Ankle arthroscopy and debridement

What is ankle arthroscopy?

Ankle arthroscopy is minimally invasive surgery of the ankle, also known as keyhole surgery.  Ankle arthroscopy involves using very small incisions to gain access to the ankle joint.  Each incision is less than 1cm and usually two incisions are required on either side of the ankle.

How is ankle arthroscopy performed?

Most ankle arthroscopy is performed under general, or occasionally regional, anaesthesia.  Firstly a padded bar is placed behind the thigh.  Next a strap is placed around the ankle and connected to a second bar distant from the first which is attached to the operating table and allows traction to be placed across the ankle.  In this way the ankle is stretched open sufficiently to allow a space with sufficient dimensions in which to operate.

For the first 24 hours:

Pain relief

When you wake up after the surgery your ankle should feel comfortable.  You will have had injections of local anaesthetic both into the joint and into the nerves around the joint whilst asleep.  Following surgery you will be given a combination of three pain killers to take regularly for the first 36 hours post-operatively and then only to be used as required. 

Mobility

After the ankle arthroscopy, once you are back on the ward the physiotherapist will start mobilising you.  You may put as much weight through the ankle as is comfortable.  The conditions where this is not the case are with an osteochondral defect and if your arthroscopy has been part of a lateral ligament reconstruction.  You will be more comfortable using crutches for a day or two and then these can be discarded.

Your operated leg will need to be elevated when non-weight bearing for the first 24 to 48 hours.

You are encouraged to exercise your ankle within the bandage both by moving it up and down as well as moving it from side to side.  You can start this exercise as soon as you are able to do so comfortably.

Length of stay after ankle arthroscopy

As long as your general medical condition and domestic circumstances permit, most ankle arthroscopy cases can be performed as a day case surgery.

Bandaging after ankle arthroscopy

Following an ankle arthroscopy you will have three layers of covering.  Closest to the wounds are two small adhesive coverings and these should be kept on for two weeks.  Overlying this is a layer of sterile wool and then a crepe bandage.  The dressings should be left intact for the first week.  The wounds themselves should be kept dry for two weeks.  One week following the surgery you may remove the outer crepe bandage and the underlying wool.  The adhesive dressings over the two arthroscopic portals should be left intact.  If these should become loose or dislodged, replace them (without touching the wound) with a good sized adhesive plaster.  These can be replaced as often as required, it is important that the wound itself is kept untouched and dry.

Driving after ankle arthroscopy

Generally you should be comfortable and safe to drive one week after your ankle arthroscopy as long as you are permitted to weight bear.

Return to sport

After ankle arthroscopy you will be back to walking, without the use of a crutch, 1-2 days following your ankle arthroscopy.  Any sporting activity is best left for at least two weeks following the procedure and vigorous exercise may take in excess of four weeks however your surgeon will advise you.

Consultants

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