Indication: this procedure is used for diagnosis as well as theraputic purpose thus indication is divided into Diagnostic indication: 1) Pain, swelling, stiffness, instability of the ankel joint that remain unexplained. 2) locking and popping symptoms of ankle joint Therapeutic Indication: 1) articular or soft tissue injury. 2) soft tissue or bone impingement and instability. 3) Inflammation of lining membranes of the joint(Synovitis). 4) inflammation of tendons (tendinitis) 5) Joint infection (septic arthritis) 6) Surgical immobilization of joint (arthrodesis) 7) Adhesion inside joints (intra articular bands) Contraindication: Absolute contraindication: 1) Active local soft tissue infection. 2) Severe degenerative (Wear & tear) joint disease. 3) Poor vascular supply the leg. Relative Contraindication: 1) Moderate degenerative (wear and tear) joint disease. 2) Severe Edema (swelling). Procedure: it is usually performe when conservative measurement fails to treat the underlying condition.These includes use of pain medication like (NSAIDS), Ankle braces, heel lift or wedge Patient preparation involve history examination and blood test including CBC(complet blood count) with ESR(erythrocyte sedimentation rate) , C-reactive protein (CRP), coagulation profile , in case of infection joint aspiration is done for culture and sensitivity, radiological investigation like X-ray, Ct-scan and MRI. After proper analgesia and anesthesia either local or Regional, a blood less field is achieved by the use of the tourniquet just above the ankle or by using high inflow out flow system that also improve visualization and irrigate the debris material.Small incisions are then made for portals, which are small tubes which are placed in different area around ankle for the instruments and camera to be placed in. after that the surgeon the perform the procedure like removal of inflamed synovial membranes and debris after ankle joint soft tissue or bone injury. at the end the portals and instruments are removed and the small incisions are stitched closed and bandaged. After procedure depending upon the patient condition and surgeons choice some are allowed to bear weight with crutches while others may be placed in an immobilizer for as long as six weeks.In case of extensive surgery or remodeling ankle is put in cast to prevent early mobilization and promote healing and if arthroscopy is performed only for diagnostic purpose simple splint is enough.
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