Ankle arthroscopy and cartilage injuries
Some ankle pain comes from damage inside the joint that X-rays may not show. Ankle arthroscopy lets the surgeon look inside and treat many of these problems through small cuts.
What is ankle arthroscopy?
Ankle arthroscopy is "scope" surgery. The surgeon makes a few small cuts around the ankle. A thin camera goes in through one cut and shows the inside of the joint on a screen. Small tools go in through the other cuts.
Problems it can treat
- Cartilage injuries of the ankle bone. The top of the ankle bone (talus) is covered with smooth cartilage. An ankle sprain or break can damage a patch of this cartilage and the bone under it. This is called an osteochondral lesion of the talus.
- Bone spurs or pinched tissue (impingement). Extra bone or thick tissue at the front of the ankle can pinch when you bend your foot up.
- Loose pieces of bone or cartilage floating in the joint
- Scar tissue that builds up after an injury
- Chronic ankle instability. Scope surgery is often done along with a ligament repair or rebuild for an ankle that keeps giving way.
Signs to watch for
- Deep ankle pain that lasts months after a sprain
- Catching, clicking, or locking in the ankle
- Swelling after activity
- Pain at the front of the ankle when you squat or climb stairs
Finding the problem
An exam and X-rays come first. Because cartilage does not show well on X-rays, an MRI or CT scan is often used to see the injury.
Treatment without surgery
Many people start here. Options include:
- Rest from activities that cause pain
- A brace or a walking boot for a period of time
- Physical therapy for strength, balance, and motion
- Medicines for pain and swelling, if safe for you
- An injection into the joint in some cases
When surgery helps
Surgery may be an option when pain, catching, or swelling keeps going after a fair trial of non-surgical care. During the scope, the surgeon may remove spurs, scar tissue, or loose pieces. For a cartilage injury, the damaged cartilage is cleaned out. Tiny holes may be made in the bone underneath to bring in blood and help new repair tissue grow (marrow stimulation, sometimes called microfracture). Larger or deeper injuries may need other cartilage repair options, which Dr. Nafal will discuss.
Recovery
Ankle arthroscopy is usually done as same-day surgery. Recovery depends on what was done inside the joint. After removing spurs or scar tissue, many people walk in a boot fairly soon. After a cartilage repair, you often keep weight off the foot for several weeks so the new tissue can form, using crutches or a knee scooter. Physical therapy is common. Return to sports often takes several months. Learn more about getting around after surgery.
After surgery, call our office if… you have a fever or chills, new pain or swelling in your calf, or drainage, opening, or spreading redness at the incisions. For chest pain, trouble breathing, or another emergency, call 911.
How Dr. Nafal can help
Dr. Nafal is board qualified by the American Board of Foot and Ankle Surgery in Foot Surgery and in Reconstructive Rearfoot and Ankle Surgery. He performs ankle arthroscopy and cartilage procedures. He explains every option in plain words, including options that don't involve surgery.
Common questions
My sprain was months ago. Why does my ankle still hurt?
Most sprains heal well, but some leave behind cartilage damage, scar tissue, or loose ligaments. Pain that lasts months after a sprain is a reason to be checked.
Will I have large scars?
Scope surgery uses small cuts, so scars are usually small. If other procedures are done at the same time, you may have a longer incision.
Can cartilage grow back?
Cartilage has a limited ability to heal on its own. Repair procedures aim to help the body fill the damaged area with new repair tissue. How well this works depends on the size and location of the injury.
Talk to Dr. Nafal about your ankle pain
Offices in Canton and Troy. New patients welcome.