Sports Injuries

Ankle Arthroscopy

Ankle arthroscopy is a minimally invasive surgical procedure in which an arthroscope, a small, soft, flexible tube with a light and video camera at the end, is inserted into the ankle joint to evaluate and treat a variety of conditions.

An arthroscope is a small, fibre-optic instrument consisting of a lens, light source, and video camera. The camera projects an image of the inside of the joint onto a large screen monitor allowing the surgeon to look for any damage, assess the type of injury, and repair the problem.

Indications

Ankle Arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, has proved to be highly effective in managing various ankle disorders including ankle arthritis, unstable ankle, ankle fracture, osteochondral defects of the talus, infection, and undiagnosed ankle pain.
The benefits of arthroscopy compared to the alternative, open ankle surgery, include:

  • Smaller incisions
  • Minimal soft tissue trauma
  • Less pain
  • Faster healing time
  • Lower infection rate
  • Less scarring
  • Earlier mobilization
  • Shorter hospital stay

Procedure

Your surgeon will make 2 or 3 small incisions around the ankle joint. Through one of the incisions an arthroscope is inserted. Along with it, a sterile solution is pumped into the joint to expand the joint area and create room for the surgeon to work.

The larger image on the television monitor allows the surgeon to visualize the joint directly to determine the extent of damage so that it can be surgically treated. Surgical instruments will be inserted through the other tiny incisions to assess and treat the problem.

After the surgery, the instruments are removed, and the incisions are closed and covered with a bandage.

Post-surgical care

After the procedure, you will be taken to a recovery room. The ankle joint will be immobilized with a splint or cast. The nature and duration of immobilization will depend on the type of repair performed and the preference of the surgeon. The surgical site should be kept clean and dry during the healing process. Patients may be prescribed pain medication for the management of pain. Elevation of the ankle and ice application helps to reduce pain and swelling. Follow your post-operative instructions for the best outcome.

Risks and complications

Ankle arthroscopy is a safe procedure and the incidence of complications is low. However, as with any surgery, risks and complications can occur. Some associated risks with ankle surgery can include infection, damage to blood vessels or nerves, bleeding, and compartment syndrome.

 

Ankle Ligament Reconstruction

A sprain is stretching or tearing of a ligament. Ligaments connect adjacent bones in a joint and provide stability to the joint.

An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular.

Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle accompanied by persistent discomfort.

Inadequate healing of a sprained ligament or incomplete rehabilitation of the affected ligament can result in instability of the ankle.

A complete medical history, including a history of any previous ankle injuries, and a physical examination is essential for an accurate diagnosis of the condition. An X-ray may be ordered to confirm the diagnosis.

Treatment

Acute injuries can be managed with conservative treatment measures such as RICE method (rest, ice, compression and elevation), medications, bracing, and physical therapy.

Surgical intervention to reconstruct the injured ligament may be considered in patients with a high degree of instability and in those who have failed to respond to non-surgical treatments.

Ankle ligament reconstruction may be performed arthroscopically under general anaesthesia. Your surgeon will make small incisions in your ankle. A tiny camera and a few special instruments are inserted through the incisions to repair and strengthen the ligaments. Stretched or torn ligaments will be shortened and stitched as needed. Sometimes, a weakened ligament is reconstructed with a section of tendon derived from the foot and around the ankle.

The recovery time after ankle ligament reconstruction depends on the extent of injury and the procedure performed. For the first few weeks after surgery, you will be instructed to use crutches or a wheelchair and avoid bearing any weight on the reconstructed ankle joint.

Specific complications of ankle ligament reconstruction include infection, nerve damage, ankle joint stiffness, and recurrent instability.

  • Medical Protection Society
  • General Medical Council
  • British Orthopadeic Association
  • American Orthopaedic Foot Ankle
  • Bofas