The development of special arthroscopes for small joints has led to major advances over the last 10 years and thus to improved treatment options for arthroscopic surgery of the ankle joint. The ankle joint can be affected by a range of sports injuries and degenerative disorders. General indicators for surgical intervention are pain, swelling, restricted mobility, instability, infringements or bleeding in the joint.
The most common cause is secondary damage after strain injuries with pain under stress, after instability, or after blockages as the result of small fibrous, cartilaginous, or bony loose bodies (‘joint mice’ or articular calculus). Arthroscopy is also a good treatment option for inflammations of the synovial membrane (synovialis), deformities and scarring with subsequent reductions in mobility (arthrofibrosis) and reductions in mobility cause by the infringement of soft tissue parts.
Bony outgrowths (osteophytes) at the front of the ankle (talocrural) joint are a frequent cause of pain, swelling and reduced mobility, particularly in ball sports and dancing. In these cases, the arthroscopic ablation of the osteophytes is a promising and proven treatment.
Arthroscopic image of the talocrural joint (ankle joint)
(TI = tibia, T = talus)
Before your operation
Do not put your joint under unnecessary strain, because this will extend the recovery period after the operation. It may be an idea to practice walking with crutches.
Arrange treatment dates with your physiotherapist or masseur, beginning about 4-5 days after the operation. If the operation is to be carried out under general anaesthesia, you must not eat or drink for six hours beforehand (‘nil by mouth’). Remember to stop taking aspirin or similar medication (including ASS 100) at least 1 week prior to the operation.
After your operation
The following are general guidelines:
Do no place your full weight on the ankle in the first days and keep your foot elevated. Cool the joint several times a day with a dry ice-pack (for about 15 minutes). Until the wound is healed (5-10 days), use crutches so as not to place any load or only a partial load on the foot. Regular mobilization of the ankle joint. Stitches are generally removed after about 12-14 days. Under the supervision of a physiotherapist, you will follow staged exercise therapy - starting with initially limited movements and then progressing to greater intensity - to normalize the mobility range.
Medication
Anti-inflammatory and analgesic tablets (diclofenac or paracetamol) prevent inflammation and control pain.
Recommended dosage: 3 x 1 tablet per day for 7-14 days
Antithrombotic injections (e.g. Fragmin) to prevent thromboses are to be administered for at least as long as you use crutches to ease the load on your foot. They are to be injected into the abdominal skin once a day as shown.