Name of the Procedure:

Arthroscopy, Ankle (Tibiotalar and Fibulotalar Joints), Surgical; Synovectomy, Partial

Summary

Arthroscopy of the ankle involves using a tiny camera to look inside the ankle joint and perform surgical procedures through small incisions. The procedure includes a partial synovectomy, where part of the inflamed or damaged synovial tissue is removed from the tibiotalar and fibulotalar joints.

Purpose

This procedure addresses conditions like chronic synovitis, arthritis, or other inflammatory processes within the ankle joint. The goal is to alleviate pain, reduce inflammation, and improve joint function and mobility.

Indications

• Persistent ankle pain unresponsive to non-surgical treatments
• Chronic synovitis or inflammation of the synovial membrane
• Arthritis causing damaged synovial tissue
• Limited ankle mobility
• Swelling or joint effusion

Preparation

• The patient may need to fast for several hours before the procedure.
• Adjustments to medications, especially blood thinners, may be required.
• Pre-operative assessments may include imaging studies like X-rays or MRIs and blood tests to ensure overall health.

Procedure Description

1. The patient is given anesthesia, either general or regional.
2. Small incisions (portals) are made around the ankle joint.
3. An arthroscope, a tiny camera, is inserted through one incision to provide a view of the joint interior on a monitor.
4. Surgical instruments are inserted through other incisions to trim away inflamed or damaged synovial tissue.
5. The joint is flushed to remove debris, and any additional necessary repairs are performed.
6. The incisions are closed with sutures or adhesive strips, and a sterile dressing is applied.

Duration

The procedure typically takes around 1 to 2 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist
• Surgical technician

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel injury
• Ankle stiffness
• Pain or swelling
• Blood clots

Benefits

• Reduced pain
• Improved ankle function and mobility
• Decreased inflammation
• Quicker recovery compared to open surgery

Recovery

• Rest and elevation of the ankle.
• Use of ice packs to reduce swelling.
• Pain management with prescribed medications.
• Physical therapy to restore mobility and strength.
• Typically, patients can resume normal activities within a few weeks but should avoid strenuous activities until fully healed.
• Follow-up appointments to monitor progress.

Alternatives

• Non-surgical treatments such as physical therapy, medications, or injections.
• Open surgical synovectomy.
• Alternative joint-preserving procedures.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be some pain, swelling, and bruising, which can be managed with medications and rest. Discomfort should gradually decrease, and improvements in joint function can be expected within a few weeks.