Foot Arthroscopy

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About foot arthroscopy
When foot arthroscopy is done?
Recommended clinic
Before foot arthroscopy
During foot arthroscopy
Recovery
Results & possible complications
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1.100 € / 880 £ / 1.350 $

(foot arthroscopy surgery)

About foot arthroscopy

Foot arhtroscopy is a high skill operation done using a very small diameter fibre optic camera (2,7-4,5 mm) inserted into the joint through a small incision (less than 1cm lenght).

This camera allows the surgeon to see a high definition view of the joint and, if required, to insert needle-thin instruments through another cut for manipulation. These procedures allow faster healing and less scaring than traditional open surgery. It also has a lesser risk for infection, therefore foot arhtroscopy is sometimes called a key-hole opearation. In many cases it can be done as a 1 day procedure with no need to stay in the hospital for the night.

Foot arthroscopy allows visualising the ankle, subtalar, and even the metatarsophalangel joint of the big toe. Due to the anatomy of the foot it can also be used to access some of its tendons.

When foot arthroscopy is done?

Most commonly this procedure is used for the removal of scar tissue or redundant cartilage from the joints. Usually joint is damaged because of arthritis or due to natural age related changes. Sometimes it happens because of trauma. These loose cartilage bodies must be removed because in as they damage the healthy cartilages and scar tissue develops. In some cases osteophytes (bony spur like structures) that form due to arthritis can be removed as well. Key-hole surgery can help patients suffering from anterior impingement, also known as "footballer’s ankle" which is caused by osteophyte in front of the ankle that makes foot extension painful.

Recommended clinic

Nordorthopaedics.com a private orthopaedic clinic in Lithuania. Modern facilities, highly qualified medical personnel led by European level surgeon distinguish the clinic in the region.

our orthopaedic clinic abroad in Lithuania our orthopaedic clinic abroad in Lithuania

Before foot arhtroscopy

Before the operation routine blood tests are required (complete blood count, evaluation of erythrocyte sedimentation rate and similar). Measurement of C-reactive protein and other tests are necessary if inflammation is presented. Also radiographies or computer tomography are done with and without bearing weights for better evaluation of bony structures, heterotopic bone in the itnerosseus space or calcifications of tendons. Magnetic resonance imaging may be necessary to visualize soft tissue damage or previously undetected edema (collection of fuid). Sometimes such periprocedural care as joint aspiration may be needed as well.

The patient is asked to stop smoking or drinking as bad habits increase the risk of infection and interfere with the healing process. Patients are advised to stop taking medicaments for a week or two that affect blood clotting (naproxen, aspirin and others).

Foot arthroscopy step by step

Most ankle arthroscopies are done under general anaesthesia. If the patient wishes, or general anaesthesia is contraindicated it can also be done under epidural or subdural anaesthesia.

Usually the procedure starts with applying a sterile tourniquet just above the ankle to lessen the blood flow. Then fine blades are used to make little cuts and deeper layers of tissues are gently separated with specific instruments to reach the joint capsule. This creates so called portals for instrument insertion. When the joint capsule is cut, the real work begins. The surgeon then visualizes and systematically examines the joint and operates. Usually instruments are inserted through cannulas for an even lesser tissue damage. When the procedure is completed the joint is irrigated, the cuts sutured and dressed with soft and sterile dressing.

Recovery

If the procedure did not involve making a large osteochondrate defect or ligament reconstruction, the patients are encouraged to stand and walk as fast as possible (even the same day). Crutches are used for the first few days to bear weight and avoid secondary damage. A physiotherapist usually sets specific procedures for a faster and more pleasant healing and rehabilitation process.

There might be some swelling, discomfort and pain due to the cuts and natural healing process. Painkillers are usually taken for only 2-3 days after the operation.

The swelling might remain up to a few months. Because of this and the relative discomfort on placing the feet on the pedals it is not recommended to drive for a few weeks. Full return to sport is usually possible after 2-3 months.

Results and possible complications

More than 70% of patients have a complete relief or a distinct improvement after key-hole surgery. Complications are rare, usually concerning various degrees of local nerve damage. Other complications, like fractures, ligament injury, post operative infection and others are not as common. The risk of complications greatly depends on the patient's illness and health status.

The operation does not cure the systematic illness that might have caused the joint damage.

Usually when autologous cartilage replacement is required ankle arhtoscopy and key-hole surgery cannot be done. It is also strictly contraindicated if the patient's ankle is infected, the joints are very severely degenerated, or leg does not have a strong enough vascularity to ensure proper healing. Sometimes severe edema also makes these procedures impossible.

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