Ankle Arthroscopy
Through small incisions and a camera, impingement, cartilage lesions and loose bodies in the ankle joint can be treated.
Ankle sprains are very common and most heal completely. In some patients, however, pain, swelling and catching continue for months. The cause of these lasting symptoms is often inside the joint. Ankle arthroscopy lets these problems be seen and treated with a camera through small incisions.
When is it used?
- Anterior impingement: Bone spurs or thickened soft tissue at the front of the joint getting pinched as the ankle bends
- Posterior impingement: Especially in ballet dancers and footballers, pinching of a bony prominence (os trigonum) at the back of the joint
- Cartilage damage of the talus (osteochondral lesions)
- Loose bodies inside the joint
- Chronic synovitis and soft tissue impingement
- Assessing problems inside the joint that accompany ligament laxity
Symptoms
Long-standing pain, a pinching feeling at the front of the ankle when climbing stairs or squatting, recurrent swelling, catching and locking, and loss of performance in sport are common.
Diagnosis
Examination assesses where the pain is and how the ankle moves. X-rays show bone spurs, MRI shows cartilage and soft tissue damage, and CT gives detail of bone lesions when needed.
How is it done?
For anterior arthroscopy, small incisions are made at the front of the ankle; for posterior arthroscopy, the patient lies face down and incisions are made on either side of the Achilles tendon. Bone spurs are removed, pinched tissue is cleaned and cartilage lesions are treated with methods such as microfracture. Ligament repair can be done in the same session if needed.
Recovery
- Most patients go home the same day or the next day.
- Crutches are used for a few days to a few weeks, depending on the procedure.
- Movement exercises start early, followed by balance and strength work.
- After impingement surgery, return to sport usually takes a few weeks; after cartilage treatment it takes longer.
Care at home after surgery
In the first days, keeping the foot above heart level reduces swelling. It is important to keep the dressing dry, do the recommended exercises regularly and not strain the ankle earlier than advised. Contact your doctor if pain increases, or you develop fever or calf swelling.
Arthroscopy in chronic sprains
Ankles that sprain often can develop cartilage damage, soft tissue impingement or loose bodies inside the joint. Treating these arthroscopically in the same session as ligament repair helps the ankle become more comfortable and stable.
Frequently asked questions
I still have pain months after a sprain. Is that normal?
Most sprains heal within a few weeks. Pain and swelling that continue for months suggest a problem inside the joint or ligament laxity and should be assessed.
Is ankle arthroscopy painful?
Thanks to the small incisions, pain after surgery can usually be controlled with painkillers.
When can I wear shoes again?
Once the swelling settles, usually within a few weeks.
When can I run after surgery?
After arthroscopy for impingement, a gradual return to running is usually possible within a few weeks. If cartilage was treated, this takes a few months.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.