A Patient’s guide to Ankle Arthroscopy

To reduce pain/discomfort and improve function, for example, walking and sports.

Following the procedure, a padded bandage will be applied. You will usually be advised to remove the outer bandages (but not the wound dressing) about 72 hours following surgery. The puncture wounds will have a stitch in place – this is to keep the edges of the incisions together. Stitches are removed in clinic about 14 days following the procedure. It is common for the joint to become inflamed following the arthroscopy. It is advisable to elevate the leg and limit the amount of walking for two weeks following the procedure, then gradually increase as you become more able. After some procedures, a backslab cast may be applied to rest the ankle for two weeks following the surgery; crutches may be required for a short duration.

If you smoke, your surgeon may refuse to operate unless you can refrain from smoking before and during the healing phase of your procedure. Research has proven that smoking delays bone healing significantly. Please see Stop before your op leaflet on our website.

Gently mobilise the ankle as soon as able (this prevents stiffness and strengthens muscles). A physiotherapist may assess walking and explain exercises that are effective to aid recovery. Refer to the end of the leaflet for an exercise regime.

Wound(s) must be kept dry for up to two or three weeks following the procedure. Keep wound sites covered. A mepore dressing will be in place following the procedure. However, it is possible to take a shower after 48 hours providing a waterproof dressing is applied. Avoid taking a bath.

Driving – manual cars can be driven usually seven days following an arthroscopy if the ankle feels comfortable. Automatic cars may be driven sooner if patients have undergone surgery on the left ankle only. It is important to be able to perform an emergency stop. You MUST notify your insurance company of the procedure that has been undertaken to ensure that your cover is valid.

Sport – gentle activity can often be resumed approximately six weeks after an arthroscopy. Competitive sport such as football, rugby or squash may take longer but it also depends on the type of surgery carried out. Ask for advice from your clinical nurse specialist.

R – rest when able. Returning to work will depend on your type of employment, the procedure that you have undergone, individual circumstances and speed of recovery. Those who have an office or sedentary type of employment will usually be able to return to work within seven days of the procedure taking place. Those whose employment involves long periods on their feet may be absent from work for four weeks.

I – ice. Apply an ice pack. This may help reduce swelling and assist with pain relief. It is important to protect the affected area with a towel prior to application; often a bag of frozen peas is very effective. When the wound has healed and stitches removed. Fill a bowl with water, add some ice cubes and submerge your ankle in this (do not leave your ankle for longer than 10 minutes). This may be repeated up to four times a day.

C – compression in the form of a tubigrip support can be worn during the day. It provides support to the ankle and it also helps reduce post operative swelling. The tubigrip must not be worn at night.

E – elevate when able. It is advised to keep the affected area above groin level as this helps to significantly reduce swelling. Anti inflammatory pain relief such as nurofen, ibuprofen combined with paracetamol is effective Ask for advice from your doctor before taking any medications.

Infection – there is a small risk (1 in 600). This is increased in patients who are diabetic, suffer from rheumatoid disease and those who smoke. The surgeon may decline to perform surgery unless you refrain from smoking.

Scarring – any type of surgery will leave a scar, occasionally this may be painful and inflamed.

Numbness or tingling – this can occur on top of the foot as a result of minor damage to small nerves. Often it is temporary; however, numbness or a sensitised area can be permanent.

Blood Clots – deep vein thrombosis (DVT) or pulmonary embolus (PE) are rare. Please inform the team if you have had a DVT or PE before or if you have a family history of clotting disorders.

REPORT SEVERE PAIN, MASSIVE SWELLING, EXCESSIVE NUMBNESS OR PINS AND NEEDLES.

The ward physiotherapist will visit you on the morning of your operation to teach you the following exercises. It is very important to start moving your knee joint and strengthen the surrounding muscles. This will aid your recovery. Try to do your exercises three times each day. Please do not attempt any of these exetcises until you have been advised to do so.

	Lie with your upper body supported and legs out straight in front of you. Take a deep breath down to the bottom of your chest. Repeat 4 to 5 times and try to cough. Repeat hourly.
	Lie on your back or in a sitting position. Bend and straighten your ankles briskly. If you feel your heels are getting sore, please stop the exercise and notify your physiotherapist. Repeat 20 times. Repeat hourly.
	Lie on your back. Squeeze your buttocks firmly together. Hold for 5 slow counts. Repeat 20 times. Repeat hourly.
	Lie on your back in a sitting position. Bend your ankles and push your knees down firmly against the bed by tightening your thigh muscles. Hold for 5 slow counts. Repeat 20 times. Repeat hourly.
	Bend and straighten your knee as far as you can. Hold it in the bent position for 5 slow counts then straighten it so your knee is flat on the bed. Repeat 10 times. Repeat as advised by your physiotherapist.

REPORT ANY EXCESSIVE PAID, REDNESS, SWELLING OR DISCHARGE TO YOUR GENERAL PRACTITIONER OR CONTACT THE FOOT AND ANKLE TEAM.