What is Ankle Arthroscopy?

Who Needs Ankle Arthroscopy?

As with most orthopaedic conditions, there are conservative and surgical treatment options. Many orthopaedic patients with ankle injuries or ankle pain will respond well to conservative treatments like: rest, over the counter pain medication, or physical therapy. However, if these measures fail, further diagnostic testing is completed to see if a patient is a good candidate for ankle arthroscopy.

Although most commonly performed in the knee and hip, arthroscopic ankle surgery may be a good treatment option for certain types of ankle pain and conditions. Some of the reasons a patient may undergo arthroscopic ankle surgery include:

• Removal of loose bone fragments or cartilage
• Partial removal of inflamed joint linings (partial synovectomy)
• Removal of bone spurs (bone growths), caused by injury
• Fixing fractures of the joint surface.
• Repairing ankle ligament tears
• Repairing articular and focal cartilage damage
• Treating and assessing tendonitis arthritis
• Removal of adhesions (areas of build up scar tissue) that can limit movement and cause pain
• Treatment of posterior ankle pain
• General evaluation of a patient’s symptoms or confirming a diagnosis

What are the Advantages of Ankle Arthroscopy?

For most patients, ankle arthroscopy will help reduce pain and discomfort and improve ankle function. Walking, running and playing sports should become easier and less painful after recovery. The advantages of arthroscopic surgery over traditional surgery include:

• Smaller surgical incisions which result in less scarring and a lower infection rate
• Less trauma to ligaments, muscles, and tissues
• Less pain and a quicker recovery period
• Earlier mobilization following surgery
• A shorter hospital stay

What Post-Operative Care should be taken?

How fast a patient recovers from ankle arthroscopy depends on what part of the ankle underwent surgery and what types injuries or conditions were being treated. Typically the more complex the surgery is, the longer the healing and recovery time will be.

Immediately following surgery your doctor may prescribe the RICE regimen: rest, ice, compression  and elevation (keeping the ankle elevated to reduce swelling). Your doctor may also instruct you to keep your surgical incisions covered, clean and dry up to two weeks following the procedure. It is also advised that patients avoid smoking and eat a healthy, balanced diet to increase the rate of healing and recovery.

Post-Operative Limitations:

Following arthroscopic ankle surgery certain tasks are unsafe or painful to execute. Such tasks may include:

• Driving – Patients must notify their insurance company that they underwent surgery to ensure that their auto coverage is still valid. If the surgery was only done on the left ankle, patients may be able to safely drive an automatic vehicle a few days after discharge. However, it may take a week or more before driving a manual car is safe. It is unsafe for a patient to drive a vehicle if they are experiencing any ankle pain, as this makes it more difficult to perform an emergency stop.
• Athletic Participation – Although recovery time varies from patient to patient, gentle activity can often be resumed six weeks after surgery. Athletes who are in peak physical condition may in some cases be able to return to athletics within a few weeks. However, patients who wish to partake in contact sports, such as football or soccer, may require more recovery time.

When I expect Return to Work After Ankle Arthroscopy?

Most patients can expect to return to school or a sedentary job about four weeks after surgery, sometimes sooner. However, patients that have a job that requires a significant amount of standing or walking may not be able to return to work for two months after ankle arthroscopy. If you have an extremely physical job you will be given more specific estimations from your doctor, as the expected time can vary greatly depending on the reason for the surgery and the nature of your job.

Physical Therapy for Ankle Arthroscopy Recovery

Many orthopedic surgeons have their patients take part in formal physical therapy after any type of ankle arthroscopy procedure. Typically, the more complex the surgery the longer the rehabilitation process will be. Some patients have a preoperative visit with their physical therapist where they are taught how to walk safely using crutches or a walker post-surgery. They also may learn some of the exercises that will be done throughout recovery. The first few physical therapy treatments after surgery are designed to help control the pain and swelling from the surgery. These early sessions also teach patients how to use of crutches or a walker safely if they were not taught prior to surgery. However, overtime, goals of physical therapy will expand to include:

• Improving ankle range of motion (ROM)
• Increasing ankle strength
• Improving balance and proprioception
• Improving exercise tolerance
• Maintaining hip and knee ROM
• Returning to all everyday and physical activities

After recovery is nearly complete, physical therapy will end. The therapist will continue to be a resource, but the patient will need to continue doing exercises at home to complete the rehabilitation process.

Although physical therapy regimens will vary from patient to patient some of the exercises done through physical therapy and at home may include:

• Active range of motion (AROM) exercises – The goal of AROM exercises is to gently increase range of motion while decreasing pain, swelling, and stiffness in the  hip, knee, ankles and toes. The patient performs the exercise without any assistance.
• Swimming and pool therapy
• Core and upper body exercises
• Hamstring, quads, IT band, and hip flexor stretches
• Gait training – This type of therapy helps patients stand and walk following surgery.