Ankle sprains remain the most common musculoskeletal injury. Their complications, including ligament and cartilage injuries, are among the most common reasons for seeing an orthopaedic specialist. As with the knee, arthroscopy is becoming a principal treatment method for ankle conditions. The minimal invasiveness of endoscopic surgery shortens postoperative rehabilitation and speeds recovery. Ankle arthroscopy uses instruments 3–4 mm in diameter, similar to those used for knee endoscopy. Specially designed instruments allow most ankle injuries and abnormalities to be treated.

Arthroscopy comes from “arthro”, meaning joint, and “skopein”, meaning to look. Literally, it means “to look inside a joint”.

The procedure uses a camera with precision optics to magnify the structures of the joint.

When is arthroscopy used?

Conditions:

  • treatment of ankle articular cartilage injuries, most often sustained during an ankle sprain
  • injury to the ankle stabilising ligaments after a severe ankle sprain
  • treatment of anterior and posterior impingement caused by overgrowth of bony or synovial joint structures
  • osteochondritis dissecans
  • endoscopic treatment of peroneal tendon injuries sustained during an ankle sprain

What does arthroscopy involve?

Although arthroscopy is much less invasive than open techniques, both require similar anaesthesia. This may be spinal anaesthesia, regional anaesthesia such as a sensory nerve block at ankle level, or, in special cases, general anaesthesia. A small skin incision approximately 1 cm long is made for the arthroscope camera. A second incision of the same length allows insertion of arthroscopic instruments, including specialised graspers, scissors and electric shavers for removing synovial membrane and cartilage tissue. Additional incisions may be needed for further instruments. The procedure depends on the preoperative diagnosis and the findings after inserting the camera. At the end, the entry sites are closed with individual sutures and a small dressing is applied. Aftercare depends on the diagnosis and treatment performed.

What complications are possible?

Arthroscopic treatment is a very safe medical procedure. Like any surgery, however, it carries a risk of postoperative complications. Those described in the literature include nerve injury and temporary nerve dysfunction, local infection, excessive scar growth, regional pain syndrome, cartilage damage and instrument breakage. These complications are very rare and are mainly reported as isolated clinical cases.

Why choose arthroscopy?

Arthroscopy is one of the newer orthopaedic techniques. Its major advantages are minimal invasiveness and rapid postoperative rehabilitation. The small wounds created during joint endoscopy heal much faster than the large wounds of open surgery. Arthroscopy often allows treatment as a day case. This field is developing rapidly, providing orthopaedic specialists with increasingly advanced treatment tools and expanding the range of applications.