Fields of treatment / Orthopedy / Arthroscopy of the ankle joint
Arthroscopy of the ankle joint
Pain, limited movement, swelling and signs of joint instability are problems caused by an traumatic or non-traumatic mechanism that brought you to the doctor, on whose recommendation you should undergo an arthroscopic examination. This should clarify the origin of your difficulties, determine the extent of joint damage and thus enable its treatment according to the available treatment methods. Surgical interventions that can be performed during arthroscopy will be performed during surgery and thus speed up and improve the treatment procedure.
Operative procedure
The operation is performed under general anesthesia. The position of the patient is on the back, sometimes with a slight pull on the operated limb. An arthroscope – an optical device containing a digital camera that transmits an image of the joint to a monitor – is inserted into the joint through one or several openings of about 1 cm. With the arthroscope, we gradually examine the entire joint space and thereby obtain information about its damage. Special instruments designed for this type of operation can be introduced into the joint through other inputs, with which we perform operations in the joint. For a better overview of the joint, the operation is performed in the so-called bloodless state. A pneumatic cuff is placed on the thigh of the operated limb, which is filled with compressed air for the duration of the operation. This will reduce blood flow to the limb and prevent bleeding into the joint. The operation takes 20-60 minutes, depending on the difficulty. According to the findings, we clean the joint, in indicated cases it is possible to adjust the front edge of the lower leg or an adequate part of the ankle bone. Any loose joint bodies - we pull out the mice. In some cases, after changing the position of the patient to the stomach, it is necessary to enter the hock using a posterior approach to treat the posterior structures.
Special circumstances that occur during the operation may lead to an extension of the surgical intervention or a change in the surgical procedure, we ask that you agree to this, rarely occurring option. If we had to proceed only in the original scope of the operation, it could also mean the burden of another operation for you.
Postoperative care
Most of the time postoperatively, we choose weight-bearing on crutches, the length and degree of load varies according to the performed arthroscopic procedure, weight-bearing is usually in the range of 2 to 6 weeks. You will be informed about the finding and possible consequences for the future by the attending physician. Of the preventive measures, the prevention of deep vein phlebothrombosis is selected as needed, usually by administering low molecular weight heparin. Exercise and bandaging are also recommended, which you will be instructed about.
Other treatment options
The introduction of arthroscopy brought a significant improvement in the results of treatment and shortened the healing time of damaged joints. Joint damage of this type can also be treated with open surgery - arthrotomy without the use of an arthroscope. However, the overview in the joint is not so good, the intervention in the joint is significantly more aggressive, and therefore the postoperative course tends to be more complicated in this type of operation. Joint problems can also be treated conservatively without surgical treatment - the use of drugs (pain reliever, anti-inflammatory, muscle tension reliever), injections of the affected joint, rehabilitation therapy including various procedures (laser, magnetotherapy, ultrasound). According to experience, further damage and changes in the joint take place here much faster than in the case of surgical treatment. The result of this process can be damage to the joint to such a degree that the only possible solution is a joint replacement or its surgical immobilization, which will eliminate the pain in the joint.
