Ankle Arthroscopy Adelaide
Dr Hutchinson has a special interest in the treatment of ankle injuries and performs a high volume of ankle reconstructions in Adelaide. He performs ankle surgery for some of the best athletes in Australia, including professionals in the AFL, AFLW, SANFL, NBL and Superleague Netball.
He offers the same very high level of care to ‘weekend warriors’ and emerging junior athletes in all sporting codes as he does to those currently competing at the highest level. Dr Hutchinson has specific, sub-specialist training, both within Australia and overseas, in treating ankle injuries in both adults and growing athletes enabling him to treat patients of all ages.
What is an Ankle Arthroscopy?
An ankle arthroscopy, or key-hole-surgery, is performed through two, small incisions in the front of your ankle joint, about 3-5mm in size. You will also have an incision about 3-4cm in length on the outer side of your ankle.
The ankle joint is inspected with a camera, to ensure there is no cartilage damage that needs to be treated. Even the best MRI scans will not diagnose a significant number of ankle cartilage injuries, so arthroscopy is the gold standard to assess and treat this.
Ankle surgery usually takes place under general anaesthesia, so you will be asleep. It is usually day surgery or a one-night stay in hospital.
If there is a small piece of cartilage loose within the joint, then this would require simple removal. If there was a larger piece of damaged bone and cartilage, then this may require fixing back into place with a small screw.
Sometimes are large piece of cartilage has broken loose, but it is too severely damaged to be fixed back into place. This may require a key-hole procedure called a microfracture.
We also remove inflamed scar tissue inside the ankle joint, called arthrofibrosis. Removing this, along with any blood that has set in the joint, will help your ankle move more freely after surgery and reduce the risk of stiffness.
Ankle Arthroscopy Recovery Time
Leaving the Hospital
Before you leave hospital, you will be seen by a physiotherapist who will give you instructions on what you can and cannot do for the first 2-3 weeks after surgery. Rehabilitation begins from the day after surgery.
You may require crutches for 3-5 days, but I allow my patients to put as much weight through their ankle as they wish, from day one of surgery. The crutches are only there for pain relief as required.
I don’t advise patients to wear a full moon boot after surgery, and you certainly will not be in a cast or a splint. In both professional athletes, and weekend warriors, the best results are seen when we move your ankle early after surgery.
You will require 1-2 weeks of regular Panadol and anti-inflammatory medication.
You could return to office-based work or study within 1 week of surgery.
You should make an appointment with your own physiotherapist within 2-3 weeks of surgery. It makes sense to see a physiotherapist who is close to where you live or work. Otherwise, you will be less inclined to see them.
If you have a manual job then it may be 2-4 weeks before you can return to work, and in that situation, I would recommend wearing a brace for 6-8 weeks.
Usually, from 8 weeks after surgery a patient can begin to gently jog in a straight line.
A return to full activities and sports can be 3-4 months. Your ankle will continue to improve for 6-12 months after surgery.
Ankle Arthroscopy Risks
All surgery has risks, but in general I would consider this a low-risk procedure with excellent results.
The risk of deep infection is far less than 1%, but if this occurred you may need further surgery and antibiotics for a number of weeks. A mild skin infection occurs 2-3% of the time, but all that is needed is some tablet antibiotics, and it is unlikely there would be any long-term problems.
It is not uncommon for patients to have some numbness on the top of their foot due to swelling, and also damage to sensory nerves beneath the skin from the key-hole surgery. This usually improves over weeks to months, but in some patients it may be permanent. It will not affect the stability or function of your ankle.
Ankle ligament repair has a high success rate, and in general your ankle should remain stable. However, if you were unlucky enough to have another injury, you could rupture the ligaments again. In this situation another period of rehabilitation, and sometimes revision surgery, is required.
Longer term outcomes are also greatly influenced by the severity of the original injury. Patients with associated cartilage injuries and/or fractures are at higher risk of ongoing pain, stiffness and arthritis. These patients will also take longer to maximally improve after their surgery.
Learn about Ankle Arthroscopy
Ankle Injuries – Everything you need to know
A comprehensive educational video that walks you through how the ankle joint works, how it is injured and what the different treatment options are for.