Foot & ankle surgery · London
Ankle arthroscopy, by a specialist foot and ankle surgeon.
Keyhole surgery for anterior impingement, OLT cartilage lesions and posterior os trigonum. A 4.0 mm 30 degree scope through 5 mm portals, day case, matched to the right surgeon for the right lesion.
Why patients choose us
- 01
A specialist foot and ankle surgeon, high arthroscopy volume
Not a general orthopaedic list. A named consultant with a portal-anatomy record and a real cartilage practice.
- 02
The right operation for the lesion
Anterior impingement, OLT and posterior os trigonum are three different operations. We match the surgeon to the lesion, not the other way round.
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Independent, and free to you
We are paid by no clinic and no surgeon. The recommendation is impartial and costs you nothing.
Indicative pricing
What private ankle arthroscopy costs in London.
Ranges across our London panel. Send the MRI and we quote firm figures for two or three options within one working day.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Consultation and MRI review | £250 to £450 | 30 to 45 min | Same visit |
| Diagnostic arthroscopy and debridement | £6,500 to £10,500 | 45 to 60 min | Day case |
| Anterior impingement, footballer ankle debridement | £7,500 to £11,500 | 45 to 75 min | Day case |
| OLT microfracture (with or without BMAC) | £8,500 to £14,000 | 60 to 90 min | Day case |
| MACI or osteochondral graft for OLT | £14,000 to £24,000 | 75 to 120 min | Day case or 1 night |
| Combined arthroscopy and lateral ligament repair | £8,500 to £13,500 | 75 to 120 min | Day case |
| Posterior arthroscopy for os trigonum or FHL release | £7,500 to £12,500 | 60 to 90 min | Day case |
Prices vary by hospital (Fortius Foot & Ankle, London Foot & Ankle Centre, HCA Wellington, ISEH at UCLH, Chelsea and Westminster Private), by surgeon and by whether a lateral ligament repair or graft is added.
The journey
From MRI to return to sport, what happens, in order.
One concierge from the first message to the last physio review.
- 01
Before
You send us your MRI and history
A short confidential form. Where it hurts, what stops you playing, and your MRI report or images if you have them.
- 02
Before
We come back with a recommendation
Within one working day: whether arthroscopy fits, or whether a lateral ligament repair, ankle replacement or non-operative pathway is the better call.
- 03
Before
Consultation and consent
A named foot and ankle surgeon, in person or on video. Portals, technique, rehab and honest risks.
- 04
On the day
Arrival at the hospital
Day-case admission, consent and a chat with the anaesthetist. General anaesthetic with a popliteal or ankle block for the first 12 to 24 hours.
- 05
On the day
The arthroscopy itself
45 to 90 minutes. Anteromedial and anterolateral portals for the front; posteromedial and posterolateral for the back. 4.0 mm 30 degree scope, shaver, RF, awls.
- 06
On the day
Home the same day
A short recovery, CAM boot fitted where needed, and home within a few hours. You will need someone to collect you and stay overnight.
- 07
After
Rehab and return to sport
Physio from day 5 to 10. Impingement: immediate full weight bearing, sport at 6 to 12 weeks. OLT: 2 weeks partial weight bearing in a boot, sport at 4 to 6 months.
When it helps
The lesions ankle arthroscopy is built for.
Anterior, posterior and cartilage. Where a scope earns its keep, and where it does not.
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Anterior ankle impingement (footballer ankle)
Anterior bony or soft-tissue block on dorsiflexion. Debridement of tibial and talar osteophytes and synovium restores clearance.
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Osteochondral lesion of the talus (OLT)
A cartilage or subchondral defect on the talar dome, usually medial. Treated by size and depth: microfracture, MACI, mosaicplasty or allograft.
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Loose bodies and chondral flaps
Catching, locking or giving way from a free fragment. Retrieval with a grasper and shaver is straightforward and definitive.
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Posterior impingement, os trigonum, Stieda
Posterior pain on plantarflexion in dancers and footballers. Posterior portals give direct access to the os trigonum and FHL sheath.
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Chronic synovitis
Persistent swelling and pain without a discrete lesion. Synovectomy with the shaver and RF settles inflammatory or post-traumatic cases.
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Ankle instability with lateral ligament repair
Recurrent giving way after ATFL and CFL injury. Arthroscopy first for co-pathology, then arthroscopic or open Brostrom repair.
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Peroneal tendon pathology (as an adjunct)
Split tears and tenosynovitis addressed alongside the intra-articular work through a small lateral incision.
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Red flag: septic arthritis
A hot, swollen, painful ankle with fever needs urgent arthroscopic washout and IV antibiotics, not a private waiting list.
OLT decision framework
Size on MRI drives the operation.
Every talar dome lesion has a right answer, and it is not always microfracture. Depth, containment and prior surgery matter too.
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<1.5 cm2 OLT: microfracture
The workhorse for small lesions. Awls perforate subchondral bone, marrow elements form fibrocartilage. 70 to 85% good outcomes at 5 years.
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1 to 2 cm2 OLT: microfracture plus BMAC
Bone marrow aspirate concentrate augments microfracture for mid-size lesions. Better fill on follow-up MRI, cleaner AOFAS scores.
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>2 to 3 cm2 OLT: MACI or OATS
Matrix-associated chondrocyte implantation or osteochondral autograft. Two-stage for MACI. Sport at 4 to 6 months. 80 to 90% durable at 10 years.
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Cystic OLT: retrograde drilling and graft
A subchondral cyst under an intact cap is drilled from below and grafted, preserving the joint surface.
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Anterior impingement: debridement
Osteophyte and soft-tissue resection through anteromedial and anterolateral portals. 85 to 95% good outcomes at 5 years.
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Posterior impingement: os trigonum
Prone posterior arthroscopy removes the os trigonum or Stieda process and releases FHL tenosynovitis. 85 to 95% return to dance at pre-injury level.
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Loose body removal
A short, high-yield operation. Symptoms of catching and locking resolve immediately in most patients.
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Septic arthritis washout
Arthroscopic lavage, synovectomy and drainage. Combined with targeted IV antibiotics under microbiology guidance.
Our London network
A small panel of foot and ankle surgeons, we picked them.
Fortius Foot & Ankle, London Foot & Ankle Centre, HCA Wellington, ISEH at UCLH Sports and Chelsea and Westminster Private. Introductions made privately, once we understand your case.
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Consultant foot and ankle surgeons on the BOFAS register with high arthroscopy volumes
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Cartilage practice: microfracture, MACI, OATS and allograft under one roof
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Prone posterior arthroscopy capability for os trigonum and FHL work
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Physiotherapy pathway aligned to your rehab protocol from day 5
Safety and rehab
Risks and recovery, honestly.
Superficial peroneal nerve, wound, DVT and CRPS are the things we plan around. Rehab is protocol-driven from day 5.
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Superficial peroneal nerve injury
The commonest neurological risk from the anterolateral portal. Careful transillumination and blunt dissection at portal placement minimises the risk to below 2%.
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Wound and portal problems
Small 5 mm portals usually heal invisibly. Superficial infection or a persistent portal sinus occurs in 1 to 2% and settles with dressings and antibiotics.
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DVT and thromboembolism
Low but real after any lower-limb surgery. Mechanical prophylaxis on the day, chemical prophylaxis if you have risk factors, and early mobilisation.
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CRPS (complex regional pain syndrome)
Under 1% incidence. Early recognition and physiotherapy-led desensitisation with pain-team input if it happens.
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OA progression
Arthroscopy treats impingement and cartilage lesions but does not reverse established arthritis. Where OA is advanced, ankle replacement or fusion is the honest conversation.
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CAM boot for 2 weeks after OLT
Partial weight bearing on crutches for 2 weeks in a CAM boot after microfracture or MACI. Immediate full weight bearing after simple impingement debridement.
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Physio from day 5 to 10
Range of motion, calf work and proprioception. A written protocol is sent to your physiotherapist before you leave the ward.
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Return to sport timeline
6 to 12 weeks for anterior impingement. 4 to 6 months for OLT cartilage work. Ballet return after posterior os trigonum: 10 to 12 weeks.
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Red flags after discharge
Fever, calf swelling, worsening pain, spreading redness or a leaking portal. Call the unit or attend A&E the same day.
Recognised by major UK insurers
Cover for ankle arthroscopy varies by insurer and by indication. We confirm cover before booking.
Frequently asked
Everything we get asked about ankle arthroscopy.
Recovery, OLT algorithm, cost and complications.
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What is ankle arthroscopy?
Ankle arthroscopy is keyhole surgery of the ankle joint. A 4.0 mm 30 degree telescope is inserted through 5 mm portals, usually anteromedial and anterolateral for the front of the joint or posteromedial and posterolateral for the back. Working instruments (shaver, radiofrequency probe, awls) address impingement, cartilage lesions, loose bodies and synovitis. It is a day-case operation done under general anaesthetic with a regional block.
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How long does recovery take?
For a simple anterior impingement debridement, full weight bearing is immediate and most patients return to running at 6 weeks and pivoting sport at 8 to 12 weeks. For an OLT microfracture you are partial weight bearing in a CAM boot for 2 weeks, cycling at 6 weeks and back to sport at 4 to 6 months. Posterior os trigonum surgery in dancers typically allows barre work by 8 weeks and full class by 10 to 12 weeks.
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How much does private ankle arthroscopy cost in London?
A diagnostic arthroscopy with debridement is £6,500 to £10,500. Anterior impingement is £7,500 to £11,500. OLT microfracture (with or without BMAC) is £8,500 to £14,000. MACI or osteochondral grafting for a larger OLT is £14,000 to £24,000. A combined arthroscopy and lateral ligament repair is £8,500 to £13,500. We confirm firm figures for two or three options within one working day.
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How is an OLT decided between microfracture, MACI and grafting?
Lesion size on MRI drives the algorithm. Under 1.5 cm2: microfracture. 1 to 2 cm2: microfracture plus BMAC or a matrix scaffold. Over 2 to 3 cm2: MACI, mosaicplasty (OATS) or fresh osteochondral allograft. Cystic lesions under an intact cap are treated by retrograde drilling and bone graft. Depth, containment and prior surgery also matter, which is why a specialist review of the MRI is worth doing before you commit.
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What are the risks?
The commonest is a superficial peroneal nerve neurapraxia from the anterolateral portal, usually transient. Wound problems occur in 1 to 2%. DVT is uncommon but not zero. CRPS is under 1%. Arthroscopy does not reverse established osteoarthritis, and where OA is advanced the honest conversation is about ankle replacement or fusion rather than a scope.
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Which London centres do you work with?
Fortius Foot & Ankle, London Foot & Ankle Centre, HCA Wellington, ISEH at UCLH for sports cases, and Chelsea and Westminster Private. Consultants are selected for BOFAS registration, arthroscopy case volume and a genuine cartilage practice covering microfracture, MACI, OATS and allograft.
Match with a foot and ankle surgeon
Send the MRI. We come back within one working day.
Two or three surgeons, two or three fixed quotes, one honest recommendation on whether arthroscopy is the right call for your ankle.
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