Are you having trouble doing your daily activities due to chronic pain and stiffness in your ankle? Your doctor may have told you about a surgery called 'Ankle Arthroscopy.' You may have felt a little scared when they said 'it's done with a camera,' right? But don't be afraid. This is not as big a deal as you think, and it's not something to be afraid of. Let's talk about everything in simple terms today.
What exactly is Ankle Arthroscopy?
Simply put, this is a minimally invasive surgery to see and treat problems inside your ankle joint. Your surgeon makes a few very small cuts in the skin of your ankle and inserts a special instrument called an arthroscope through them.
This arthroscope is a small tube about the size of a pencil with a camera and a light on the front. The doctor can see what's going on inside the joint clearly by viewing the images from this camera on a large screen. Then, other small instruments are inserted through another small incision to repair the damaged area.
Because the incisions made in this surgery are usually smaller than half an inch, there is much less pressure on the body than with open surgery, which involves a larger incision.
Who needs this surgery and for what conditions?
Your doctor will not usually recommend this surgery right away. This is only done if non-surgical treatments such as painkillers, steroid injections, and physical therapy do not relieve your ankle pain and stiffness.
The table below lists several conditions that can be treated with this surgery.
| Problem | A simple explanation |
|---|---|
| Instability of the joint | Sometimes, a deformity in the bones can cause the ankle to roll uncontrollably when standing or walking. The doctor can find the cause and correct it with this surgery. |
| Impingement | Overuse of the tissues around the joint can cause swelling and pain. Over time, this swelling can cause the joint to become stiff and unable to move properly. |
| Removal of damaged bone, cartilage, or scar tissue | After an injury, bone or cartilage can become damaged, or small pieces of it can become lodged in the joint and cause pain. Pain can also be caused by scar tissue that forms as the injury heals. This surgery is used to remove these. |
| Torn ligaments | Ligaments are like rubber bands that connect our bones together. If these are torn in an accident, the function of the ankle will be impaired. These can also be repaired with this surgery. |
How do you prepare before surgery?
Your doctor will give you some instructions before the surgery. It is very important to follow these exactly.
- Blood thinners: It's important to tell your doctor about all the medications you're taking, including vitamins and supplements. Blood thinners, especially those that prevent blood clots, can be dangerous during and after surgery. Your doctor will tell you which medications to stop and how to stop them.
- Smoking: If you smoke, it is best to stop at least four weeks before surgery. Smoking reduces the body's ability to heal wounds.
- Alcohol: Alcohol can also thin the blood, so it is important to avoid alcohol before and after surgery.
- Food and drink: Your doctor or hospital staff will tell you how many hours you need to fast before surgery. It is usually best to not eat or drink anything other than water for 8-12 hours before surgery.
What happens during and after the surgery?
During the surgery, the doctor inserts the arthroscope through the small incisions mentioned above to identify and treat the problem inside the joint. During this time, you will either be numbed only in the ankle area (regional anesthesia) or you will be put to sleep (general anesthesia) . The surgery usually takes about an hour, but the time may vary depending on your condition.
Let's learn a little about what debridement is.
Debridement is one technique doctors use during this surgery. This involves "cleaning and removing" damaged tissue and loose cartilage fragments from inside the joint.
Think about your kitchen. Some days you need a big cleanup. Other days you need a little sweeping and tidying. Either way, the end result is a clean, tidy kitchen. Debridement is like that. The doctor cleans out the inside of your joint and removes any unwanted, painful material.
After surgery, you will probably be able to go home the same day. However, since you will not be able to drive, it is essential to have someone to drive you. Here are some things to keep in mind after you go home:
- Avoid putting weight on your ankle until your doctor tells you to.
- Keep the ankle elevated and apply ice.
- Keep the incision clean and covered .
- Take painkillers prescribed by your doctor for pain, such as `NSAIDs` (Nonsteroidal anti-inflammatory drugs).
- Until the wound heals, use a shower instead of a bath and take care not to wet the wound.
You will need to wear a splint on your ankle for a few weeks, and then you will need to start physical therapy.
What are the benefits and risks of this surgery?
The main advantage of this surgery is that it can be done with a very minimal incision. Therefore:
- Recovery time is short (you can return to normal within a few weeks).
- Less pain than open surgery.
- Bleeding and scarring are very minimal.
- The risk of complications is very low compared to other surgeries.
Like any surgery, there are some minor risks involved, but these are very rare.
- Allergy to anesthesia.
- Nerve damage.
- Blood clots in the blood vessels, e.g. (Deep Vein Thrombosis - DVT) .
- Wound infection.
- Excessive bleeding or swelling.
- Numbness in the ankle and foot.
How long will it take to recover and when should I see the doctor?
It usually takes several months to fully recover. It depends on the reason for your surgery and how well you do with physical therapy exercises. At first, you will need to use crutches, and then you will be able to walk in a special shoe (boot).
If your job or schoolwork requires sitting, you can return to it in a few weeks. However, you should definitely check with your doctor before starting heavy lifting or sports.
Call your doctor immediately if you have the following symptoms:
- If there is severe pain or bleeding .
- If nausea and vomiting go away.
- If the wound area is discolored, red, swollen, or showing signs of infection, such as fever .
Take-Home Message
- Ankle arthroscopy is a minimally invasive, safe, and highly successful surgery for ankle problems.
- To recover quickly after this, it is essential to follow the doctor's instructions exactly and to do physical therapy properly.
- Inform your doctor about all medications you are taking before surgery.
- If you experience any unusual symptoms after surgery, such as excessive pain, swelling, or fever, contact your doctor immediately.
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