To carry out an ankle arthroscopy, the surgeon makes two tiny incisions (cuts), one for the arthroscope and a second for the surgical instrument itself.
Arthroscopy is usually performed as a day case procedure under a general anaesthetic, along with an injection in the ankle which numbs it to reduce pain after surgery.
Immediately after surgery:
- Your foot will be bandaged and will be numb but pain free
- You will be referred to a physiotherapist who will be able to advise you on weight-bearing exercise, depending on the exact procedure the surgeon preformed
- You will be sent home only when 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
- Your doctor may suggest that you take anti-inflammatory medication for six weeks after surgery
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 any stitches removed
- 6 weeks – routine follow-up appointment
- 12 weeks – final appointment and discharge
When can I start to walk?
This will depend on the type of procedure you’ve had. Below is a guide to weight-bearing after surgery, but everyone is different and you should always contact the Fortius Clinic if you are worried.
- Impingement operation: weight bear if you can using crutches immediately after surgery
- Ankle osteochondral defects of joint surface (OCDs): non weight bearing for two weeks, then 50% weight-bearing using crutches for the next two weeks; then fully weight-bearing
- Ankle arthritis tidying (debridement): weight bear if you can using crutches immediately after surgery
- Loose material/bone removal: weight bear if you can using crutches immediately after surgery
- Ankle fusion surgery: don’t bear your full weight for at least six to 12 weeks
How do I wash and shower?
In the first two weeks it’s important to keep the bandaging/foot totally dry although you will be able to shower with a waterproof cover over the leg. After two weeks you can shower as normal if the wounds have healed, but gently dab them dry.
How can I look after the wound?
Remove the bandage after five days and replace it with an elastic compression bandage (tubigrip) but keep the small sticky dressings on the wound. Once the bandage is removed, don’t pull at scabs but let them fall away naturally. If your wound becomes red, swollen or sore you should contact the Fortius Clinic and arrange to see your consultant to check you don’t have an infection.
Getting back to normal
Your specialist will refer you to a physiotherapist who can guide you through the stages of rehabilitation including gait re-education (walking correctly again), ankle mobilisation exercises, and reducing swelling and muscle tightness.
When can I start to drive again?
The DVLA states that it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is if you can stamp down hard with the foot to stop the car during an emergency stop. It may take at least two weeks to be able to do this, and if you have had an osteochondral defect or joint surface debridement, it can take at least six weeks or longer.
Although your specialist will advise you about when it’s safe to start driving again, it remains your responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered.
When can I return to work?
This depends on the type of work you do and how quickly you recover. As a general guide, if your job involves sitting down for most of the time, you should be able to return to work after two weeks; if it involves manual work, you may need to have up to six weeks off.
What long-term outcome can I expect after surgery?
The outcome will depend on the type of condition and the exact procedure you have had. Most people are able to return to full activity and sports within three to six months, although your ankle may remain swollen for at least six months.
What are the risks?
Below is a guide to the risks of this type of surgery. However, your surgeon will discuss these with you before your procedure, and answer any questions you may have:
- The chance of infection is less than 1% and can usually be treated with antibiotics. Significant consequences from infection are very rare (less than 0.5%)
- Nerve damage
- Small nerves that supply feeling to the skin near the operation site can be damaged, although the risk of this is small (less than 2%). If your toe stays numb after surgery, this may be because the nerve is bruised but this will usually recover
- Deep Vein Thrombosis (DVT)
- You may be given blood-thinning medication after the surgery if you are at a higher risk of DVT (where a blood clot forms in a deep vein in the leg). However, the risk of this is less than 1% and may be reduced if you keep your ankle moving and carry out the recommended physiotherapy exercises
Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please contact us for advice if you’re worried about any aspect of your health or recovery