Ankle arthroscopic surgery

Arthroscopy is a way to find problems and do surgery inside a joint without making a large cut (incision). Your doctor puts a lighted tube with a tiny camera through small incisions. The camera is called an arthroscope, or scope.

This surgery can treat several problems.

• For arthritis, the doctor smooths rough surfaces of the ankle bones.
• For an ankle that does not move easily or feels as though it locks, the doctor may put back or take out a loose piece of bone or cartilage.
• For a broken ankle, the doctor can put the bones back in the right positions.
• For an ankle with pain and limited movement, the doctor may find and remove scar tissue. Or a growth called a ganglion cyst may be removed.

You may go home on the day of surgery. Your ankle may be in a brace, a flexible boot, or a cast. You will probably need about 6 weeks to recover. If your doctor repaired a broken bone or torn tissue, recovery will take longer. You may have to limit your activity until your ankle strength and movement are back to normal. You may need physical therapy.

You may be able to go back to your normal routine a few days after the surgery. If you lift things or stand or walk a lot at work, it may be 1 to 2 months before you can go back to work. If you had surgery for a broken bone (fracture), it may be even longer before you can do physical labor.

After surgery and rehab, you will probably have less pain and more strength and movement in your ankle.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. Use pillows to raise your ankle and leg above the level of your heart.
• Try to walk each day, as soon as your doctor says you can. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• You may have a cast, a brace, or a boot on your ankle and leg. If you have a brace or boot, your doctor will tell you when to wear it and when to take it off.
• If you have a desk job, you may be able to go back to work a few days after the surgery. If you lift things or stand or walk a lot at work, it may be 1 to 2 months before you can go back.
• Your doctor will tell you how often and how much you can move your ankle and leg.
• You can take a shower 48 to 72 hours after surgery and clean the cuts (incisions) with regular soap and water. Do not take a bath or soak your ankle until your doctor says it is okay.
• Ask your doctor when you can drive again.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids, unless your doctor tells you not to.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have a dressing over your incisions, keep it clean and dry. You may remove it 48 to 72 hours after the surgery.
• If your incisions are open to the air, keep the areas clean and dry.
• If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.

Exercise

• Move your toes as much as your bandages allow.
• Depending on why you had the surgery, you may have to do ankle and leg exercises. Your doctor or physical therapist will give you exercises as part of a rehabilitation program.
• Stop any activity that causes sharp pain. Talk to your doctor or physical therapist about what sports or other exercise you can do.

Ice

• To reduce swelling and pain, put ice or a cold pack on your ankle for 10 to 20 minutes at a time. Do this every 1 to 2 hours. Put a thin cloth between the ice and your skin. If your doctor recommended cold therapy using a portable machine, follow the directions that came with the machine.