Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis
CPT4 code
Name of the Procedure:
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis
Common name(s): Ankle arthroscopy with fusion, Ankle joint surgery, Ankle fusion surgery
Summary
Arthroscopy is a minimally invasive surgical procedure used to diagnose and treat problems in the ankle joint. When combined with arthrodesis, the procedure aims to fuse bones in the ankle to alleviate pain and improve stability.
Purpose
Arthroscopy with ankle arthrodesis addresses severe ankle arthritis or instability. The procedure aims to reduce pain, improve function, and increase the stability of the ankle joint by fusing the bones.
Indications
- Severe ankle arthritis unresponsive to non-surgical treatments
- Chronic ankle instability
- Pain and loss of function affecting quality of life
- Failed previous ankle surgeries
- Significant cartilage damage or bone spurs
Preparation
- Fasting for at least 8 hours prior to the procedure
- Stopping certain medications (e.g., blood thinners) as advised by your physician
- Preoperative assessment including imaging studies such as X-rays or MRI
- Medical evaluation and clearance for surgery
Procedure Description
- Anesthesia is administered—general or regional anesthesia.
- Small incisions are made around the ankle joint.
- Arthroscope and surgical instruments are inserted through the incisions.
- The surgeon examines and addresses any intra-articular issues.
- The surfaces of the ankle bones are prepared for fusion.
- Bones are positioned and secured using screws, plates, or rods.
- Incisions are closed with sutures or staples.
Duration
The procedure typically takes 1.5 to 3 hours, depending on the complexity of the case.
Setting
Performed in a hospital or specialized surgical center with orthopedic capabilities.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
Risks and Complications
- Infection
- Blood clots
- Nonunion or improper fusion of bones
- Nerve damage
- Persistent pain or stiffness
- Complications related to anesthesia
Benefits
- Reduction or elimination of chronic ankle pain
- Increased ankle stability
- Improved functionality and quality of life
- Potential to resume daily activities with less discomfort
Recovery
- Immobilization in a cast or boot for 6 to 12 weeks
- Gradual weight-bearing as advised by your physician
- Physical therapy to regain strength and mobility
- Follow-up appointments to monitor bone fusion progress
- Full recovery may take several months
Alternatives
- Conservative treatments such as physical therapy, medications, and orthotics
- Joint-preserving surgeries (e.g., debridement or joint resurfacing)
- Total ankle replacement
- Pros of alternatives: Less invasive, preservation of joint movement
- Cons of alternatives: May not be suitable for severe conditions, potential for less effective pain relief
Patient Experience
- During the procedure: Patients will be under anesthesia and should feel no pain.
- After the procedure: Expect swelling, pain, and limited mobility initially.
- Pain management: Prescribed analgesics and anti-inflammatories
- Comfort measures: Elevation, ice packs, and specialized footwear or devices during recovery