Ankle Arthroscopy
After an ankle sprain, surgery may be necessary. At the Foot Clinic, we use arthroscopy to repair ankle injuries. Find out more about our surgical procedure below.
What is an ankle arthroscopy?
An ankle arthroscopy is a surgical way to operate on an ankle; it is a tool. Most ankle injuries are accessible by arthroscopy, that is to say, by camera-assisted surgery, but not all injuries can be treated by arthroscopy. Procedures that involve "opening" the ankle are called "open" surgeries.
Ankle arthroscopic surgery
Arthroscopy makes it possible to treat ligament injuries by repairing, strengthening, or even replacing the ligaments with tendon grafts.
- Osteochondral lesions are accessible by arthroscopy, such as osteochondral lesions of the talar dome (LODA). They can be treated by microfractures after osteocartilaginous debridement. Depending on the location of the LODA, arthroscopy may be anterior, posterior, or both.
- Arthroscopy also makes it possible to treat ankle cysts, allowing for precise removal with magnified visualization and minimal incisions.
- Arthroscopy is useful for analyzing tendons, in which case it is called tendoscopy.
Tendoscopy of the fibular tendons or peroneal tendons allows the treatment of fissure lesions and helps pinpoint the area of the tendon that requires repair.
Achilles tendoscopy enables the treatment of Achilles tendinopathies and to perform a transfer of the long flexor of the hallux to offset a poor-quality, degenerative Achilles tendon. - Lesions involved in the "posterior impingement syndrome," common among dancers and football players, are treated arthroscopically.
- We systematically use arthroscopy in the assessment of ankle fractures to identify and treat associated lesions.
- Fusion of the hindfoot joints, such as subtalar arthrodesis, can be performed arthroscopically.
- Arthroscopy is a technique used to treat chronic ankle instability.
Ankle arthroscopy is therefore a way to perform ankle surgery through incisions about 5 mm in size, with enlarged and high-quality visualization.
It allows for:
- Less significant tissue dissection
- Reduced postoperative pain
- Reduced risk of skin and tissue healing problems
- Analysis of joint lesions
Although postoperative recovery is generally easier, it is not necessarily shorter, since the healing time for the various tissues is the same as with open surgery. The small holes in the skin do not reflect what has actually been done inside the ankle.
Preparation for ankle arthroscopic surgery
The preparation is the same as for a traditional open surgery.
Once the surgical indication has been established, an anesthesia consultation will be required.
Arthroscopic ankle procedures require preoperative skin preparation; the aseptic protocols in the operating room are the same as for an open surgery.
Ankle surgery with arthroscopy
Ankle arthroscopy is performed under a tourniquet to limit bleeding, increase intraoperative visibility, and thus improve the precision of the surgical procedure.
We make as many small puncture incisions as necessary to treat the ankle lesions.
At the end of the procedure, a stitch closes each skin opening.
Postoperative course after ankle arthroscopy
Postoperative outcomes vary depending on the procedure performed.
After a simple arthroscopy, weight-bearing is immediate, protected by 2 crutches for 15 to 21 days.
Some procedures require wearing a splint for 21 to 45 days.
When other surgical procedures are performed open during the same surgical time as the arthroscopy, they may require plaster immobilization ranging from 21 to 45 days postoperatively.
Recovery after ankle arthroscopy
Recovery depends on the procedure performed, and on the patients' lifestyle.
If you undergo left ankle arthroscopy, you may be able to drive the day after the procedure if you have an automatic car, for example.
Sick leave after ankle arthroscopy
The duration of sick leave also depends on your procedure and the nature of your work.
Returning to work can be considered quickly in the case of shift work.
Exercises and postoperative rehabilitation after ankle arthroscopy
Contracture of the gastrocnemius muscles is frequently associated with ankle pathologies. We recommend doing self-rehabilitation stretching exercises for the posterior muscle chains before and after surgery.
Arthroscopic ankle ligamentoplasties require more specific rehabilitation than other procedures. About twenty rehabilitation sessions are generally necessary after ligamentoplasty.
FAQ
After an arthroscopy, the ankle is always swollen because of the arthroscopy fluid, which is then drained out.
Depending on the surgical procedures performed, the ankles may remain swollen 3 weeks after an arthroscopy.
The use of anti-inflammatories and refrigerated splints helps to limit the swelling.
Returning to sports after an ankle arthroscopy depends on the type of sport, but also on the level of athletic activity.
All sports activities can be resumed between 2 and 6 months post operation.
Yes, there are at least 2 scars after an ankle arthroscopy. There is one entry point for the camera and one entry point for the instruments. The number of scars generally increases with the number of surgical procedures performed.