Knee & Ankle
Ankle arthroscopy is a minimally invasive surgery, in which the surgeon uses a tiny camera (arthroscope) to examine, diagnose, or repair tissues inside or surrounding the ankle joint. Surgeons use several small incisions (usually 1cm or smaller) to insert the arthroscope and other surgical instruments into the ankle joint. At Hospital for Special Surgery, patients typically receive regional anesthesia, which means that their ankle is numb, but they are breathing on their own.
Ankle arthroscopy offers the advantages of using smaller incisions and incurring less damage to the surrounding tissue. Consequently, ankle arthroscopy has a very low infection rate and is usually less painful than an open ankle surgery. Due to this decreased pain, patients must be cautious not to return to normal activity too quickly. It is vital to adhere to the doctor’s recommendations and restrictions on activity to allow for adequate tissue healing after surgery. Dr. Joshua Dines uses ankle arthroscopy to treat conditions that have not responded to conservative treatment, such as:
- Loose bodies are free floating cartilage, bone or scar tissue in the ankle joint that can cause pain, clicking and catching.
- Ankle arthroscopy can be utilized to find and remove these loose bodies.
- Ankle OCD is a condition in which there is a loss of blood supply to the bone that is covered by cartilage in the joint, ususally caused by a severe ankle sprain or fracture.
- Ankle Arthroscopy can be used to remove the damaged cartilage and bone and drill holes to promote bone healing or to perform a bone graft.
Osteochondral lesions of the ankle (Ankle OCD) is a condition in which there is a loss of blood supply to the bone that is covered by cartilage in the joint. Ankle OCD can cause pain and stiffness and is commonly the result of trauma to the ankle, such as severe sprains or small fractures. The talus is a large foot bone that forms part of the ankle joint. The top of the talus is covered by articular cartilage, which helps to reduce friction while the bone of the ankles slide against each other. When a chip-type fracture to the talus occurs, oftentimes due to a severe ankle sprain, the fragment may displace. Displacement prevents blood vessels from supplying blood to the fragment, which decreases the likelihood of healing. Your physician can diagnose ankle OCD through a physical examination and with the help of diagnostic imaging, such as X-ray, CT scan, and MRI.
Nonsurgical treatment options include the use of crutches, a splint, or a cast. Rest and avoiding heavy use of the ankle joint is important for healing. If ankle OCD is not caught early, surgical treatment can be performed to remove the loose fragments of bone and/or cartilage from the ankle. Drill holes are then placed where the missing bone was located, allowing for new blood vessels to grow and form scar tissue to replace the space of the missing bone. This procedure can be done either arthroscopically or as an open procedure, depending on the patientâ€™s individual needs and the specific location of the injury. Screws can also be put into place to help fix the injury or a new piece of bone or cartilage (graft) can be used to replace the damaged bone and cartilage. Crutches are required after surgery, followed by physical therapy.