Technology and unique instrumentation have led to the development of surgical techniques for the diagnosis and repair of joint disorders. Knee arthroscopy was developed in the late 1960’s. Small joint arthroscopy was developed in the early 1980’s by orthopedic and podiatric surgeons and adapted to foot and ankle joints. Your podiatric surgeon may identify a potential problem with a foot or ankle joint after examining the lower extremity. Ankle Arthroscopy may be recommended to confirm a diagnosis or perform a surgical procedure within a joint using an arthroscopic instrument.
For example, needle-like probes enter the joint through a small opening of the skin. The podiatric surgeon introduces a tiny camera to inspect the joint. The podiatric surgeon may also insert surgical instruments through another small incision to perform additional procedures within the joint. Unlike traditional joint surgery that requires large incisions to expose the joint, arthroscopy uses small openings to examine the joint. By eliminating the need for large incisions, arthroscopy reduces the risk of infection and swelling. Podiatric surgeons may perform arthroscopic surgery in hospitals, outpatient surgery centers and in their offices. Arthroscopy is often a “same day” procedure allowing the patient to return home after surgery. Your podiatric surgeon will discuss all aspects of surgery with you.
Podiatric surgeons use delicate instruments and miniature video cameras to perform arthroscopic surgery. These instruments include cutting tools, burrs, graspers, shavers, fastening tools, sutures, laser and electrocautery to control bleeding. Arthoscopic techniques allow for a variety of procedures that are performed on foot and ankle joints. The following table reflects conditions for which the arthoscope can be used to diagnose and perform reconstructive procedures.
CONDITION ARTHROSCOPIC TREATMENT
Chronic Ankle Pain Diagnosis, biopsy
Arthritis Biopsy, arthroplasty, fusion
Loose bodies Excision
Ankle instability (the feeling of giving way) Ligament repair
Cartilage fractures, chrondromalacia Cartilage repair or removal
Meniscoid body (scar tissue) Excision, biopsy
Advantages of arthroscopic surgery include reduced trauma due to the small instruments used. Small instruments cause less damage to surrounding skin, ligaments, tendons and bony structures. Movement of the joint reduces swelling, stiffness, and postoperative discomfort. Your podiatric surgeon may recommend exercising the joint to hasten your recovery to bathing, walking, and sports activity.
Your podiatric surgeon may recommend rest, ice, compression, and elevation (“RICE”) to help speed healing.
REST: Ask your podiatric surgeon how long you should rest or restrict activity.
ICE: Ice reduces swelling, bleeding and pain following surgery.
COMPRESSION: Dressings help reduce swelling and stabilize the joint, preventing unnecessary motion. Dressings should be snug but should not interfere with proper circulation.
ELEVATION: Keep the foot at or above the level of your heart to drain excess fluids away from your foot. This helps to reduce swelling and discomfort.
Arthroscopy allows your podiatric surgeon to look directly into your ankle and reach a more accurate diagnosis. Additional benefits of arthroscopy include a shortened postoperative course and rapid recovery.