Ankle
The ankle joint is a critical piece of our body for supporting functional movement. It’s part of what allows us to respond to walking or running on different types and uneven surfaces. It’s also a necessary component of other types of movement like jumping and kicking. And it also helps us maintain our balance and shift our weight as we’re doing all of those kinds of movements.
Arthroscopic surgery of the ankle allows the direct visualization of all intra-articular structures of the ankle without an arthrotomy or malleolar osteotomy. Technological advances and a thorough understanding of anatomy have resulted in an improved ability to perform diagnostic and operative arthroscopy of the ankle. The decreased morbidity and faster recovery times make it an appealing technique compared with open arthrotomy.
Dr. Shetty and his department have 2 decades of praactise in ankle arthroscopy, he is one of the few surgeons in the whole country to have specialised in ankle scopy.
Related to pain
Anteromedial Ankle Impingement (AAI)
Anteromedial ankle impingement is a condition characterized by chronic pain in the front and inside of the ankle due to bone or soft tissue compression. Treatment may involve conservative measures such as physical therapy and anti-inflammatory medications or surgical intervention to remove the impinging tissues and alleviate symptoms.
Posteroankle Impingement
This condition occurs when there’s compression or pinching at the back of the ankle, often exacerbated during certain movements. Treatment typically involves rest, anti-inflammatory medications, and physiotherapy. In severe cases or when conservative treatments fail, surgery might be recommended to address the impinging tissues and restore normal ankle function.
Os Trigonum
The os trigonum is an accessory bone that can sometimes be found behind the ankle joint. Individuals with an os trigonum may experience pain, especially during activities that involve the flexing of the ankle. Treatment may range from rest and anti-inflammatory medications to surgical removal of the os trigonum if symptoms persist.
Osteochondral Defect of Talus (OCD)
An osteochondral defect of the talus is a condition where there’s damage to the cartilage and underlying bone of the talus in the ankle joint. Treatment options may include conservative measures like bracing or casting, or surgical interventions like arthroscopic debridement, microfracture, or grafting procedures to promote healing and restore joint function.
Synovitis, Synovial Osteochondrometosis
Synovitis is the inflammation of the synovial membrane in the joint, while synovial osteochondrometosis is a rare condition where benign cartilage nodules form within the synovial membrane. Treatments may range from anti-inflammatory medications and joint injections to surgical intervention to remove the nodules or address the inflammation.
Ankle Arthritis
Ankle arthritis is characterized by the degeneration of cartilage within the ankle joint, leading to pain, stiffness, and reduced mobility. Treatment plans may include a combination of conservative measures like physical therapy, orthotics, and anti-inflammatory medications, or surgical interventions like arthroscopy, arthrodesis (fusion), or ankle replacement to alleviate symptoms and improve joint function.
Related to Instability
ATFL Tear
The Anterior Talofibular Ligament (ATFL) is a critical ligament located on the outside of the ankle that helps stabilize the joint. A tear in the ATFL can result from a severe ankle sprain or repeated sprains, leading to pain, swelling, and instability in the ankle joint. Initial treatment often includes rest, ice, compression, and elevation (RICE) to manage inflammation, along with physical therapy to restore strength and mobility. In more severe cases or when conservative treatments fail to provide relief, surgical intervention may be necessary. Surgery for an ATFL tear aims to repair or reconstruct the ligament, restoring stability to the ankle and alleviating symptoms. Post-surgical rehabilitation is crucial to regain full function and prevent future injuries.
Chronic Ankle Sprain, Instability
Chronic ankle instability often arises from repeated ankle sprains or a single sprain that hasn’t healed properly, leading to a cycle of instability, re-injury, and further weakening of the ligaments around the ankle. Treatment for chronic ankle instability aims to break this cycle and restore strength and function to the ankle joint. Conservative treatments may include physical therapy to improve strength, balance, and coordination, along with bracing or taping to provide extra support. In cases where conservative treatments don’t provide satisfactory relief, or when there’s significant ligament damage, surgical intervention may be recommended. Surgery for chronic ankle instability may involve ligament repair or reconstruction, using either the patient’s own tissue or donor tissue. A tailored rehabilitation program following surgery is vital to achieve the best outcomes and reduce the risk of future instability.
Surgeries/Procedures
Arthroscopic Decompression
Arthroscopic decompression is a minimally invasive procedure aimed at alleviating pressure within the ankle joint, often due to bone spurs or other structural abnormalities. The procedure allows for direct visualization and removal of offending structures, thereby improving joint movement and reducing pain.
Os Trigonum Excision
An os trigonum is an extra bone that can be present behind the ankle joint. If symptomatic, its excision can alleviate posterior ankle impingement symptoms. The procedure can be performed arthroscopically, allowing for a faster recovery and less post-operative pain.
Arthroscopic Bone Marrow Stimulation, OATS, ACI
These procedures aim to repair cartilage defects within the ankle. Bone Marrow Stimulation encourages cartilage healing by creating microfractures in the bone beneath the cartilage. OATS (Osteochondral Autograft Transfer System) and ACI (Autologous Chondrocyte Implantation) involve transplanting healthy cartilage tissue or cells to the defect site to promote cartilage repair.
Arthroscopic Synovectomy, Loose Body Removal
Synovectomy involves the removal of inflamed synovial tissue from the ankle joint, which can alleviate pain and improve joint function. Loose body removal involves extracting free-floating bone or cartilage fragments from the joint, which can cause pain and impede movement.
Arthroscopic Assisted Ankle Fusion
This procedure is typically recommended for severe ankle arthritis. It involves fusing the bones of the ankle joint to eliminate movement and alleviate pain. Arthroscopic assistance allows for better visualization and preparation of the joint surfaces for fusion, which can improve the procedure’s success rate.
Arthroscopic ATFL Repair
Anterior Talofibular Ligament (ATFL) repair aims to restore ankle stability by repairing the ligament. Arthroscopic repair is less invasive than open surgery, leading to a quicker recovery and less post-operative pain.
Modified Brostrom Repair
This procedure aims to correct lateral ankle instability by repairing and tightening the ligaments on the outside of the ankle. It’s a highly effective procedure for patients with recurrent ankle sprains and instability.
