A small incision solution to your ankle pain? Let's learn about Ankle Arthroscopy!

Have you been experiencing pain in your ankle for a long time? Perhaps you feel a pinching or numbness when walking or climbing stairs? Or do you suffer from pain in the inside of your ankle even when you are just standing? Hasn't this condition improved despite taking medication and undergoing physical therapy? Then your doctor may have told you about a surgery called 'Ankle Arthroscopy'. Hearing this name may have scared you a little. You may have thought, "Another surgery?" But don't worry. Today, we will talk about everything in a very simple way that you can understand.

What is Ankle Arthroscopy?

Simply put, this is a surgery that is performed like looking through a keyhole. That's why it's also called "keyhole surgery." Instead of making a large incision in your ankle and opening it up like in the past, with this procedure, your doctor makes just a few very small incisions (usually less than half an inch) in the skin of your ankle.

Then, through that small incision, a special instrument is inserted. It's called an arthroscope . It's a thin tube with a very small camera and a light attached to it. The images from this camera are displayed on a large screen (monitor), so the doctor can clearly see everything inside your ankle joint, including the bones, cartilage, and ligaments.

Once the exact location of the problem is identified, small surgical instruments are inserted through another small incision to repair the damage inside the joint. Since it is not a major incision, this is a less stressful operation.

Who needs this surgery?

Usually, when a patient experiences ankle pain, a doctor does not immediately refer them for surgery. Non-surgical treatments such as painkillers, steroid injections, and physical therapy are first used.

However, if none of these things provide adequate relief from your pain and stiffness, it could be that the problem is within the joint itself. That's when your doctor will consider ankle arthroscopy. If your ankle is so unstable that you can't walk, or if you frequently roll your ankle, this surgery may be a good solution.

What conditions can be treated with Ankle Arthroscopy?

This keyhole surgery can solve many ankle problems. Let's take a look at the main conditions treated with this surgery.

How should you prepare before surgery?

For the surgery to be successful, you need to be prepared beforehand. It is very important to follow the doctor's instructions exactly.

What happens during surgery?

After you are taken to the operating theatre, the anaesthetist will give you anaesthesia. This can be done in two ways:

1. General Anesthesia: In this, you will be completely asleep until the surgery is complete. You will not feel anything.

2. Regional Anesthesia: This numbs only the area below your waist or around your ankles. You are conscious, but you don't feel any pain.

After anesthesia, the surgeon makes several small incisions in the ankle and inserts an arthroscope to examine the inside of the joint. Once the exact location of the problem is seen, the surgeon inserts the necessary instruments through other incisions to repair the damage. The entire procedure usually takes about an hour . However, this time may vary depending on your condition.

What is Debridement?

You may hear this word when talking about surgery. Debridement simply means 'cleaning' . Imagine that a room in your house is messy. Maybe it needs a little tidying up. Maybe it needs a thorough cleaning. Either way, the end result is the same, and that is a clean, tidy room. Debridement is something like that. This is what the doctor means by removing the unwanted, damaged tissue, bone fragments, and cartilage fragments from inside your ankle joint and 'cleaning' the joint.

What happens after the surgery?

This is usually an outpatient procedure . You will be monitored for a few hours after the procedure and then allowed to go home. The doctor or nurse will explain to you what you need to do after you go home.

• Avoid putting weight on the leg that was operated on for the first few weeks. You will need to use crutches for this.
• Ice and Elevate Your Ankle: Elevating your leg, such as on a chair, can help reduce swelling. Iceing your ankle for 15-20 minutes several times a day is also good for pain and swelling.
• Keep the wound clean: Cuts should be covered and kept clean. Cover them with a waterproof cover when bathing. It is not a good idea to take a bath or go to swimming pools until the wounds have healed.
• Painkillers: Take painkillers (such as NSAIDs) prescribed by your doctor on time.
• Splint: For the first few weeks, you will be asked to wear a splint or boot to limit the movement of your ankle.

In a few days, the doctor will see you again, cut the stitches, and tell you what to do next. After that, you will need to start physical therapy . This is essential to regain strength and movement in your ankle.

What are the advantages of this surgery?

Compared to more invasive surgeries, ankle arthroscopy has many advantages.

• Quick recovery: Since there is no major injury, the recovery time is very short. You can resume normal activities in a few weeks.
• Less pain: The pain after surgery is very minimal.
• Minimal bleeding and small scars: Small incisions result in minimal bleeding, and only a few small, barely visible scars remain.
• Low risk of complications: The risk of complications like infections is very low.

Are there any risks?

As with any surgery, there are some risks, but these are very rare conditions that don't occur very often.

• Allergic reaction to anesthesia
• Nerve damage
• Blood clots, especially in the veins of the legs (Deep Vein Thrombosis - DVT)
• Wound infection
• Excessive bleeding or swelling
• Numbness in the ankle and foot
• Perhaps, if the problem is not completely resolved, another surgery may be needed.

Don't be afraid of these risks. Your doctor will take all necessary steps to minimize these risks.

When should I see the doctor after surgery?

It is important to pay attention to your body after you go home after surgery. If you have any of the following symptoms, call your doctor immediately or go to the hospital where you received treatment.

• If you experience unbearable pain .
• If the wound is bleeding excessively .
• If nausea and vomiting persist.
• If you see signs of infection (e.g. fever, redness, swelling, warmth around the incision, pus).