An ankle arthroscopy can help your doctor diagnose and treat several ankle issues. This minimally invasive procedure allows a surgeon to obtain a closer look at the ankle without resorting to large incisions or open surgery.
But, how does it work?
Using the advanced technology of magnifying lenses, fiber optics, and digital video monitors, a surgeon obtains a clearer view of the ankle through small incisions. Tiny surgical equipment allows the surgeon to treat even complicated ankle issues with less damage to surrounding tissues.
But, first, let’s take a step back.
Gaining a better understanding of the ankle can give you a clearer idea of how an ankle arthroscopy can help you.
The tibiotalar (ankle) joint connects three major bones: the talus (or uppermost bone in the foot), the tibia (or shin bone), and the fibula (or bone on the outer part of the leg). The ankle joint functions as both a hinge and a synovial joint. Your ankle allows for upward and downward foot movements relative to the shin bone.
Likewise, the tibia and fibula are bound together by strong ligaments. Their connection creates a socket-shaped structure, in which the wedge-shaped part of the talus fits snugly inside the socket created by the leg bones.
By design, the ankle stays together thanks to ligaments on either side of the ankle joint. The outer ligaments connect the fibula with the talus and/or calcaneus (heel bone). In fact, it’s these outer ligaments that are usually associated with ankle sprains. In contrast, the strong deltoid ligaments stabilize the inner side of the ankle. These ligaments connect the bony part of the ankle (i.e. part of the tibia) to other bones in the foot.
A series of muscles starting in the calf help to move the ankle. Elastic tissues, known as tendons, connect these muscles to the bones.
Most importantly, the ankle plays a major role in how you get around every day. It also helps support the weight of your entire body. Given these important responsibilities, it’s no wonder the ankle is so prone to injuries. Of course, some ankle injuries are relatively minor. They may only require rest, elevation, and the application of ice or heat.
More significant injuries and ankle conditions, however, may require extensive treatment, such as an ankle arthroscopy. For example, studies have shown that an ankle arthroscopy is recommended for fusing the ankle joint as well as for treating osteochondral lesions and ankle impingement. It may also be effective for addressing ankle instability.
Surgery may make you feel a little uncertain, even scared. After all, many people envision surgery as a masked doctor with a large scalpel making deep cuts into the body. This may be the case with open surgeries. And, sometimes, those large incisions are necessary.
Most people, however, don’t need open surgery for ankle problems—even those who require surgery.
Minimally invasive procedures can effectively treat a variety of ankle issues without resorting to large incisions with that big scalpel. Most importantly, the benefits of minimally invasive procedures are much more extensive than simply calming your fears about open surgery.
Check out the next section to learn more about the advantages of minimally invasive ankle arthroscopy.
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Surgeons continue to use technology and techniques that make surgical procedures less invasive. Arthroscopic procedures have revolutionized the treatment of ankle and other joint disorders.
Specifically, if you need surgery, then how can an ankle arthroscopy benefit you?
Minimally invasive procedures use small incisions and tiny surgical equipment. As a result you can expect:
Sounds pretty good? Well, there’s actually more…
Most ankle arthroscopies are performed on an outpatient basis. This means that you can usually go home the same day of your surgery. Instead of lying in a hospital bed eating a bland meal, you could enjoy the comforts of home with your loved ones as you recover.
Okay…So, you’ve heard about the benefits. But, you’re probably wondering what happens during an ankle arthroscopy. Let’s take a closer look.
In most cases, you will be placed under general anesthesia. Sometimes a pain block or sedative will be used. Then a tourniquet is applied to the leg as well as surgical prepping and sterilization.
Once the ankle and foot are positioned, at least two incisions are made in the ankle. These incisions can be as small as 1/6th of an inch depending on your condition. Known as ankle arthroscopy portals, this is where a tiny camera and surgical instruments enter your ankle. In fact, there are strategic positions in the front or back of the ankle that intentionally avoid blood vessels or nerves.
During surgery, the camera and instruments can be exchanged through the portals. This allows the surgeon to see effectively and operate on the specific areas of the ankle.
Exactly how long does an ankle arthroscopy take? Depending on your condition, ankle arthroscopy can be completed in an hour or two.
Once the surgery is complete, the incisions are sutured and covered with a sterile dressing. You will then enter a recovery room where you are medically monitored until the anesthesia wears off and you are deemed safe enough to return home.
You will receive specific aftercare and rehabilitation instructions. Following these instructions carefully plays a big role in a successful recovery.
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Generally speaking, if your ankle issues don’t improve with conservative treatments, then an ankle arthroscopy may be used to diagnose and treat the problem.
Some ankle arthroscopy indications include:
A condition marked by inflammation of the synovium—soft tissue lining the ankle joint. This can be caused by trauma, overuse, degenerative joint disease (osteoarthritis), or inflammatory arthritis. Symptoms include swelling, pain, and difficulty moving the ankle. An ankle arthroscopy can remove the inflamed synovium to decrease swelling and ease pain.
When your ankle suffers injury, scar tissue or articular cartilage can break free in the joint. This creates a “loose body.” In addition, an extra piece of formed bone, known as exostosis, can break off existing bone. Loose bodies can cause issues in the ankle joint, leading to clicking sounds or sensations, swelling, pain, and loss of your range of motion. An ankle arthroscopy can help to find and remove these loose bodies.
Formally known as anterior ankle impingement, this condition results from inflammation in the front part of the ankle joint. It is usually caused by irritation or repetitive stress. As the name suggests, this is a common injury for athletes—especially those prone to sprained ankles. Eventually, bone spurs may develop in the ankle, causing pain and limiting your range of motion. An ankle arthroscopy can remove any bone spurs or troublesome soft tissues from the area.
An unstable ankle can make a person more prone to sprains and other injuries. Osteochondral defects (OCDs) in the ankle can be caused by genetics, metabolic abnormalities, degeneration of the ankle, and vascular problems. OCDs can lead to persistent or worsening ankle pain and swelling. One may also feel or hear the sensation of clicking, popping, or the ankle catching. Treatment often depends on the size and location of the OCD as well as a person’s symptoms and activity level. Using techniques like drilling and bone grafting, your doctor can use arthroscopic surgery to correct the ankle issue.
While not always necessary, an ankle arthroscopy can be used to ensure the bones of the ankle joint are properly aligned after an ankle fracture. This may reduce your risk of reinjuring the area and/or subsequently developing arthritis in the ankle.
Sometimes diagnostic imaging cannot determine the cause of your ankle pain. The tiny camera used during an arthroscopy can allow the doctor an opportunity to look directly into the joint. This helps with achieving an accurate diagnosis and planning the appropriate treatment.
As you can probably guess, technology continues to improve and evolve. This is just a short list of some of the ankle conditions that doctors can treat with an arthroscopy.
It is normal to experience pain and swelling for a few days after an ankle arthroscopy. Oral medications and elevating the leg can help to ease your discomfort. Depending on the actual procedure, you may have some restrictions regarding walking and bearing weight on your recovering ankle. More complicated procedures may require up to two months of staying off your ankle.
Follow any post-operative instructions closely. These will include wound care, what you can and cannot do on your ankle, and ways to manage pain. Sutures holding together the incisions are generally removed within one or two weeks after surgery.
After the swelling subsides, you will probably work with a physical therapist or another rehab specialist to restore functioning, strength, and range of motion to the ankle. A successful ankle arthroscopy, along with proper follow-up care, can lead to very positive outcomes. In fact, many patients return to work in about two weeks after the procedure. Athletes may get back on the field or court within 4 to 6 weeks.
If you are ready to take the next step in treating and caring for your ankle issues, NJ Spine & Orthopedic is ready to help. We empower you with information about both conservative and surgical options. From there, you can make an informed decision based on your preferences and recovery goals.
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