for better visibility.
Once the joint is ready, the surgeon puts a small camera (called an arthroscope) and other necessary tools into the portals. The camera shows pictures of the inside of your joint on a screen, and the surgeon uses these images to guide the surgery.
Next, the surgeon fixes the issues in your foot or ankle. This could involve repairing damaged tissue or even removing it.
If there’s scar tissue (extra tissue that forms when your body heals) that’s causing problems, the surgeon removes it in a process called “debridement.” This process helps improve how your joint works and lessens any pain.
In some situations, if the damage in the joint is too extensive, a larger cut might be needed. Your surgeon may switch to a traditional “open” surgery to properly fix the problem.
After the operation, the cuts are closed carefully with sutures (stitching thread) or staples. The surgeon will put your ankle in a splint or cast to help your joint stay in place as it heals.
Once you’re stable after the surgery, you can go home the same day.
What Is the Recovery Like Post Arthroscopy Procedure?
Depending on the surgery, your doctor will allow you to bear weight in a cast boot or splint for the first 4 weeks after surgery before transitioning to athletic shoes. In some cases, you may be able to transition into athletic shoes and resume normal activities sooner.
Make sure to keep your cast dry while you are in the shower by using a cast protector. You can also use crutches to help stabilize yourself while bearing weight in the cast.
Physical therapy may be needed after certain ankle scope surgeries (such as ankle ligament repairs) to improve range of motion, decrease pain, and improve balance.
Physical therapy will need to be completed 3 times a week for 1 month.
What Are the Risks and Complications of Ankle Joint Arthroscopy?
Ankle arthroscopy, while a common and generally safe procedure, does come with certain risks and potential complications.
Listed below are risks associated with surgery.
Infection: As with all surgeries, there is a risk of infection. However, the likelihood is quite low with ankle arthroscopy due to the minimal incisions used.
Nerve Damage: There’s a chance of nerve injury, which could result in sensations of numbness, tingling, or burning in the foot. This nerve damage could be temporary or, in rare cases, permanent.
Joint Stiffness: Post-operative joint stiffness can occur, particularly if your ankle is immobilized in a cast for an extended period.
Vascular Injury: Though the risk is low, there’s a possibility of injury to blood vessels during the surgery. This could potentially lead to the formation of blood clots and even localized tissue death in rare cases.
When Can You Return to Work After Ankle Arthroscopy Surgery?
The timeline for returning to work after ankle arthroscopy surgery varies widely depending on the nature of your job. Generally, if your job is desk-based and doesn’t involve physical exertion, you may be able to return to work within a week or two.
However, if your job involves manual labor or standing for prolonged periods, you might need several weeks to a few months to fully recover. Ask your doctor for recommendations.
Can You Drive After an Ankle Scoping?
Most people can resume driving 2-4 weeks after the procedure. This will be dependent on your situation and whether your doctor has cleared you to drive.
Make sure to avoid driving while taking narcotic pain medications. You should be able to fit your foot into a comfortable shoe to operate the gas and brake pedals before you start driving.
How Do You Go Upstairs After the Procedure?
Use your leg that has not been operated on to lead when going up the stairs. Hold onto a handrail when going up the stairs. This will reduce the likelihood of falls.
Here’s a helpful video by Worcestershire Acute Hospitals NHS Trust on how to ascend and descend the stairs safely.
When should you call a health care provider to receive information about whether you need the procedure done?
Reaching out to a healthcare provider for advice about an ankle arthroscopy procedure is recommended if you experience the symptoms listed below.
- Persistent Ankle Pain: If you’re experiencing ongoing pain in your ankle that doesn’t improve with rest or over-the-counter medication.
- Limited Mobility: If your ankle’s range of motion is noticeably decreased or if you’re having trouble walking.
- History of Previous Injury: If you’ve previously injured your ankle and the symptoms are persisting or have worsened.
- Ankle Instability: If your ankle frequently “gives out” or feels unstable during daily activities.
- Swelling or Inflammation: If your ankle is persistently swollen or inflamed, particularly if these symptoms aren’t responding to home remedies.
In conclusion, the complexities of ankle arthroscopy can be quite vast, depending on individual cases and their severity. This procedure has become a popular choice for treating numerous ankle conditions (arthritis, fusion surgery, and scar tissue removal) as highlighted in many recent cases.
Postoperative instructions are important to ensure a smooth recovery and to prevent complications. It is always beneficial to seek physician/nurse advice and care during the recovery period for a comprehensive understanding of the healing process.
This can prepare you with the necessary information to manage potential discomfort and navigate the rehabilitation phase effectively.
Remember, each person’s experience with ankle arthroscopy is unique, and comparing your recovery with others is not helpful.
What remains universally relevant is to listen to your body and seek medical advice promptly whenever something feels wrong.
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