Minimally Invasive Surgery

Ankle Arthroscopy

Ankle arthroscopy is a minimally invasive surgical procedure in which an arthroscope, a small, soft, flexible tube with a light and video camera at the end, is inserted into the ankle joint to evaluate and treat a variety of conditions.

The camera projects an image of the inside of the joint onto a large screen monitor allowing the surgeon to look for any damage, assess the type of injury, and repair the problem.

Indications

Ankle Arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, has proved to be highly effective in managing various ankle disorders including ankle arthritis, unstable ankle, ankle fracture, osteochondral defects of the talus, infection, and undiagnosed ankle pain.

The benefits of arthroscopy compared to the alternative, open ankle surgery, include:

• Smaller incisions
• Minimal soft tissue trauma
• Less pain
• Faster healing time
• Lower infection rate
• Less scarring
• Earlier mobilization
• Shorter hospital stay

Procedure

Your surgeon will make 2 or 3 small incisions around the ankle joint. Through one of the incisions an arthroscope is inserted. Along with it, a sterile solution is pumped into the joint to expand the joint area and create room for the surgeon to work.

The larger image on the television monitor allows the surgeon to visualize the joint directly to determine the extent of damage so that it can be surgically treated. Surgical instruments will be inserted through the other tiny incisions to assess and treat the problem.

After the surgery, the instruments are removed, and the incisions are closed and covered with a bandage.

Post Surgical Care

After the procedure, you will be taken to a recovery room. The ankle joint will be immobilized with a splint or cast. The nature and duration of immobilization will depend on the type of repair performed and the preference of the surgeon. The surgical site should be kept clean and dry during the healing process. Patients may be prescribed pain medication for the management of pain. Elevation of the ankle and ice application helps to reduce pain and swelling. Follow your post operative instructions for the best outcome.

Risks and Complications

Ankle arthroscopy is a safe procedure and the incidence of complications is low. However, as with any surgery, risks and complications can occur. Some associated risks with ankle surgery can include infection, damage to blood vessels or nerves, bleeding, and compartment syndrome.

Ankle arthroscopy is a less invasive surgical procedure than traditional open surgery for the management of various ankle disorders. Benefits of arthroscopy include faster healing, less pain, and fewer complications.

Subtalar Arthroscopy

Subtalar arthroscopy is a surgical procedure performed to treat pain caused by problems of the subtalar joint in the ankle. The surgery is minimally invasive, performed through small incisions, by using a viewing instrument called an arthroscope. An arthroscope is a thin long tube with a camera attached, which helps your surgeon clearly view the surgical site on a monitor.

The subtalar joint is a complex joint located below the ankle joint and is formed by the union of the heel (calcaneus) and the talus (ankle) bone. The subtalar joint allows side to side movement of the foot. This joint can be injured with a sprain or fracture of the talus or calcaneus bones, causing pain and instability.

Indications

Subtalar arthroscopy is indicated when non-surgical methods do not help the following conditions:

• Scar tissue present in the subtalar region
• Severe sprains
• Twisting injuries
• Fractures of the talus or calcaneus bones

It is also recommended for subtalar joint fusion.

Subtalar arthroscopy may be contraindicated in:

• Patients with severe subtalar joint problems, who may require larger incisions
• Poor leg circulation
• Active infection
• Diseases such as uncontrolled diabetes

Surgical Procedure

Subtalar arthroscopy is performed under general anesthesia or a nerve block. Saline solution is injected into the ankle to expand the area for better viewing. Your surgeon makes 2 to 3 small incisions on your ankle. The arthroscope and other surgical instruments are inserted through these incisions. Images from the arthroscope can be viewed on a monitor by your surgeon to perform the procedure.  Special tools such as biters, graspers and motorized shavers are used to repair the damage to the subtalar joint. Once the problem has been treated the surgical instruments are removed and the incisions are closed.

Post-Operative Care

After the surgery, your foot will be placed in either a plaster, splint or a removable boot to immobilize the joint, and reduce swelling and pain. You will be advised to use crutches so you do not bear weight on your foot. Physical therapy will be ordered to assist you with strengthening exercises and range of motion. Recovery may take 6 to 12 months.

Advantages

The advantages of subtalar arthroscopy over traditional open surgery include:

• Less post-operation pain, disability and swelling
• Shorter hospital stay
• Faster recovery
• Risks and complications.
• As with all surgical procedures, subtalar arthroscopy may be associated with certain complications such as:
• Risks related to anesthesia
• Infection
• Problems in wound healing
• Injury to neighboring nerves or blood vessels
• Bleeding
• Blood clots

Subtalar arthroscopy is a minimally invasive procedure performed through tiny incisions with an arthroscope to treat ankle injuries to the subtalar joint at the back of the foot, allowing you to get back to your regular activities.