What Is An Arthroscopic Repair?

The goal of this surgery is to restore normal stability to the ankle. This should also fix a patient’s feeling that the ankle “gives way” and any pain that is associated with an unstable ankle.

This type of surgery is usually carried out as a day case procedure where you will be given a general anaesthetic along with an injection around the ankle so that it’s numb and pain-free after surgery.

In some cases, Dr. Kim or Dr. Haskell will first carry out ankle arthroscopy to inspect the joint before repairing the ligament. The procedure itself involves one incision (cut) on the outside of the ankle to allow the surgeon to locate the scar tissue from the torn ligament near the fibula bone, and carry out a repair with stitches to the bone.

Recovery

Immediately after surgery:

• Your foot will be in a plaster cast below the knee, numb and pain free

• You will be sent home only once you are comfortable, when you will be given a follow-up appointment and painkillers if required

During the first few weeks:

• Elevate your foot (raise it above the level of your heart) as much as possible to reduce swelling

• Move around only when you need to, for example to wash or use the toilet. Don’t put weight on the operated leg

• Some blood ooze can be expected. However, if you are worried, contact the Fortius Clinic for advice

• Dr. Kim or Dr. Haskell may suggest that you take anti-inflammatory medication for around six weeks after surgery

Follow-up appointments:

Everyone is different, so healing and post-operative programmes vary from person to person. However, the schedule of follow-up appointments below is typical:

• Two weeks – your wound will be checked and you will be fitted with a new boot

• Six weeks – your boot will be removed and you will be able to wear normal shoes

• 12 weeks – begin more advanced exercises, returning to sports closer to 16 weeks

Types Of Arthroscopic Repairs

What are Arthroscopic Procedures?

Many painful conditions of the ankle and hindfoot are related to injury to the joint’s cartilage. Cartilage is the smooth white surface the caps the ends of bones and allows joints to glide smoothly during activity. When the cartilage is injured, cysts may form, joints may grind, catch, swell, and are frequently painful. Spurs and soft tissue may pinch and catch. Flakes of cartilage or bone may catch and rub in the joint. Damage to the joint’s cartilage, including osteochondral defects (OCDs) may require an arthroscopic procedure to relieve your symptoms.

Arthroscopy involves making very small incisions around a joint and placing a camera and instruments, typically only a few millimeters in diameter, inside to visualize and treat your condition. The technique and instrumentation has made great advances in the last twenty years, so we are able to treat a broader variety of problems minimally invasively. Even tendons and ligaments may be approached through a minimally invasive technique.

• Osteochondral defects
• Impingement syndrome
• Os trigonum syndrome
• Loose bodies
• Arthroscopic ankle fusion
• Arthroscopic ligament repair
• Tendonoscopy

Osteochondral Defects

Osteochondral defects (OCD, osteochondritis dissecans, osteochondral lesion) may be found in the talus, distal tibia or any of the joints of the hindfoot. They are frequently associated with ankle sprains or fractures, or they may congenital. Symptoms include deep ankle pain with weight-bearing and possibly locking or catching. They are frequently unidentified for months or years and at times are only revealed on MRI scans.
A variety of treatments may be used to treat OCDs. The most common technique for smaller lesions with shallow cysts is arthroscopic microfracture. This technique releases stem cells from the bone beneath the lesion to fill the lesion with a fibrocartilage cap. Larger or deeper lesions may require grafting using your own bone (autograft), bone and cartilage (osteochondral autograft, OATS), or cadaver bone and cartilage (allograft OATS). These techniques may require cutting into the ankle for access to the lesion (osteotomy). Recovery may require a period of up to six weeks of not putting weight on the foot.

We have developed a novel technique that uses your own bony architecture to fill the defect associated with larger OCDs without damaging your own knee or using cadaver parts.

Impingement Syndrome

Ankle impingement refers to pain associated with soft tissue, synovial tissue, or scar tissue buildup around a joint. This is most commonly around the front of the ankle joint, but can also affect the back of the ankle or the subtalar joint. Arthroscopic surgery allows for minimally invasive access to and removal of the impinging spurs or soft tissue. Recovery is typically rapid.

Os Trigonum

An os trigonum is a small bone at the back of the ankle present in a per-cent of people. Os trigonum syndrome is a specific case of impingement in which the os trigonum irritates the surrounding soft tissue and joint structures. It can easily be removed with a minimally invasive arthroscopic approach.

Loose Bodies

Loose bodies occur when pieces of cartilage or bone spurs break off and float in the joint. They cause pain and catching or locking when they get caught between the weight bearing surfaces of a joint. They can cause joint damage by grinding away the joint’s cartilage surface.
Loose bodies are easily removed using arthroscopic techniques.

Arthroscopic Ankle Fusion

Loose bodies occur when pieces of cartilage or bone spurs break off and float in the joint. They cause pain and catching or locking when they get caught between the weight bearing surfaces of a joint. They can cause joint damage by grinding away the joint’s cartilage surface.
Loose bodies are easily removed using arthroscopic techniques.

Tendonoscopy

Loose bodies occur when pieces of cartilage or bone spurs break off and float in the joint. They cause pain and catching or locking when they get caught between the weight bearing surfaces of a joint. They can cause joint damage by grinding away the joint’s cartilage surface.
Loose bodies are easily removed using arthroscopic techniques.

Arthroscopic Ligament Repair

Loose bodies occur when pieces of cartilage or bone spurs break off and float in the joint. They cause pain and catching or locking when they get caught between the weight bearing surfaces of a joint. They can cause joint damage by grinding away the joint’s cartilage surface.
Loose bodies are easily removed using arthroscopic techniques.

What Is An Arthroscopic Repair?

The goal of this surgery is to restore normal stability to the ankle. This should also fix a patient’s feeling that the ankle “gives way” and any pain that is associated with an unstable ankle.

This type of surgery is usually carried out as a day case procedure where you will be given a general anaesthetic along with an injection around the ankle so that it’s numb and pain-free after surgery.

In some cases, Dr. Kim or Dr. Haskell will first carry out ankle arthroscopy to inspect the joint before repairing the ligament. The procedure itself involves one incision (cut) on the outside of the ankle to allow the surgeon to locate the scar tissue from the torn ligament near the fibula bone, and carry out a repair with stitches to the bone.

Recovery

Immediately after surgery:

• Your foot will be in a plaster cast below the knee, numb and pain free

• You will be sent home only once you are comfortable, when you will be given a follow-up appointment and painkillers if required

During the first few weeks:

• Elevate your foot (raise it above the level of your heart) as much as possible to reduce swelling

• Move around only when you need to, for example to wash or use the toilet. Don’t put weight on the operated leg

• Some blood ooze can be expected. However, if you are worried, contact the Fortius Clinic for advice

• Dr. Kim or Dr. Haskell may suggest that you take anti-inflammatory medication for around six weeks after surgery

Follow-up appointments:

Everyone is different, so healing and post-operative programmes vary from person to person. However, the schedule of follow-up appointments below is typical:

• Two weeks – your wound will be checked and you will be fitted with a new boot

• Six weeks – your boot will be removed and you will be able to wear normal shoes

• 12 weeks – begin more advanced exercises, returning to sports closer to 16 weeks

Types Of Arthroscopic Repairs