ARTHROSCOPY OF THE ANKLE
DEFINITION OF ANKLE INSTABILITY
Ankle instability refers to a condition where the ankle exhibits an inability to maintain its normal stability, which can cause the ankle to feel weak, unstable, or giving way during movements, such as walking, running or practicing physical activities. This condition is often associated with a history of ankle injuries, including repeated sprains.
There are two main types of ankle instability :
- Mechanical instability : This occurs when the anatomical structures of the ankle, such as ligaments, tendons and muscles, are damaged or weakened, resulting in a loss of joint stability. Repeated sprains can stretch or tear the ligaments in the ankle, compromising their ability to maintain joint stability.
- Functional Instability : This refers to a subjective perception of ankle instability without necessarily an apparent structural injury. People with functional ankle instability may experience a feeling of weakness or lack of confidence in their ankle during physical activities, even when there are no objective signs of injury.
Common symptoms of ankle instability include a feeling of the ankle slipping or giving way, persistent pain, recurrent swelling, muscle weakness, and decreased overall stability of the ankle.
Treatment for ankle instability depends on the severity and underlying cause of the condition. It may include conservative measures such as physical therapy to strengthen the muscles around the ankle, orthotics or ankle supports to provide additional support, rehabilitation exercises to improve proprioception and balance, and modifications of activity to avoid movements that aggravate instability.
In cases that are severe or refractory to conservative treatment, surgery may be considered to repair damaged structures in the ankle, such as ligaments, tendons or cartilage, to restore joint stability. It is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan for ankle instability.
WHY OPERATE ON ANKLE INSTABILITY?
Surgery to treat ankle instability may be recommended in cases where conservative measures such as physical therapy, orthotics, or muscle strengthening exercises have failed to provide adequate symptom relief, or when the Ankle instability is severe and causes significant limitation in daily or sporting activities. Here are some reasons why surgery may be considered for ankle instability :
- Severe Structural Injury : If ankle instability is caused by a serious structural injury, such as extensive ligament rupture or severe joint laxity, surgery may be necessary to repair or reconstruct the damaged structures and restore ankle stability.
- Failure of conservative treatment : When conservative treatments have failed to relieve symptoms or improve ankle stability, surgery may be considered as a more effective treatment option to address persistent instability.
- Demanding activities or sports : For people who participate in demanding physical activities or sports, such as running, basketball or football, an unstable ankle can lead to an increased risk of serious injuries, such as recurrent sprains or fractures. . In such cases, surgery to strengthen ankle stability may be recommended to prevent future injuries and allow a safe return to activity.
- Improved quality of life : For individuals whose ankle instability causes a deterioration in quality of life, surgery may be considered to reduce pain, improve function, and restore the ability to participate in daily activities and to leisure.
- Restore stability and function : The primary goal of ankle instability surgery is to restore normal stability to the joint and restore normal function to the ankle, allowing the patient to regain mobility and function. optimal functional activity.
Before deciding on surgery to treat ankle instability, it is important to consult with an orthopedic specialist or ankle and foot surgeon to assess the severity of the condition, discuss appropriate treatment options, and understand the risks and benefits of surgery. An individualized approach is essential to determine the best treatment strategy for each patient based on their specific needs and lifestyle.
DEFINITION OF ANKLE ARTHROSCOPY
Ankle arthroscopy is a minimally invasive surgical procedure used to diagnose and treat ankle joint problems. This technique allows the surgeon to look inside the ankle joint using an arthroscope, a thin, flexible instrument equipped with a small camera and lights. The arthroscope is inserted into the ankle through small incisions in the skin, allowing the surgeon to view the internal structures of the joint on a video screen in real time.
Ankle arthroscopy can be used for both diagnostic and therapeutic purposes. Here are some of the conditions for which ankle arthroscopy may be used :
- Diagnosis of intra-articular injuries : Arthroscopy allows the surgeon to identify and evaluate intra-articular injuries such as ligament tears, joint fractures, foreign bodies, cartilage damage and signs of arthritis .
- Treatment of ligament injuries : Arthroscopy can be used to repair tears of the ankle ligaments, such as tears of the external lateral ligament (lateral collateral ligament) or anterior talofibular ligament, using suturing or reconstructive techniques.
- Cartilage Debridement : In cases of cartilage damage in the ankle, arthroscopy may be used to remove damaged or degenerated cartilage tissue, which can help relieve pain and improve joint function.
- Foreign body extraction : If foreign bodies, such as bone fragments or joint debris, are present in the ankle joint, arthroscopy may be used to remove them, which can reduce inflammation and pain .
- Assessment and treatment of compression syndromes : Arthroscopy can be used to assess and treat nerve compression syndromes, such as tarsal tunnel syndrome or anterolateral impingement, by releasing compressive structures and improving circulation and nervous function.
- Other Procedures : In addition to the procedures mentioned above, ankle arthroscopy can also be used for other surgical procedures, such as fixing intra-articular fractures, resecting synovial cysts, or performing biopsies.
Ankle arthroscopy has several advantages over open surgical techniques, including smaller skin incisions, less tissue trauma, faster postoperative recovery, and decreased complications. However, as with any surgical procedure, there are potential risks associated with ankle arthroscopy, such as infection, nerve or vascular damage, and abnormal scar formation. It is therefore important to discuss the benefits, risks and alternatives of ankle arthroscopy with a qualified healthcare professional before undergoing this procedure.
POST-OPERATIVE REHABILITATION AND RESUMPTION TO ACTIVITIES
Ankle arthroscopy requires convalescence and rigorously respected rehabilitation.
The advantage of this type of operation is that it allows the patient to return to activities more quickly.
After the operation, dressings are required for 15 days and must be changed every 2 days.
Anticoagulant treatment is not systematic and depends mainly on the risk factors presented by the patient.
The latter can also walk with the help of canes following the operation and must start rehabilitation the day after the operation, to promote the rapid recovery of their motor skills.
Rehabilitation with a physiotherapist lasts approximately one month and the patient must undergo post-operative follow-up in the first month, third month and sixth month.
Following the ankle arthroscopy, work stoppage is approximately one month.
RISKS AND COMPLICATIONS OF ANKLE ARTHROSCOPY
Ankle arthroscopy is a procedure which, like many, can involve certain complications, although in this specific case they are minimal.
In the case of an ankle arthroscopy, the complications can be varied: they can be in the form of joint stiffness, infections or healing problems.
Most of the time, this can be joint effusion, which requires a puncture or infiltration.
This type of complication generally occurs due to too rapid a return to professional or physical activity.
Phlebitis is also one of the complications.
Phlebitis corresponds to a blood clot which can in certain cases lead to pulmonary embolisms, which is why some patients need treatment with anticoagulants.
Among the complications, we must mention algodystrophy, which is a set of pain and stiffness, which disappears in a few months but which requires prolonged rehabilitation.
EXPECTED RESULTS OF THE OPERATION
Ankle arthroscopy should allow the patient to improve the stability of the ankle and remedy the pathology being treated.
In most cases, the results obtained following arthroscopy are very encouraging.
Arthroscopy is a popular operation because it is less invasive than a traditional operation and allows the patient to regain their motor skills more quickly.
Arthroscopic ankle surgery limits pain and allows an earlier return to personal, professional and physical activities.
