Our Summary

This research paper examines the current standard technique for performing ankle arthroscopy (a minimally invasive surgical procedure on a joint), which is generally carried out with the ankle in a dorsiflexion position (bent or flexed upward) and sometimes involves distraction (pulling the joint apart). This method is preferred because it provides a larger, safer area to work on, reduces the tension of structures in the front of the ankle, and moves them away from the area of operation, protecting them from accidental damage. Furthermore, this technique has been associated with a lower rate of complications. The use of distraction, however, is only recommended in specific cases. The authors provide an infographic detailing when distraction should be used and more general recommendations for carrying out the dorsiflexion arthroscopic technique on the ankle.

FAQs

  1. What is the standard technique for performing ankle arthroscopy?
  2. Why is the dorsiflexion position preferred in ankle arthroscopy?
  3. When is the use of distraction recommended in ankle arthroscopy?

Doctor’s Tip

A doctor might tell a patient undergoing arthroscopy to follow post-operative instructions carefully, including keeping the affected joint elevated and applying ice to reduce swelling. They may also advise the patient to gradually increase movement and activity as directed by the surgeon to promote healing and prevent stiffness. Additionally, the doctor may recommend attending physical therapy sessions to help improve strength and range of motion in the joint.

Suitable For

Patients who are typically recommended for ankle arthroscopy include those with:

  1. Chronic ankle pain or instability
  2. Ankle injuries such as ligament tears or cartilage damage
  3. Ankle fractures that may require surgical intervention
  4. Ongoing ankle swelling or inflammation that has not responded to conservative treatments
  5. Recurrent ankle sprains or dislocations
  6. Unexplained ankle pain or limited range of motion
  7. Inflammatory conditions such as arthritis affecting the ankle joint

Overall, arthroscopy may be recommended for patients who have not responded to conservative treatments and may benefit from a minimally invasive surgical procedure to diagnose and treat their ankle issues.

Timeline

Before arthroscopy:

  1. Patient presents with symptoms such as pain, swelling, stiffness, or limited range of motion in the joint.
  2. Patient undergoes a physical examination and possibly imaging tests to diagnose the problem in the joint.
  3. If conservative treatments like medication, physical therapy, or injections do not provide relief, the patient may be recommended for arthroscopy.

During arthroscopy:

  1. Patient is given anesthesia to numb the area or put to sleep.
  2. Small incisions are made around the joint to insert the arthroscope and surgical instruments.
  3. The arthroscope transmits images of the joint to a monitor, allowing the surgeon to see inside and perform the necessary procedures.
  4. Damaged tissues, loose fragments, or bone spurs may be removed, and repairs may be made to ligaments or cartilage.

After arthroscopy:

  1. Patient may experience some pain, swelling, and stiffness in the joint, which can be managed with pain medication and rest.
  2. Physical therapy may be recommended to improve strength, flexibility, and range of motion in the joint.
  3. Follow-up appointments with the surgeon are scheduled to monitor healing and progress.
  4. Most patients can return to normal activities within a few weeks, depending on the extent of the procedure and individual recovery.

What to Ask Your Doctor

  1. What is the purpose of the arthroscopy procedure for my specific condition?

  2. Are there any alternative treatment options to consider before proceeding with arthroscopy?

  3. What are the potential risks and complications associated with arthroscopy?

  4. How long is the recovery time after arthroscopy, and what can I expect during the recovery process?

  5. Will I need physical therapy or rehabilitation after the arthroscopy procedure?

  6. How many arthroscopy procedures have you performed in the past, and what is your success rate?

  7. Will I need any additional imaging tests or consultations before the arthroscopy procedure?

  8. What type of anesthesia will be used during the arthroscopy procedure?

  9. What are the expected outcomes of the arthroscopy procedure for my condition?

  10. Are there any specific instructions or precautions I should follow before and after the arthroscopy procedure?

Reference

Authors: Dalmau-Pastor M, Vega J. Journal: Arthroscopy. 2019 Dec;35(12):3171-3172. doi: 10.1016/j.arthro.2019.10.013. PMID: 31785741