ARTHROSCOPY OF THE FOOT AND ANKLE
Robert H. Sheinberg, DPM

Foot and ankle injuries are very common in sports or in general activities of daily living. Many structures including bone, ligament, cartilage and joint lining may be injured. Injuries may occur from a single traumatic event or from overuse.

These injuries may cause stiffness in the foot and ankle, especially in the morning. Pain, swelling, and instability may often develop.

When these injuries are unresponsive to conservative care, arthroscopic procedures may benefit the injured area.

A miniature camera is placed into the injured joint allowing an image to be seen on a television screen. The joint is visualized and small instruments, including laser, are introduced into the joint to repair the damage. Fragments of bone and cartilage are often removed. Suctioning of debris and smoothing rough surfaces will often allow a joint to resume its normal gliding motion.

CONDITIONS TREATED:

ADVANTAGES:

1. chronic joint pain and swelling
2. arthritis and bone spurs
3. loose bone and cartilage fragments
4. stiff, scarred joints
5. chronic instability
6. shoulder pain (rotator cuff repair)
7. knee ligament reconstruction (ACL)

1 .faster recovery
2. less pain and swelling
3. avoids large incisions
4. low risk of infection
5. outpatient procedures
6. quick return to activities

Joints are designed to give our bodies freedom of movement. Wear and tear of a joint due to injury or due to aging may alter the lifestyle of an individual. When conservative treatments fail to alleviate the pain and deformity of a joint arthroscopic surgery should be considered.

 

The synovial tissue that lines the joint can be inflamed, which leads to loss of and/or painful range of motion at the ankle joint.


Actual Arthroscopic still picture of the lateral(outside edge) of the ankle joint with inflamed
synovial tissue(note large portion at 9 o'clock) being removed(debriding instrument at 6 o'clock)

The ankle joint is not the only area that can be surgically addressed through an arthroscope. Due to improvements in technology and equipment, even some of the smallest joints, such as toe joints can be visualized. Also, inflammatory tissue between a tendon and it's sheath can be visualized and removed.
 

Still Pictures of a 1st MPJ(Big Toe Joint) Arthroscopy- In small spaces, a Holmium LASER is utilized to vaporize the inflamed synovial tissue


A tendoscope of the Posterior Tibial Tendon- note the inflamed tenosynovitis at 10 o'clock- also, it was discovered that this patient had a partial tear of the PT tendon(note that there appears to be a small strand of tendon to the left of the debridement instrument), which was undetected on an MRI- for this patient, the tendon scope proved to be a valuable diagnostic tool as well as a therapeutic measure. Upon discovery of the partial tear, the surgery was easily converted to an open procedure and the tendon tear was repaired.

Our Arthroscopy Suite Page contains live video of arthroscopic surgeries on various areas of the body. This will help to demonstrate how a joint can be cleaned in order to help restore range of motion and decrease pain.

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