Key-Hole Surgery - Ankle Arthroscopy
An arthroscopy is a key-hole operation of a joint that is performed using a small camera and helps the surgeon to identify and treat the problem within your painful joint.
Why is an arthroscopy done?
Arthroscopy is performed if the symptoms after an ankle injury fail to resolve despite of trying all the usual measures for a considerable duration. An MRI scan is usually performed prior to considering an arthroscopy as the MRI helps to delineate the underlying problem. Arthroscopy also helps to assess and treat the soft tissue inflammation and joint surfaces.
Arthroscopy is performed as a day case procedure. It can be done either under a general or a spinal anaesthetic (the options discussed by the anaesthetic in detail prior to surgery) depending on your medical fitness and mutual preference.
Stability of your ankle ligaments is assessed under the anaesthetic. Two small cuts (incisions) are made at the front of the ankle to allow the camera and other small instruments to be inserted into the ankle. The inside of the ankle is visualised through the camera and any necessary treatment is performed. The ankle is cleaned out and the cuts are closed with stitches. You will have a bulky wool and crepe bandage around the ankle and allowed to weight bear and mobilise as you are able.
In the first few days, elevation of the foot is recommended (above the level of heart) to help minimising the swelling. You will require oral pain killer medications in the first few days to keep the pain under control. You will be reviewed in clinic or at your GP surgery in 2 weeks after surgery to check the wound and remove the sutures. You will then be reviewed at 6 weeks stage in clinic for assessment of your symptoms and will be assessed for the need of physiotherapy.
Driving, Work and Sports
In case of left foot surgery, you can start driving an automatic car once the wound has healed. In case of right foot surgery, most individuals can start driving at around 4 to 6 weeks after surgery. Air travel is not recommended within 6 weeks after surgery. Return to an office based job may be possible at around 4 to 6 weeks (depending on the need for driving). Strenuous physical activity and sports can be resumed when your ankle is feeling strong, comfortable and no longer swollen, usually after 6 weeks, but this depends on the type of surgery carried out. You should gradually increase your level of activity and before returning to competitive sport.
What complications can occur after surgery?
Potential risks and complications after surgery include infection, wound problems, bleeding, blood clots in the legs or lungs (deep vein thrombosis, pulmonary embolism), ongoing pain, stiffness, numbness around the scars, chronic regional pain syndrome and anaesthetic risks. These potential problems occur in a small percentage of cases but the risk increases with the presence of certain medical conditions and the use of certain long-term medications.