Ankle arthroscopy

You may receive general anesthesia before this surgery. This means you will be asleep and unable to feel pain. Or, you may have regional anesthesia. This means your leg and ankle area will be numbed so that you do not feel any pain. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

During the procedure, the surgeon does the following:

• Inserts the arthroscope into your ankle through a small incision. The scope is connected to a video monitor in the operating room. This allows the surgeon to view the inside of your ankle.
• Inspects all the tissues of your ankle. These tissues include cartilage, bones, tendons, and ligaments.
• Repairs any damaged tissues. To do this, your surgeon makes 1 to 3 more small incisions and inserts other instruments through them. A tear in a muscle, tendon, or cartilage is fixed. Any damaged tissue is removed.

At the end of the surgery, the incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and what repairs they made.

Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues.

Arthroscopy may be recommended for these ankle problems:

• Ankle pain -- Arthroscopy allows the surgeon to explore what is causing your ankle pain.
• Ligament tears -- A ligament is a band of tissue that connects bone to bone. Several ligaments in the ankle help keep it stable and allow it to move. Torn ligaments can be repaired or cleaned up with this type of surgery.
• Ankle impingement -- Tissues in your ankle can become swollen and sore from overuse. This makes it hard to move the joint. Arthroscopy can remove the tissue so you can move your joint.
• Scar tissue -- This can form after an injury to the ankle. This surgery can remove scar tissue.
• Arthritis -- Arthroscopy can be used to help reduce pain and improve movement.
• Cartilage injuries -- This surgery can be used to diagnose or repair cartilage and bone injuries.
• Loose fragments -- These are pieces of bone or cartilage inside the ankle that can cause the joint to lock up. During arthroscopy these fragments can be removed.

Risks of anesthesia and surgery in general are:

• Allergic reactions to medicines
• Breathing problems
• Bleeding, blood clot, or infection

Risks of ankle arthroscopy are:

• Failure of surgery to relieve symptoms
• Failure of repair to heal
• Weakness of the ankle
• Injury to tendons, blood vessels, or nerves

Tell your surgeon what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• You may be asked to temporarily stop taking blood thinners. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other medicines.
• Ask your surgeon which medicines you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your health care provider who treats you for these conditions.
• Tell your provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, try to stop. Ask your provider or nurse for help. Smoking can slow wound and bone healing.
• Tell your surgeon if you develop a cold, flu, fever, herpes breakout, or other illness before your surgery. If you do get sick, the procedure may need to be postponed.

On the day of surgery:

• Follow instructions about when to stop eating and drinking before the procedure.
• Take any medicines you're asked to take with a small sip of water.
• Follow instructions on when to arrive at the hospital. Arrive on time.

You can usually go home the same day after you recover from the anesthesia. You should have someone drive you home.

Follow any discharge instructions you're given. These may include:

• Keep your ankle elevated above your heart for 2 to 3 days to help reduce swelling and pain. You can also apply a cold pack to reduce swelling.
• Keep your bandage clean and dry. Follow instructions for how to change the dressing.
• You can take pain relievers, if needed, as long as your provider says it is safe to do so.
• You will need to use a walker or crutches and keep weight off your foot unless your provider says it is OK to put weight on your foot.
• You may need to wear a splint or boot for a few weeks or longer to keep the ankle stable as it heals.

Arthroscopy uses small cuts in the skin. Compared to open surgery, you may have:

• Less pain and stiffness
• Fewer complications
• Faster recovery

The small cuts will heal quickly, and you may be able to resume your normal activities in a few days. But, if a lot of tissue in your ankle had to be repaired, it may take several weeks to heal. How quickly you heal depends on how complicated the surgery was.

You may be shown how to do gentle exercises as you heal. Or, your surgeon may recommend that you see a physical therapist to help you regain the full use of your ankle.

Ankle surgery; Arthroscopy - ankle; Surgery - ankle - arthroscopy; Surgery - ankle - arthroscopic

Murphy GA. Arthroscopy of the foot and ankle. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 50.

Smyth NA, Kaplan JR, Aiyer AA, Campbell JT, Triche R, Cerrato R. Ankle arthroscopy. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 115.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.