Arthroscopic treatment of the ankle joint

Ankle joint arthroscopy – effective injury treatment

• What is the function of the ankle joint?

The ankle joint, commonly called the ankle bone, actually consists of two joints: the upper ankle joint and the lower ankle joint. The upper ankle joint allows dorsiflexion and plantarflexion of the foot, while the lower ankle joint allows adduction and abduction of the foot.

Thus, the ankle joint enables bending and rotational movements of the foot. Its function is essential for maintaining proper gait.

• What are the injuries of the ankle joints?

The ankle joint is highly susceptible to injuries, which most often occur due to slipping, tripping on uneven surfaces, or simply stepping awkwardly. Typical ankle joint injuries include:

• Sprain, which is exceeding the physiological range of motion in the ankle joint, leading to damage of soft tissues: the joint capsule and ligaments;
• Dislocation, which is an abnormal displacement of joint surfaces (usually the talus and tibia bones), often resulting in tearing of the joint capsule and ligaments, with the displaced elements usually not returning to their original position.

Active rehabilitation is fundamental for recovery after injury.

However, in cases where there is no significant improvement after about six months or when the injury is severe and requires direct intervention within the joint, surgical treatment – ankle joint arthroscopy – is recommended.

What Does Ankle Arthroscopy Involve?

Ankle arthroscopy is a minimally invasive orthopedic surgical procedure that allows precise assessment and treatment of various problems inside the ankle joint with minimal damage to surrounding tissues.

The essence of this method is that a microcamera is inserted into the joint, and using special surgical instruments, even very complex operations can be performed without the need to open the joint. The course of the operation is observed on a television monitor, often with significant magnification. An experienced orthopedist can thus repair damaged parts of the joint, including cartilage, ligaments, and bone.

What Are the Indications for Ankle Arthroscopy?

Indications for ankle arthroscopy include, among others:

• ligament injuries causing joint instability where conservative treatment has not been effective,
• degenerative changes in the ankle joint manifested by pain and limited joint mobility,
• presence of detached bone or cartilage fragments within the joint causing pain and restricting joint movement,
• osteochondral necrosis presenting with progressive pain and swelling in the ankle joint,
• inflammatory changes related both to joint overload and infection,
• presence of osteophytes, i.e., bone spurs, and tissue adhesions that limit joint mobility,
• fractures of the fibula, tibia, and talus bones.

What does the arthroscopic ankle joint treatment procedure involve?

The ankle joint arthroscopy procedure is performed in an operating room under regional anesthesia (spinal anesthesia) with additional peripheral nerve blocks. The patient is positioned lying on the operating table. The surgeon makes small incisions at the front or back of the ankle through which an arthroscope (microcamera) and microsurgical instruments are introduced. The interior of the joint is filled with sterile fluid to allow better visualization during the procedure. After surgery, sutures are placed on the incisions through which the instruments and camera were inserted. A sterile dressing is applied over the sutures. The duration of the procedure depends on the individual patient’s condition and the extent of the procedures performed during the operation. Ankle joint arthroscopy is usually a relatively short procedure, lasting from several tens of minutes up to about 2 hours.