Arthroscopy of the ankle joint

The ankle joint is one of the more complicated parts of the human skeletal and articular system. Therefore, it is exposed to many injuries. It is very often damaged during sports activities.

Arthroscopy of the ankle joint is a very popular and non-invasive procedure that makes it possible to inspect the joint without opening the body completely.
The arthroscopy procedure involves making small incisions in the skin (about 1 cm) and inserting a thin, rigid optical element ending in a video camera (which allows imaging of the inside of the joint) and arthroscopic tools. Thanks to the use of multiple magnification, as well as the use of saline solution, the surgeon can see the inside of the operated joint, much more accurately than in open surgery.

• diagnosis of the joint with simultaneous treatment of any damage found,
• excision of pathologically hypertrophied synovial membrane and fibrosis with the aim of improving mobility and reducing inflammation,
• excision of the abnormal or damaged os trigonum from the posterior compartment of the joint,
• removal of free intra-articular bodies,
• excision of osteophytes in degenerative disease,
• treatment of damaged articular cartilage,
• arthrodesis.

Indications for ankle arthroscopy
Ankle arthroscopy is performed in patients suffering from pain and dysfunction of the ankle joint, such as gait disturbances (limping), reduced range of motion, and a jumping sensation.
With the help of arthroscopy most of the tissue pathologies within the joint can be treated, including:
bone conflict or soft tissue conflict, anterior or posterior

• cartilage damage,
• cartilage-bone damage, otherwise known as cartilage-bone necrosis,
• some ligament ruptures,
• displaced ankle bone fracture,
• arthroscopic joint stiffening procedure
• fold conflict or injury scars,
• removal of the Stieda process or os trigonum.

Benefits of the arthroscopic method
Arthroscopy of the ankle joint is characterised primarily by low invasiveness, which significantly reduces postoperative complications. Among the significant benefits of arthroscopic treatment, the possibility of quick “activation” of the patient should be mentioned, as rehabilitation usually begins the next day after surgery. Early commencement of rehabilitation prevents the negative effects of the surgery (such as oedema, restriction of mobility, decrease in muscle strength) and contributes to a faster return to fitness and the possibility of returning to sports activities. A huge advantage is the quick duration of the procedure, which usually takes about an hour, and the fact that it is performed on an outpatient basis, which means that the patient does not have to be kept under observation.

Rehabilitation
After an ankle arthroscopy a drain is removed, the wound healing process is checked, the dressing is changed, and then the patient is discharged home. After ankle arthroscopy the patient is given painkillers and anticoagulants for a few days. After the surgery it is recommended to limit physical activity for at least a week. The patient can sit and stand up on the first day after the surgery. After the arthroscopy it is necessary to re-educate walking with the help of a physiotherapist. Learning to walk should initially be done with the use of two supportive elbow crutches, with which the patient walks for about a week after the operation. After the surgery, the doctor will tell you with what strength you can stand on the operated leg. Usually it is possible to put full weight on the leg already on the second day after the surgery. After arthroscopy there is usually no need to use a joint stabilizer, but you should take care of proper wound hygiene and minimize swelling by using cooling compresses and elevating the limb.