May 19, 2020
Ankle Arthroscopy – Treating Ankle Injuries with Keyhole Surgery
People have reservations about surgery, but keyhole operations have a minimal impact. Simon Moyes discusses treating ankle injuries with keyhole surgery.
Arthroscopic ankle surgery uses small surgical instruments and a tiny camera inserted through small incisions in your skin. The whole operation is carried out by looking at the inside of your ankle on a monitor. Using such fine instruments means that a surgeon can be ultra-precise, causing very little damage to other tissues in your ankle. The result: quicker recovery time.
Are you ready to go ‘under the knife’?
Most people have some reservations about surgery, but keyhole operations have such a minimal impact that it really doesn’t need to be something to worry about.
Arthroscopic ankle surgery uses small surgical instruments and a tiny camera inserted through small incisions in your skin. The whole operation is carried out by looking at the inside of your ankle joint on a monitor. Using such fine instruments means that a surgeon can be ultra-precise, causing very little damage to other tissues in your ankle. The result: quicker recovery time. In almost all cases, you can go home on the same day as surgery.
Who has ankle surgery?
By the time you have been referred to a specialist for surgery, the chances are you’ve already been working through non-surgical options such as rest and physiotherapy exercises. You will probably have had various ways of managing pain and swelling – from ice and anti-inflammatories to steroid injections.
You may have consulted with a specialist and had MRI or ultrasound scans to work out the cause of your problems before you started on a programme of non-surgical treatment.
But there are many circumstances where surgery is the best or the only option. Typically, this would be for conditions which will get worse over time – such as arthritis – and for conditions which cause ongoing pain, immobility or instability.
What can arthroscopic surgery treat?
There are many conditions of your ankle that can be easily and effectively treated by keyhole surgery. Some of the most common problems that I have treated over the years include:
- Footballer’s ankle – a bony lump, or bone spur, can form between the ankle bone (talus) and the shin bone (tibia) in the front of the ankle – usually through repeated actions such as kicking a football. This causes pain, swelling and restricted movement. Arthroscopic surgery is an efficient way to remove the bone spur and help with speed of recovery.
- Sprain or injury – the tough, fibrous ligaments that stabilise your ankle can get stretched or torn when you twist your ankle. Arthroscopic surgery is used to tighten or reattach damaged ligaments. Ankle injuries can also cause other soft tissue damage, most of which can be repaired through minimally invasive techniques.
- Arthritic joint debridement – arthritis is a degenerative bone disease, and it can cause the bone surface, along with its cartilage coating, to wear away. It can also lead to your bone developing growths (bone spurs), or broken pieces of bone (loose bodies) in your ankle. This prevents smooth movement of your ankle joint, and causes pain and swelling. Keyhole surgery can be used to carefully shave or vacuum the damaged parts away without affecting other parts of your joint.
As I mentioned before, the greatest benefit of keyhole surgery is the speed of recovery. The accuracy of surgery, and the ability to thread the instruments into the joint without opening it up, means that virtually no healthy tissue gets displaced or damaged. There is also less chance of infection, nerve damage or build-up of scar tissue.
In most cases, you will be able to bear weight immediately afterwards. A large number of our ankle arthroscopy patients are treated as day cases.
The sooner you are (literally) back on your feet, the less chance there is for you to develop blood clots or deep vein thrombosis – both possible risk factors if you are unable to move about after a lower leg operation.
Recovery times vary, depending on your condition. But suffice to say, I have treated enough professional sportspeople to know that keyhole surgery – combined with expert guidance in rehabilitation physiotherapy – is the quickest way to get back to work… And when your work depends on your ability to be at the peak of physical fitness as quickly as possible, that means a lot.
Simon Moyes is an internationally renowned orthopaedic surgeon and leader in the field of arthroscopic (keyhole) surgery. His Capital Orthopaedics team works from The Cromwell Hospital in London, with its state-of-the-art diagnostic and surgical equipment, and top sports medicine professionals.