Ankle Arthroscopy (Complex)

Learn more about ankle arthroscopy at King Edward VII’s Hospital

Not knowing the source of your ankle pain can be an upsetting experience and can cause delays to your treatment.  Here you can find out more about our London ankle arthroscopy specialists and find out if this treatment is the right option for you. On this page King Edward VII’s Hospital London ankle arthroscopy consultants answer your questions about the procedure.

Why would I need ankle arthroscopy surgery?

Most people who require ankle arthroscopy surgery need it because they have either unexplained and persistent ankle pain or they have arthritis or inflammation caused by ankle injury that is causing them to experience pain, swelling or stiffness in the ankle joint.

Ankle arthroscopy surgery can be used to both diagnose and treat ankle problems at the same time, such as in the case of loose or damaged cartilage, bone or muscle tissue. If these are identified during the procedure, the surgeon can potentially remove or repair the problem straight away.

Complex ankle arthroscopy is usually undertaken:

• For ankle and subtalar stabilisation
• For hindfoot pathology
• For peroneal and posterior tibial endoscopy
• For ankle fusion
• For subtalar fusion

Other ankle problems may require a therapeutic ankle arthroscopy.

What symptoms does ankle arthroscopy surgery address?

Most people having an ankle arthroscopy do so because they have ankle pain that hasn’t responded to other treatments, or unexplained ankle pain that cannot be diagnosed from x-rays and MRI scans.

When should you speak to your specialist about ankle arthroscopy surgery?

If you have ankle pain caused by an unknown reason, or by injury, speak to your ankle arthroscopy specialist. They may suggest a series of tests and scans, and may refer you for an ankle arthroscopy procedure.

How is ankle arthroscopy performed?

An ankle arthroscopy procedure is carried out as a keyhole procedure. It involves your ankle arthroscopy consultant surgeon making a small surgical incision, usually on the front of the ankle in order to pass a long, thin instrument with a camera attached, into the ankle joint, called an arthroscope.

There are 3 types of ankle arthroscopy procedures:

Anterior arthroscopy – performed at the front of ankle (this is the most common)

Posterior arthroscopy – performed at the back of ankle

Subtalar arthroscopy – performed on the side of ankle and heel

The arthroscope allows your surgeon to take a look inside the ankle joint, but they may need to inject a sterile fluid into the joint to expand it and get a better view.

Your surgeon will make one or two other small cuts in order to pass other surgical instruments into the ankle joint to remove or repair damaged tissue.

The procedure is carried out under a general anaesthetic and will take between 30 minutes to 2 hours. You will wake having had your surgical incisions stitched up, and your ankle bandaged.

What is the recovery like for ankle arthroscopy surgery?

Your recovery from ankle arthroscopy surgery will depend on multiple factors, including your age, fitness level and the nature of your procedure.

Most patients can return home the same day after this kind of surgery but some may be required to spend one night in hospital.

You can expect some pain and swelling following surgery.

You may be given crutches and a special shoe to wear for your recovery. Depending on the treatment you’ve had, you may be able to walk on the leg immediately or you may need to wait. Your surgeon will advise you on this.

Your nursing team and physiotherapy team will give you advice that will help you best recover, based on advice from your surgeon. This includes when you can put weight on your ankle, how long to keep your ankle elevated for, when your stitches should be removed or dissolved by and when your dressings should come off.

You will also be advised how long you may need off work and resting from your normal activities. This is usually between 1-2 weeks.

Are there any risks/complications associated with ankle arthroscopy surgery?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist or surgeon beforehand will help you avoid any adverse reactions.

Ankle arthroscopy surgery has a relatively low risk of serious complications, but the following risks and complications can occur in a small number of cases:

• An infection in the surgical wound
• Bleeding inside the ankle joint
• A blood clot called a deep vein thrombosis (DVT)
• Nerve damage
• Stiffness
• Swelling

How can I prepare for ankle arthroscopy surgery?

Prior to ankle arthroscopy surgery, your surgeon will discuss with you how best to prepare for surgery, as each patient is different.

Common preparations for ankle arthroscopy surgery include:

• Routine blood tests, x rays or scans as requested by your surgeon
• Taking steps to stop smoking if you smoke
• Losing weight if you’re overweight
• Remaining active and doing regular exercise

Are there alternatives for ankle arthroscopy surgery?

Depending on the severity of your ankle discomfort, it may be possible to manage your pain using painkillers, steroid injections and physiotherapy.