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Left ankle arthroscopy. Ankle Arthroscopy: Advanced Treatment Options and Techniques by Top Baltimore Foot Doctors

What are the benefits of ankle arthroscopy. How is ankle arthroscopy performed. What conditions can be treated with ankle arthroscopy. What is the recovery process after ankle arthroscopy. How effective is ankle arthroscopy for treating ankle disorders. What are the potential risks and complications of ankle arthroscopy. Who are the best candidates for ankle arthroscopy.

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Understanding Ankle Arthroscopy: A Minimally Invasive Approach to Ankle Treatment

Ankle arthroscopy is a minimally invasive surgical procedure that allows foot and ankle specialists to diagnose and treat various ankle disorders with precision and efficiency. This advanced technique involves inserting a small camera, called an arthroscope, into the ankle joint through tiny incisions. The arthroscope provides a clear, magnified view of the joint’s interior, enabling surgeons to perform intricate procedures with minimal tissue damage.

But how exactly does ankle arthroscopy work? The procedure typically involves the following steps:

  1. Small incisions are made around the ankle joint
  2. The arthroscope is inserted through one of the incisions
  3. Surgical instruments are inserted through additional incisions
  4. The surgeon views the joint on a monitor and performs necessary treatments
  5. Incisions are closed with stitches or surgical tape

This minimally invasive approach offers several advantages over traditional open surgery, including reduced pain, faster recovery times, and lower risk of complications. As a result, ankle arthroscopy has become an increasingly popular option for treating a wide range of ankle conditions.

Common Ankle Disorders Treated with Arthroscopic Techniques

Ankle arthroscopy is a versatile procedure that can be used to diagnose and treat numerous ankle disorders. Some of the most common conditions addressed through this technique include:

  • Anterior ankle impingement syndrome
  • Osteochondral lesions of the talus
  • Ankle fractures
  • Chronic ankle instability
  • Synovitis
  • Loose bodies in the joint
  • Ankle arthritis

One of the key advantages of ankle arthroscopy is its ability to both diagnose and treat these conditions in a single procedure. For example, in cases of anterior ankle impingement syndrome, the surgeon can visualize the impinging tissue and remove it during the same arthroscopic session.

Spotlight on Osteochondral Lesions of the Talus

Osteochondral lesions of the talus (OLTs) are a particularly common indication for ankle arthroscopy. These lesions involve damage to both the cartilage and underlying bone of the talus, often resulting from trauma or repetitive stress. Arthroscopy allows surgeons to assess the extent of the damage and perform various treatments, such as debridement, microfracture, or cartilage transplantation.

A study by van Bergen et al. (2013) found that arthroscopic treatment of OLTs yielded positive outcomes even at long-term follow-up, with 78% of patients reporting good to excellent results 8 to 20 years after surgery. This demonstrates the lasting effectiveness of arthroscopic techniques in managing these challenging lesions.

Advanced Arthroscopic Techniques: Pushing the Boundaries of Ankle Surgery

As technology and surgical expertise continue to evolve, so too do the capabilities of ankle arthroscopy. Recent advancements have expanded the range of procedures that can be performed arthroscopically, including:

Arthroscopic Ankle Fusion

Traditionally, ankle fusion (arthrodesis) was performed through open surgery. However, arthroscopic techniques have emerged as a viable alternative in select cases. A study by Quayle et al. (2018) compared arthroscopic and open ankle arthrodesis, finding that the arthroscopic approach resulted in shorter hospital stays and quicker return to work, with comparable fusion rates.

All-Inside Arthroscopic Lateral Ankle Ligament Repair

Recent innovations have made it possible to perform lateral ankle ligament repair entirely arthroscopically. This technique offers the potential for reduced surgical trauma and faster recovery compared to traditional open repair methods.

Arthroscopic-Assisted Fracture Fixation

In cases of ankle fractures, arthroscopy can be used in conjunction with traditional fixation techniques to ensure optimal reduction and address any intra-articular pathology. Bonasia et al. (2011) highlighted the role of arthroscopy in managing ankle fractures, noting its utility in detecting and treating associated lesions that might be missed with standard radiographic evaluation.

The Importance of Proper Portal Placement in Ankle Arthroscopy

Successful ankle arthroscopy relies heavily on proper portal placement. Portals are the small incisions through which the arthroscope and instruments are inserted. Accurate portal placement is crucial for optimal visualization and access to the joint, while minimizing the risk of neurovascular injury.

What are the key considerations for portal placement in ankle arthroscopy? Here are some important factors:

  • Anatomical landmarks: Surgeons use specific bony and soft tissue landmarks to guide portal placement
  • Neurovascular structures: Care must be taken to avoid damaging nearby nerves and blood vessels
  • Joint distraction: The degree of ankle distraction can affect portal placement and accessibility
  • Specific pathology: The location of the target lesion may influence portal selection

A study by de Leeuw et al. (2010) examined the course of the superficial peroneal nerve in relation to ankle position, providing valuable insights for safe anterolateral portal placement. Similarly, Mercer et al. (2020) investigated the course of the distal saphenous nerve, offering guidance for medial portal placement.

To further enhance accuracy and safety, some surgeons employ cannulated instruments for portal localization, as described by Needleman (2016). This technique can help ensure precise portal placement, particularly in challenging cases or for less experienced surgeons.

Optimizing Visualization: The Role of Arthroscope Selection and Positioning

Achieving optimal visualization is crucial for the success of ankle arthroscopy. The choice of arthroscope and its positioning within the joint can significantly impact the surgeon’s ability to diagnose and treat various ankle conditions effectively.

Arthroscope Selection: 30° vs. 70°

Ankle arthroscopy typically employs either a 30° or 70° arthroscope. But which one is better? A cadaveric study by Tonogai et al. (2018) compared ankle joint visualization between 30° and 70° arthroscopes. The researchers found that the 70° arthroscope provided superior visualization of certain areas, particularly the posterior ankle compartment. However, the 30° arthroscope remains the most commonly used due to its versatility and ease of use.

The Impact of Ankle Position and Distraction

The position of the ankle and the use of joint distraction can significantly affect arthroscopic visualization. Phisitkul et al. (2017) investigated the effect of ankle positions and distraction on arthroscopic access to osteochondral lesions of the talus. They found that different combinations of ankle flexion/extension and distraction were optimal for accessing various regions of the talar dome.

These findings highlight the importance of adjusting ankle position and distraction throughout the procedure to ensure comprehensive evaluation and treatment of the entire joint.

Innovative Treatments for Osteochondral Lesions: Beyond Basic Arthroscopy

While ankle arthroscopy is an excellent tool for diagnosing and treating osteochondral lesions, some cases may require more advanced interventions. Several innovative techniques have emerged to address challenging OLTs:

Autologous Chondrocyte Implantation (ACI)

ACI involves harvesting cartilage cells from the patient, expanding them in a laboratory, and then implanting them into the defect site. This technique has shown promising results for larger lesions that may not respond well to microfracture alone.

Osteochondral Autograft/Allograft Transfer

For deeper lesions involving significant bone loss, osteochondral grafting may be necessary. Ahmad and Jones (2016) compared autografts and allografts for treating recurrent or large talar osteochondral lesions, finding that both techniques yielded good outcomes, with autografts showing a slight advantage in terms of graft incorporation.

Biodegradable Implants

Larsen et al. (2005) investigated the use of bioabsorbable screws for fixation of osteochondritis dissecans lesions. These implants offer the advantage of providing stable fixation while eventually being resorbed by the body, eliminating the need for hardware removal.

The Future of Ankle Arthroscopy: Emerging Technologies and Techniques

As technology continues to advance, the field of ankle arthroscopy is poised for further innovation. Some exciting developments on the horizon include:

3D Printing and Patient-Specific Instrumentation

The use of 3D-printed models and custom surgical guides based on patient-specific imaging data may enhance the precision of arthroscopic procedures, particularly in complex cases.

Augmented Reality (AR) in Surgical Planning and Navigation

AR technology has the potential to revolutionize surgical planning and intraoperative guidance by overlaying critical anatomical information onto the surgeon’s field of view.

Advanced Imaging Integration

Improved integration of high-resolution MRI and CT data with arthroscopic visualization may enhance the surgeon’s ability to navigate complex anatomy and identify subtle pathology. Potter et al. (2008) highlighted the role of advanced MRI techniques in evaluating cartilage repair, which could be further enhanced through direct integration with arthroscopic systems.

Biological Augmentation

The incorporation of biologics, such as platelet-rich plasma (PRP) or stem cell therapies, into arthroscopic procedures may enhance tissue healing and regeneration. Giannini et al. (2009) reported promising results using bone marrow-derived cells for the treatment of osteochondral lesions of the talus, suggesting a potential role for these therapies in conjunction with arthroscopic techniques.

As these technologies continue to evolve, ankle arthroscopy is likely to become even more precise, effective, and minimally invasive, further improving outcomes for patients with a wide range of ankle disorders.

Role of Arthroscopy in Various Ankle Disorders

1. Tol JL, van Dijk CN. Etiology of the anterior ankle impingement syndrome: a descriptive anatomical study. Foot and Ankle International. 2004;25(6):382–386. [PubMed] [Google Scholar]

2. Zengerink M, van Dijk CN. Complications in ankle arthroscopy. Knee Surgery, Sports Traumatology, Arthroscopy. 2012;20(8):1420–1431. [PMC free article] [PubMed] [Google Scholar]

3. Dalmau-Pastor M, Malagelada F, Kerkhoffs GM, Karlsson J, Guelfi M, Vega J. Redefining anterior ankle arthroscopic anatomy: medial and lateral ankle collateral ligaments are visible through dorsiflexion and non-distraction anterior ankle arthroscopy. Knee Surgery, Sports Traumatology, Arthroscopy. 2020;28(1):18–23. [PubMed] [Google Scholar]

4. Leontaritis N, Hinojosa L, Panchbhavi VK. Arthroscopically detected intra-articular lesions associated with acute ankle fractures. Journal of Bone and Joint Surgery. 2009;91(2):333–339. [PubMed] [Google Scholar]

5. van Bergen CJA, Kox LS, Maas M, Sierevelt IN, Kerkhoffs GMMJ, van Dijk CN. Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up. Journal of Bone and Joint Surgery. 2013;95(6):519–525. [PubMed] [Google Scholar]

6. Glazebrook MA, Ganapathy V, Bridge MA, Stone JW, Allard J-P. (2009). Evidence-based indications for ankle arthroscopy. Arthroscopy, 25(12), 1478–1490. https://www.arthroscopyjournal.org/article/S0749-8063(09)00418-6/abstract [PubMed]

7. Bonasia DE, Rossi R, Saltzman CL, Amendola A. The role of arthroscopy in the management of fractures about the ankle. Journal of American Academy of Orthopaedic Surgeons. 2011;19(4):226–235. [PubMed] [Google Scholar]

8. Quayle J, Shafafy R, Khan MA, Ghosh K, Sakellariou A, Gougoulias N. Arthroscopic versus open ankle arthrodesis. Foot and Ankle Surgery. 2018;24(2):137–142. [PubMed] [Google Scholar]

9. Tonogai I, Hayashi F, Tsuruo Y, Sairyo K. Comparison of ankle joint visualization between the 70° and 30° arthroscopes: a cadaveric study. Foot and Ankle Specialist. 2018;11(1):72–76. [PubMed] [Google Scholar]

10. de Leeuw PAJ, Golanó P, Sierevelt IN, van Dijk CN. The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications. Knee Surgery, Sports Traumatology, Arthroscopy. 2010;18(5):612–617. [PMC free article] [PubMed] [Google Scholar]

11. Mercer D, Morrell NT, Fitzpatrick J, Silva S, Child Z, Miller R, et al. (2020). the course of the distal saphenous nerve: a cadaveric investigation and clinical implications. Iowa Orthopedic Journal, 31, 231–235. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215141/ [PMC free article] [PubMed]

12. Prakash R, Bhardwaj AK, Singh DK, Rajini T, Jayanthi V, Singh G. Anatomic variations of superficial peroneal nerve: clinical implications of a cadaver study. Italian Journal of Anatomy and Embryology. 2010;115(3):223–228. [PubMed] [Google Scholar]

13. Needleman RL. Use of cannulated instruments to localize the portals in anterior ankle arthroscopy: a technique tip. Journal of Foot and Ankle Surgery. 2016;55(3):659–663. [PubMed] [Google Scholar]

14. Ferkel, R.D. (1996). Diagnostic arthroscopic anatomy. In: T. L. Whipple (Ed.) Arthroscopic surgery. The foot and ankle. Philadelphia: Lippincot

15. Vega J, Malagelada F, Karlsson J, Kerkhoffs GM, Guelfi M, Dalmau-Pastor M. A step-by-step arthroscopic examination of the anterior ankle compartment. Knee Surgery, Sports Traumatology, Arthroscopy. 2020;28(1):24–33. [PubMed] [Google Scholar]

16. Phisitkul P, Akoh CC, Rungprai C, Barg A, Amendola A, Dibbern K, et al. Optimizing arthroscopy for osteochondral lesions of the talus: the effect of ankle positions and distraction during anterior and posterior arthroscopy in a cadaveric model. Arthroscopy. 2017;33(12):2238–2245. [PubMed] [Google Scholar]

17. Potter HG, Chong LR, Sneag DB. Magnetic resonance imaging of cartilage repair. Sports Medicine and Arthroscopy Review. 2008;16(4):236–245. [PubMed] [Google Scholar]

18. Elias I, Raikin SM, Schweitzer ME, Besser MP, Morrison WB, Zoga AC. Osteochondral lesions of the distal tibial plafond: localization and morphologic characteristics with an anatomical grid. Foot and Ankle International. 2009;30(6):524–529. [PubMed] [Google Scholar]

19. Larsen MW, Pietrzak WS, DeLee JC. Fixation of osteochondritisdissecans lesions using poly(l-lactic acid)/poly(glycolic acid) copolymer bioabsorbable screws. American Journal of Sports Medicine. 2005;33(1):68–76. [PubMed] [Google Scholar]

20. Ahmad J, Jones K. Comparison of osteochondralautografts and allografts for treatment of recurrent or large talarosteochondral lesions. Foot and Ankle International. 2016;37(1):40–50. [PubMed] [Google Scholar]

21. Giannini S, Buda R, Ruffilli A, Cavallo M, Pagliazzi G, Bulzamini MC, et al. Arthroscopic autologous chondrocyte implantation in the ankle joint. Knee Surgery, Sports Traumatology, Arthroscopy. 2014;22(6):1311–1319. [PubMed] [Google Scholar]

22. Giza E, Delman C, Coetzee JC, Schon LC. Arthroscopic treatment of talus osteochondral lesions with particulated juvenile allograft cartilage. Foot and Ankle International. 2014;35(10):1087–1094. [PubMed] [Google Scholar]

23. Wylie JD, Hartley MK, Kapron AL, Aoki SK, Maak TG. What is the effect of matrices on cartilage repair? A systematic review. Clinical Orthopaedics and Related Research. 2015;473(5):1673–1682. [PMC free article] [PubMed] [Google Scholar]

24. Zengerink M, Szerb I, Hangody L, Dopirak RM, Ferkel RD, van Dijk CN. Current concepts: treatment of osteochondral ankle defects. Foot and Ankle Clinics. 2006;11(2):331–359. [PubMed] [Google Scholar]

25. Savage-Elliott I, Ross KA, Smyth NA, Murawski CD, Kennedy JG. Osteochondral lesions of the talus: a current concepts review and evidence-based treatment paradigm. Foot and Ankle Specialist. 2014;7(5):414–422. [PubMed] [Google Scholar]

26. van Bergen CJA, van Eekeren ICM, Reilingh ML, Sierevelt IN, van Dijk CN. Treatment of osteochondral defects of the talus with a metal resurfacing inlay implant after failed previous surgery: a prospective study. Bone Joint Journal. 2013;95(12):1650–2165. [PubMed] [Google Scholar]

27. Mardani-Kivi M, Mirbolook A, Khajeh-Jahromi S, Hassanzadeh R, Hashemi-Motlagh K, Saheb-Ekhtiari K. Arthroscopic treatment of patients with anterolateral impingement of the ankle with and without chondral lesions. Journal of Foot and Ankle Surgery. 2013;52(2):188–191. [PubMed] [Google Scholar]

28. Vega J, Dalmau-Pastor M, Malagelada F, Fargues-Polo B, Peña F. Ankle arthroscopy: an update. The Journal of Bone and Joint Surgery. 2017;99:1395–1407. [PubMed] [Google Scholar]

29. Urgüden M, Söyüncü Y, Ozdemir H, Sekban H, Akyildiz FF, Aydin AT. Arthroscopic treatment of anterolateral soft tissue impingement of the ankle: evaluation of factors affecting outcome. Arthroscopy. 2005;21(3):317–322. [PubMed] [Google Scholar]

30. Parma A, Buda R, Vannini F, Ruffilli A, Cavallo M, Ferruzzi A, et al. Arthroscopic treatment of ankle anterior bony impingement: the long-term clinical outcome. Foot and Ankle International. 2014;35(2):148–155. [PubMed] [Google Scholar]

31. Zwiers R, Wiegerinck JI, Murawski CD, Fraser EJ, Kennedy JG, van Dijk CN. Arthroscopic treatment for anterior ankle impingement: a systematic review of the current literature. Arthroscopy. 2015;31(8):1585–1596. [PubMed] [Google Scholar]

32. Walsh SJ, Twaddle BC, Rosenfeldt MP, Boyle MJ. Arthroscopic treatment of anterior ankle impingement: a prospective study of 46 patients with 5-year follow-up. American Journal of Sports Medicine. 2014;42(11):2722–2726. [PubMed] [Google Scholar]

33. Feng S-M, Wang A-G, Sun Q-Q, Zhang Z-Y. Functional Results of All-Inside Arthroscopic Broström-Gould Surgery With 2 Anchors Versus Single Anchor. Foot and Ankle International. 2020 doi: 10.1177/1071100720908858. [PubMed] [CrossRef] [Google Scholar]

34. Lan S, Zeng W, Yuan G, Xu F, Cai X, Tang M, et al. All-inside arthroscopic anterior talofibular ligament anatomic reconstruction with a gracilis tendon autograft for chronic ankle instability in high-demand patients. Journal of Foot and Ankle Surgery. 2020;59(2):222–230. [PubMed] [Google Scholar]

35. Vega J, Golanó P, Pellegrino A, Rabat E, Peña F. All-inside arthroscopic lateral collateral ligament repair for ankle instability with a knotless suture anchor technique. Foot and Ankle International. 2013;34(12):1701–1709. [PubMed] [Google Scholar]

36. Higashiyama R, Sekiguchi H, Takata K, Endo T, Takamori Y, Takaso M. Arthroscopic reconstruction of the anterior tibiotalar ligament using a free tendon graft. Arthroscopy Techniques. 2020;9(4):e541–e547. [PMC free article] [PubMed] [Google Scholar]

37. Dent C, Patil M, Fairclough J. Arthroscopic ankle arthrodesis. The Journal of Bone and Joint Surgery. 1993;75(B5):830–832. doi: 10.1302/0301-620X.75B5.8376451. [PubMed] [CrossRef] [Google Scholar]

38. Ferkel RD, Hewitt M. Long-term results of arthroscopic ankle arthrodesis. Foot and Ankle International. 2005;26(4):275–280. [PubMed] [Google Scholar]

39. Crosby LA, Yee TC, Formanek TS, Fitzgibbons TC. Complications following arthroscopic ankle arthrodesis. Foot and Ankle International. 1996;17(6):340–342. [PubMed] [Google Scholar]

40. Vivek Panikkar K, Taylor A, Kamath S, Henry APJ. (2003).A comparison of open and arthroscopic ankle fusion. Foot and Ankle Surgery 9(3), 169–72. http://www.sciencedirect.com/science/article/pii/S1268773103000730

41. Myerson MS, Quill G. Ankle arthrodesis. A comparison of an arthroscopic and an open method of treatment. ClinOrthopaedRelat Res. 1991;268:84–95. [PubMed] [Google Scholar]

42. Vega J, Golan׳o P, Peña F. Iatrogenic articular cartilage injuries during ankle arthroscopy. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24(4):1304–1310. [PubMed] [Google Scholar]

43. Young BH, Flanigan RM, DiGiovanni BF. Complications of ankle arthroscopy utilizing a contemporary noninvasive distraction technique. Journal of Bone and Joint Surgery. 2011;93(10):963–968. [PubMed] [Google Scholar]

44. van Dijk CN, Scholten PE, Krips R. A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy. 2000;16(8):871–876. [PubMed] [Google Scholar]

45. Hayashi D, Roemer FW, D’Hooghe P, Guermazi A. Posterior ankle impingement in athletes: pathogenesis, imaging features and differential diagnoses. European Journal of Radiology. 2015;84(11):2231–2241. [PubMed] [Google Scholar]

46. Yasui, Y., Hannon, C.P., Hurley, E., Kennedy, J.G. (2016). Posterior ankle impingement syndrome: a systematic four-stage approach. World Journal of Orthopedics7(10), 657–663. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065672/ [PMC free article] [PubMed]

47. Ribbans WJ, Ribbans HA, Cruickshank JA, Wood EV. The management of posterior ankle impingement syndrome in sport: a review. Foot and Ankle Surgery. 2015;21(1):1–10. [PubMed] [Google Scholar]

48. Labib SA, Pendleton AM. Endoscopic calcaneoplasty: an improved technique. Journal of Surgical Orthopaedic Advances. 2012;21(3):176–180. [PubMed] [Google Scholar]

49. Vega J, Baduell A, Malagelada F, Allmendinger J, Dalmau-Pastor M. Endoscopic achilles tendon augmentation with suture anchors after calcaneal exostectomy in Haglund syndrome. Foot and Ankle International. 2018;39(5):551–559. [PubMed] [Google Scholar]

50. Hirtler L, Schellander K, Schuh R. Accessibility to talar dome in neutral position, dorsiflexion, or noninvasive distraction in posterior ankle arthroscopy. Foot and Ankle International. 2019;40(8):978–986. [PMC free article] [PubMed] [Google Scholar]

51. Kim HN, Kim GL, Park JY, Woo KJ, Park YW. Fixation of a posteromedial osteochondral lesion of the talus using a three-portal posterior arthroscopic technique. Journal of Foot and Ankle Surgery. 2013;52(3):402–405. [PubMed] [Google Scholar]

52. Nickisch F, Barg A, Saltzman CL, Beals TC, Bonasia DE, Phisitkul P, et al. Postoperative complications of posterior ankle and hindfoot arthroscopy. Journal of Bone and Joint Surgery. 2012;94(5):439–446. [PubMed] [Google Scholar]

53. Zwiers R, Wiegerinck JI, Murawski CD, Smyth NA, Kennedy JG, van Dijk CN. Surgical treatment for posterior ankle impingement. Arthroscopy. 2013;29(7):1263–1270. [PubMed] [Google Scholar]

Professional Ankle Arthroscopy Services | Sforzo Dillingham

What is ankle arthroscopy? Ankle arthroscopy surgery is a minimally invasive type of surgery performed to help alleviate ankle pain.  Small incisions are made about the ankle and a camera is used to look inside the ankle.

Injuries like the osteochondral injury of your talus, ankle fractures, forms of tendonitis, ankle impingement, and ankle sprains are some of the causes of ankle or foot conditions that may require arthroscopy procedure. In some cases, ankle arthroscopy can become an alternative treatment method to open ankle surgery.

Arthroscopy plays a critical role in diagnosing and treating different ankle joint disorders. 

Some of these problems may include:

Ankle arthritis: This is condition refers to end-stage ankle arthritis. The procedure applied in treating ankle arthritis is called ankle fusion, and it involves ankle arthroscopy. This treatment option provides a minimally invasive way of performing ankle fusion. 

Ankle fractures: Your surgeon may suggest ankle arthroscopy along with the open surgical procedure to repair an ankle fracture. This treatment procedure ensures normal alignment of cartilage and bone within your ankle. It also helps locate injured cartilage inside the ankle when performing ankle cartilage repair

Ankle instability: Whenever your ligaments stretch out (within the ankle), they can make you feel like the ankle is giving way. Your orthopedic surgeon can use the ankle arthroscopy technique to repair damaged ligaments or tighten them through surgery. The arthroscopic technique is the ultimate solution to treating moderate instability in your foot. 

Reasons for Ankle Arthroscopy

You need to know that not every ankle pain problem is treatable by an arthroscopic procedure. However, there are numerous reasons why you should opt for ankle cartilage repair, ankle debridement, or knee scraping surgery

Some of these reasons include:

  1. Restoration of Your Ankle Cartilage Damage

Sustaining injury on your ankle joint can cause cartilage damage. If you don’t get treated at the right time, your ankle cartilage may cause generalized arthritis around the ankle joint. With ankle arthroscopy, our surgeon Dr. Christopher L. Dillingham at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, will be able to assess the injured areas of your cartilage damage before restoring the normal cartilage surface to the ankle joint. In this case, your Ankle cartilage repair may involve stimulating new cartilage growth using a microfracture, chondrocyte implantation, or cartilage transfer. Alternatively, your surgeon will repair the damaged cartilage surgically. 

  1. Removal of Bone Spurs in Your Ankle Joint

Sometimes bone spurs may form in the front of your ankle joint. This formation of bone spurs causes your ankle to pinch whenever you push your foot towards the shin. Another name of this condition is anterior ankle impingement syndrome, footballer’s ankle, or athlete’s ankle. To remove these floating bone chips in the ankle, you need to go for ankle arthroscopy. In addition, the removal of bone spurs from your anterior ankle can help improve the motion of your ankle joint. 

  1. Surgical Removal of Inflamed Synovium

Synovitis describes the inflammation of soft tissue lining around your ankle joint or synovium. This type of inflammation can easily manifest as ankle swelling after knee surgery, pain, or complete loss of motion. Synovitis occurs due to acute trauma, rheumatoid arthritis (inflammatory arthritis), and degenerative joint disease or osteoarthritis. Ankle arthroscopy can help remove inflamed synovium. 

Ankle Arthroscopy Diagnosis

Before the treatment for your injured  ankle starts, the surgeon will perform some diagnostic tests such as:

  1. X-ray: Usually, the X-ray provides images of bones within the ankle. In the case of a broken bone joint, your orthopedic surgeon will be able to point out the exact place that needs arthroscopic surgery.
  2. MRI: Magnetic Resonance Imaging (MRI) is another test that your surgeon will perform to rule out other problems that may affect your ankle. This non-invasive imaging technology produces clear three-dimensional detailed images for effective diagnosis of the injured ankle.
  3. EMG: Electromyography is a diagnostic procedure that Dr. Christopher L. Dillingham at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine performs to assess the condition of the muscles and nerve cells around the ankle. Your surgeon will identify damaged muscles, nerve cells, and even ligaments within the ankle through EMG.


Ankle Arthroscopy Treatment –
Surgical

Surgical procedure using ankle arthroscopy with debridement is carried out under regional or general anesthesia. Once adequate anesthesia is administered, the surgeon creates an incision or “portal” that provides access to the damaged ankle joint. Mostly, portals are strategically placed in a specific location to help minimize the potential for damage to surrounding blood vessels, tendons, and nerves. These portals also reduce the size of ankle surgery scars after recovery. 

The Procedure of Ankle Arthroscopy

During the ankle arthroscopy procedure, your surgeon will follow these steps:

  1. Adequate regional or general anesthesia is established, followed by the application of a tourniquet.
  2. The leg is propped and draped carefully in a sterile fashion.
  3. Mechanical distraction devices are used to help the surgeon temporarily enlarge the space of the injured ankle.
  4. At least two small incisions are made. One incision is used to insert a small camera, while the other is for inserting surgical instruments.
  5. Sterile fluid can flow inside the ankle via the incisions to further open the joint.
  6. At the end of the procedure, the surgeon places small sutures in the skin to secure or close the portals.
  7. A sterile compressive dressing, a boot, or splint is applied before taking you to a recovery area.

This procedure applies to both right and left ankle arthroscopy.

Risks of Ankle Arthroscopy Surgery

Just like other ankle surgery types, ankle arthroscopy has its own risks. Ankle swelling after the surgery and visible ankle surgery scar are some of the common risks that come with this procedure. Other risks include injuries to the tendons or nerves surrounding the ankle joint, damage, and infections to the ankle joint cartilage. 

Post-Operative Care of Ankle Arthroscopy Surgery 

Post ankle arthroscopy surgery care includes:

  • Elevation of the affected leg
  • Taking oral pain killer medications for several days
  • Restriction of bearing weight on the injured leg
  • Progressive weight-bearing with crutches
  • Active range of motion as part of physical therapy
  • Progressive strengthening routine
  • Routine follow-up with your doctor


Find the Best Ankle Arthroscopy Center near me in Sarasota, Florida

At Sforzo I Dillingham I Stewart  Orthopedics + Sports Medicine in Sarasota, Florida, our doctors specialize in performing different types of surgical operations, including ankle arthroscopy. The doctors go the extra mile to help those suffering from ankle pain (due to injury or trauma) get the expert care and treatment you deserve. 

Our surgeon Dr. Christopher L. Dillingham at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, works hard with patients to determine the most appropriate treatment option for their condition. At Sforzo I Dillingham I Stewart Orthopedics you will get expert medical care and treatment in line with your ankle injury. All doctors are board-certified and fellowship-trained orthopedic surgeons with many years of experience in performing technically difficult surgical procedures. 

Final Thought

Arthroscopic ankle surgery is a treatment option for different types of ankle pain, including loose ankle, posterior ankle pain, and cartilage damage. During the surgery, a small incision is made by your surgeon to pave the way for the arthroscopy camera to be inserted inside the damaged ankle joint. These incisions also help your surgeon to insert surgical instruments to remove or repair damaged structures. 

Arthroscopy recovery time may vary depending on the nature of your ankle injury and damage to the cartilage. Typically, the ankle arthroscopy recovery time can range from three weeks to six weeks. For additional information on ankle arthroscopy surgery, contact Sforzo I Dillingham I Stewart  Orthopedics + Sports Medicine today.

 

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As healthcare is ever changing, Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, is doing things differently…

  • Christopher R. Sforzo, M.D.




    Christopher R. Sforzo, M.D. is a board certified orthopedic surgeon and fellowship trained in hand and upper extremity surgery. He provides expert care in the treatment of problems involving the shoulder, arm, elbow, forearm, wrist and hand.

    He performs many procedures using minimally invasive techniques includi

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  • Christopher L. Dillingham, M.D.




    Christopher L. Dillingham, M.D. is a board certified orthopedic surgeon and fellowship trained in hand, shoulder, and arm surgery. He specializes in the treatment of problems with rotator cuff disorders, carpal tunnel syndrome and nerve injury, joint replacement, arthritis surgery, fracture repair, foot and ankle

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  • Charles E. Stewart, M.D.


    Charles E. Stewart M.D. is a board-certified, Johns Hopkins fellowship-trained orthopedic surgeon specializing in adult complex reconstruction of the lower extremity.  His specialties include lower extremity sports injuries, meniscal injuries, ACL reconstruction, partial knee replacement, total hip and knee arthroplas

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  • Philip A. Meinhardt, M.D.


    Philip A. Meinhardt, M.D. is a board certified orthopedic surgeon and fellowship trained spine surgeon. He specializes in adult spinal surgeries including reconstruction of spinal deformities, minimally invasive/microscopic spinal procedures, decompression, spinal instrumentation, fusion procedures and microscopic cer

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Testimonial

After tearing my rotator cuff, not only was I experiencing pain but my quality of life was diminished. Playing golf and working out were painful rather than enjoyable. Graci and I sought out Fellowship trained Dr. Christopher Sforzo and the team at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine. I was treated non-surgically and am now pain free, mobile and enjoying everything I did before.

– Dennis and Graci McGillicuddy

As avid golfers and tennis enthusiasts, our rotator cuff injuries left us in pain, and unable to enjoy our sport. In researching for the most qualified surgeons, we found that Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine not only had the highest level of training and experience, but they were also highly recommended by friends and associates who had excellent results. We, too, had outstanding…

– Mike Wilton, Bud Polley and Arnie Vance

I was visiting the area looking at property and considering a full time re-location from Minnesota when I was in a traffic accident. The result was a very painful shoulder injury that would ultimately require bilateral RTC repairs. I was unable to undertake regular day-to-day activities or participate in my favorite sport – tennis. It was essential that I choose a shoulder specialist that could quickly set…

– Pat Cooper

Over the years we had seen several orthopedists in town but were never impressed. They seemed to lack knowledge or compassion or both. Then when Liza was in high school, she went to Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine for a minor sports injury. They not only diagnosed her somewhat obscure problem, but explained things in a way that she understood without being patronizing…

– Liza, John and Betsy Kane-Hartnett

As a very busy business owner in Sarasota, having not one, but two, massive rotator cuff tears had a debilitating effect on both my personal and professional life. From my first consultation with Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine, I knew I was in good hands. The surgeons are board-certified and fellowship-trained, which gave me the confidence in achieving a successful outcome. More importantly,…

– Bob Kirschner

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