Ankle arthroscopy: keyhole ankle surgery explained, with risks and recovery

The ankle joint is a tight space that is hard to assess from the outside. RNOH says arthroscopy is used to reduce pain and improve function, such as walking and sport, by treating conditions like bony spurs, loose fragments and inflamed soft tissue.

Many ankle problems never need an operation. Milton Keynes lists painkillers, physiotherapy and activity modification as alternatives, and notes they should be considered before surgery. If the cause is a stiff, worn joint rather than a specific mechanical block, keyhole surgery may not help, which is why an accurate diagnosis comes first.

Before arthroscopy, a physiotherapist can assess strength, balance and the pattern of pain, and imaging may show spurs or loose pieces. If symptoms are mainly instability or recurrent sprains, a different operation may suit better; your surgeon will explain.

• A structured rehabilitation programme for balance and calf strength, supervised by a physiotherapist.

• Footwear or support changes, such as a brace for certain activities.

• Activity pacing, particularly if the ankle is sore after impact sport.

• A second opinion if the reason for surgery is not clear.

Pre-assessment covers your general health, current medicines and the type of anaesthetic. Follow the fasting rules in your letter. Bring crutches if you already have them, a loose trouser leg or shorts, and a plan for getting home.

Arrange for someone to drive you home, try to have a friend or relative nearby for the first night, and prepare a place to rest with the leg raised, since swelling control is a large part of early recovery.

RNOH says arthroscopy is usually done under general anaesthetic, either as a day case or occasionally as an overnight stay. Milton Keynes says a spinal or regional anaesthetic that numbs the leg is an alternative, so ask if you would prefer to avoid a general anaesthetic.

The surgeon makes small cuts: RNOH says two or three puncture wounds in front of the ankle, and Milton Keynes says cuts of about 1cm at the front and/or back. A small camera and instruments are passed in, and the joint is inspected and treated. How much weight you may put through the ankle afterwards, Milton Keynes says, depends on the treatment performed.

RNOH lists infection (quoting 1 in 600), scarring, numbness or tingling and describes blood clots as rare. Milton Keynes adds ongoing symptoms and chronic regional pain syndrome, and says numbness on top of the foot or outer toes is the commonest problem, though unusual.

Persistent symptoms are also possible if the joint damage is wider than the operation can address. Ask what the operation is expected to achieve in your case and what would count as a good result.

RNOH advises elevating the leg and limiting walking for 2 weeks, then gradually increasing activity, and keeping the wounds dry for two to three weeks. Stitches come out at about 14 days.

Gentle activity can often resume about six weeks after the operation according to RNOH, while Milton Keynes says returning to your normal level of sport can take at least six months. Use your own discharge sheet for specifics, since what was done inside the joint changes the plan.

RNOH advises reporting severe pain, massive swelling, excessive numbness or pins and needles, and excessive pain, redness, swelling or discharge. Contact the hospital or GP promptly, or NHS 111 when closed. A hot, swollen, tender calf or breathlessness needs urgent help; call 999 for chest pain or severe breathlessness.

• What exactly do you expect to find and treat inside my ankle?

• Will I be allowed to put weight on the foot straight away?

• How long will I be off work, given my job?

• Which sports will be affected, and for how long?

• What if the keyhole operation does not help?

The technique is the same. Private care may mean an earlier date and a choice of surgeon, while NHS services may have longer waits for ankle surgery but follow established pathways. Ask whether physiotherapy is part of the package and whether a follow-up scan is included.