Arthroscopic Debridement

Ankle Arthroscopy is a minimally invasive procedure used to help alleviate arthritic pain in a joint. As cartilage starts to break down from arthritis in the joint, bone spurs and osteophytes can develop causing bone to rub against bone. This causes the body to lay down more bone to repair the damage but without the cartilage this leads to pain. Arthroscopy is then used by utilizing a small camera and small incision holes to remove these small bone spurs or fragments to alleviate the pain. The goal of this procedure is to help relieve pain, stiffness and other symptoms.

 

Used to Treat

• Mild to moderate Ankle Arthritis

• Unstable Ankle

• Ankle Fractures

• Anterior  and Posterior Ankle Impingement

• Osteochondral defects

 

Pre-Treatment

• You and your physician will discuss if this is the right option for you.

• Complete history will be taken as well as ruling out any contraindications for surgery, such as:

  • Cellulitis

  • Any acute or chronic open wounds

  • Dermatitis

  • Severe arthritis changes that there is loss of joint space

  • Peripheral vascular disease

  • Peripheral neuropathy

  • Reflex sympathetic dystrophy/complex regional pain syndrome

  • Edema

• Any X-ray’s or prior imaging will be gone over

• It is recommended that you arrange a ride to and from the surgery

 

Procedure

Ankle arthroscopy is usually an outpatient surgery done under general anesthesia or with a spinal/nerve block.

1. A tourniquet is first applied and then the leg is prepped and draped.

2. Traction may be applied to the ankle to help increase the joint space between the leg bones and create room for the surgeon to work.

3. Once the ankle is in proper position small incisions are made for the camera to be inserted as well as surgical instruments.

4. Fluid is then flowed through the incisions to help further open the joint. 

5. A tiny, flexible arthroscopic camera with a camera will be inserted which will show the ankle joint on a larger screen.

6. The surgeon will then remove any bone fragments, bone spurs or damaged cartilage out of the ankle joint. 

7. If any other repairs are needed these will be performed now as well.

8. Once finished with all repairs the incisions will be closed with small sutures. 

9. The ankle will then be placed in a sterile compressive dressing with possibly a splint or boot as well.

10. You will then be taken to the recovery area.

 

Post-Treatment

• Pain and swelling can be expected following surgery. Compression socks can be used to help decrease the swelling.

• Elevation of the leg and oral pain medications will be recommended for the next several days.

• Expect to be non-weight bearing and on crutches after surgery. 

• Depending on the procedure you may be on a strict non weight bearing protocol or you may be able to progressively weight bear with crutches.

• A follow up doctor's appointment will be made with your physician 10-14 days post-opt to remove dressing and sutures as well as make sure everything is healing correctly.

• Active range of motion may be allowed immediately after procedure. 

• Once swelling has decreased and strengthening is allowed, your physician will prescribe physical therapy. 

 

Pros

• Arthroscopy requires only small incisions so recovery time is shorter.

• Less visible scars

• Minimizes the complications of an open surgery such as bleeding, wound breakdown and infection.

• Can be an outpatient procedure

• Rehabilitation can begin sooner which means returning to activities and sports sooner.

 

Complications/Cons

• Injury to nerve, vessel, tendon, ligament or cartilage around the ankle. 

• Deep or superficial infection

• Scarring

 

If you have any of the following symptoms they should be reported to your surgeon urgently:

• Pain not controlled by medication

• Nausea, vomiting, fevers or chills

• Wound redness, swelling, warmth or drainage

• New numbness, weakness, or tingling