Ankle Arthroscopy

Diagnosis:

Impingement/Osteochondral lesion/Loose Body/ Scar tissue

Surgery:

Ankle Arthroscopy
+/- Debridement of bone or soft tissue impingement +/- Treatment of OCD

Hospital stay:

Day surgery

Post operative orders:

Keep dressing clean and dry
If bandages only: May remove outer bandages after 72 hours. Leave underlying dressings on until wound review in office at 2 weeks. These are waterproof so you may shower, but do not soak in the bath/hot tub
If plaster backslab: Leave intact – do not remove. Keep clean and dry at all times. Elevate: as much as possible
Ice: at least 3 times per day 20 mins on, 20 mins off (ice should not be directly contacting skin)

Wounds:

Please keep the wounds with any dressings applied at the time of surgery clean and dry and intact.
The dressings will be changed at the time of first review in the office, 10-14 days post surgery.

Signs of infection:

Increased redness, swelling, malodorous discharge or persistent wound ooze, feeling unwell, fever. If these occur please contact the office straight away.

Weight bearing Status:

Full/Partial weight/Non weight bearing with crutches/knee scooter and limit time on foot.

Exercises:

Gentle ankle ROM as directed

Driving:

Casts/boots and strong pain medications can interfere with your ability to drive.
You must be able to safely operate the vehicle including the accelerator, brake and clutch pedals at all times and respond in the event of an emergency
Minimum 3-6 weeks if the driving foot was operated on When safely weight bearing without crutches
When off strong pain medications
DVT (Deep Venous Thrombosis or blood clots) prophylaxis:
100mg aspirin whilst NWB 2 weeks/6 weeks OR other anticoagulation:

Exercises:

Gentle ROM exercises of ankle
Toe stretches. Upper body and core work.

Commence physiotherapy:

This will be advised. It is determined by the nature of your surgery and rehabilitation required.

Pain medication:

Strong pain medication may be prescribed on discharge from hospital. In general this will not be required for >1 week. It is important to take pain relief as required to stay comfortable post surgery.

Many patients will have a regional nerve block in addition to general Anaesthetic. It is important to take pain medication before this has completely worn off to remain in control of your postoperative pain.

Change to simple pain medication when the pain has reduced e.g. panadol/ panadeine

No Alcohol or driving whilst taking strong pain medication Narcotics eg Endone are not prescribed in the office.

Swelling:

Expected to decrease when elevated
May have persistent or intermittent swelling for up to 2 years post surgery

Return to Sports:

Determined by injury/surgery/recovery
Return to most activities by 3 months. May be longer depending on the surgery.

Travel:

It is usually safe to travel short distances on a plane or longer distances in the car 1 week after surgery
You may experience increased swelling
It is more difficult to get around the airport and plane. You will need assistance.

If there is any concern regarding DVT then air travel or long car travel is not advised. In general long haul flights should be avoided for at least 3 months post surgery.

Please take usual precautions for healthy travel such as elevation of the limb, regular movements of the limb and moving around the cabin, stay well hydrated and avoiding alcohol. Additional DVT prophylaxis may be required.
Please discuss any travel plans prior to your surgery

Follow up:

2 weeks – Wound review. Removal of sutures +/- CAM Boot. Determine ongoing WB status
6 weeks – May require repeat X-rays. Determine ongoing WB status 12 weeks – Review +/- X-rays or additional imaging.

Concerns:

Please contact the office (during working hours) or attend your nearest Emergency Department with any concerns e.g. increased leg swelling despite elevation for 30 mins, pain in calf, chest pain, shortness of breath, wound ooze, increasing pain despite pain relief.