Ankle Arthroscopy

Arthroscopy (or key hole surgery) is a procedure to view the inside of a joint. Arthroscopy is a very useful way to treat cartilage damage, scar tissue, spurs and impingement of the ankle.

There are a number of steps involved in ankle arthroscopic surgery. These include:

• General anaesthetic, antibiotics
• Two small incisions (each 1 cm long) over the front of the ankle
• Insertion of arthroscope
• Insertion of arthroscopic equipment including scissors, scrapers, shaver and burr
• Infiltration with local anaesthetic
• Wound closure with stitches/sutures

All surgical procedures carry some risk. The risk of complications with ankle arthroscopic surgery is low. Some of the risks of surgery include:

• Infection
• Nerve injury – this may result in numbness, tingling and/or pins and needles on the top of the foot
• Deep venous thrombosis/pulmonary embolism (the risk of DVT increases with smoking, the oral contraceptive pill and hormone replacement therapy, immobility and obesity)
• Anaesthetic complications
• Drug allergy
• Post operative synovitis (inflammation of the lining of the joint), this usually settles with anti-inflammatory medications
• Stiffness
• Ongoing pain

Rest

• You will have a boot on your leg. Keep foot elevated as much as possible, especially for initial 72 hours. Keep dressings dry and intact until post operative appointment.
• Mobilise short distances as pain allows, aim to remain in your own home for the first few weeks limiting long periods of standing or mobilising
• Bear weight as tolerated unless instructed otherwise by Dr Phegan

Pain

• Pain relief may be required for up to 2 weeks; depending on your other medications this may include:
• Regular paracetamol, anti-inflammatory drugs and break through opiate type medications

Driving

• Any surgery performed on the right foot or both feet will mean no driving for a minimum of 6 weeks
• If surgery was performed on the left foot then driving in an automatic is possible, but Dr Phegan would recommend waiting a minimum of two weeks before attempting to drive

Driving any vehicle with a cast or boot is potentially hazardous and you should consider this before getting behind the wheel.

Follow up

• Keep all dressings dry and intact for the first two weeks
• Removal of stitches/sutures typically occurs at an appointment with Dr Phegan and his in-house therapists at 10-14 days at first post operative appointment. Very occasionally some sutures need to stay in for longer
• Your appointment will be booked by Dr Phegan and a confirmatory SMS will be sent informing you of the time and date for follow up

Typical milestones

• 2 weeks: Wound review and removal of sutures, commence rehabilitation with physio
• 2-6 weeks: regular physiotherapy to increase range, strength and proprioception
• 6 weeks to 3 months: work on swelling reduction, scar massage and mobility
• Full recovery 3-6 months

Every patient's recovery is individual and depends on the severity of the injury and the complexity of the surgery.