Arthroscopy for Ankles

A surgical procedure widely used on knees can also repair damaged ankles claim the researchers.

Arthroscopy may be the best known for repairing knee injuries, but it is also a valuable method for treating ankles.

As it is a minimally invasive surgical technique it is being applied in new ways by orthopedic surgeons to relieve different ankle problems, including ligament damage, bone chips and recurrent pain from end-stage arthritis.

An arthroscope is a tubular instrument with a lighted tip that is inserted through a small incision. The arthroscope projects an enlarged image on a monitor screen, allowing the surgeon to see inside the joint to diagnose and treat problems.

Arthroscopy has been used for about 25 years and was first used for knees, says Dr. John J Stienstra, an orthopedic surgeon at the Permanente Medical Group in Union City, California. Over the years, arthroscopy instruments have become smaller and techniques improved.

Arthroscopy has a number of benefits compared with conventional surgery in treating damaged ankles, including eliminating the need for large incisions. "To do anything in a joint requires that you are able to get in there, see what you're doing and manipulate tissue. The clear advantage of arthroscopy is that you do much less tissue damage in order to accomplish the work, it can be done through a few small punctures in the skin, compared to having to make a 6-to-7 centimeter incision and possibly having to break a bone to get into a joint, Stienstra says.

Patients with ankle damage caused by arthritis or injury can be treated with arthroscopy and resume normal activities in a week or less. That compares to a minimum of six to eight weeks of recovery after open ankle surgery. One of the benefits of arthroscopy is fusion surgery, used as a last resort to relieve persistent and debilitating pain in the ankle for patients with end-stage arthritis. Stienstra says arthroscopy improves the success of ankle fusion surgery compared to traditional surgery.

New technologies such as electrothermal and laser probes have expanded the ability of arthroscopy to remove bone chips and repair tissue damage in the ankle. Sparing patients from surgical injury and lengthy recovery and rehabilitation time not only saves patients from pain and inconvenience, it also saves them money, Stienstra says.