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Introduction

An active lifestyle often comes with its share of wear and tear. The ankle, a complex joint that bears significant weight and facilitates movement, is particularly susceptible to cartilage damage. This damage can lead to pain, stiffness, and difficulty with everyday activities. At Prisk Orthopaedics and Wellness, PC, we understand the frustration and limitations associated with ankle cartilage issues. Arthroscopic ankle cartilage surgery offers a minimally invasive approach for repair and restoration, potentially leading you back to an active life.

Understanding Cartilage Damage in the Ankle

Cartilage, a smooth, white tissue covering the ends of bones, acts as a shock absorber and lubricant in joints like the ankle. When this cartilage is damaged or torn, it can expose the underlying bone, causing pain, inflammation, and a grinding, catching or locking sensation. Three common types of cartilage lesions can affect the ankle:

  • Traumatic Osteochondral Lesions: These occur due to a sudden impact, such as a sports injury or a fall. The impact can cause a piece of cartilage and underlying bone to detach from the joint surface.
  • Osteochondritis Dissecans Lesions: These develop over time due to repetitive stress on a specific area of the ankle joint. This repetitive stress can lead to a fragment of cartilage loosening and potentially separating from the bone. They can also be congenital, meaning you are born with the defect.
  • Osteoarthritis: This is a degenerative condition where the cartilage thins and wears away progressively. Age, previous injuries, and repetitive stress can all contribute to the development of osteoarthritis in the ankle.

Symptoms of Ankle Cartilage Damage:

  • Pain, especially with weight-bearing activities like walking or running.
  • Swelling and stiffness in the ankle joint.
  • Difficulty flexing or extending the ankle fully.
  • Catching or locking sensation in the joint.
  • Instability or weakness in the ankle.

Treatment Options for Ankle Cartilage Lesions:

The treatment approach for ankle cartilage damage depends on several factors, including the severity and type of lesion, your age and activity level, and overall health. At Prisk Orthopaedics and Wellness, PC, we believe in a comprehensive approach, focusing on both non-operative and operative options to achieve the best possible outcomes.

Non-Operative Treatment:

  • Rest, Ice, Compression, and Elevation (RICE): This initial approach helps reduce inflammation and pain.
  • Physical Therapy: Strengthening exercises and flexibility training can improve stability and range of motion in the ankle joint.
  • Anti-inflammatory medications: Over-the-counter pain relievers and medications prescribed by your doctor can help manage pain and inflammation.
  • Footwear modifications: Supportive shoes or braces can help offload pressure on the affected joint.

When Surgery Becomes Necessary:

If non-operative measures fail to provide adequate pain relief or improve joint function, arthroscopic ankle cartilage surgery may be recommended. This minimally invasive procedure utilizes a small camera (arthroscope) inserted into the joint to visualize the damage. Specialized tools are then used through other tiny incisions to address the cartilage issue.

Types of Arthroscopic Ankle Cartilage Surgery:

  • Debridement: This procedure involves removing loose fragments of cartilage and smoothing out any rough edges of the joint surface.
  • Microfracture: Tiny holes are drilled into the underlying bone to stimulate the growth of new cartilage-like tissue.
  • Osteochondral Autograft Transfer System (OATS): Healthy cartilage is harvested from a non-weight-bearing area of the knee and transplanted to the damaged area in the ankle. This often requires a more extensive open procedure.
  • Autologous Chondrocyte Implantation (ACI): Involves harvesting healthy cartilage cells, growing them in a lab, and then implanting them back into the damaged area. Currently, this is not covered by insurance.
  • Allograft Chondroplasty: This involves the use of donor cartilage to restore cartilage in larger defects. This can be done with a fresh donor graft or preserved grafts that are either structural or particulate (DeNovo, Biocartilage).

Impact of Lesion Size on Surgical Outcomes:

The size of the cartilage lesion plays a significant role in determining the type of surgery recommended and the potential outcomes.

  • Smaller Lesions: Procedures like debridement or microfracture may be suitable for smaller lesions, often leading to good patient satisfaction and a return to previous activity levels.
  • Larger Lesions: Larger lesions may require more complex procedures like OATS or ACI to achieve optimal results. These procedures can have longer recovery times and may not guarantee a complete return to pre-injury activity levels.

Recovery after Arthroscopic Ankle Cartilage Surgery:

Following surgery, you can expect a period of immobilization in a splint or cast to allow for initial healing. Physical therapy plays a crucial role in regaining strength, flexibility, and range of motion in the ankle joint. Recovery times can vary depending on the type of surgery performed and the extent of the damage.

**At Prisk Orthopaedics and Wellness, PC, we are committed to providing personalized care for your ankle cartilage issues. Dr. Prisk will work with you to determine the most appropriate treatment plan, whether non-operative or surgical. (EXPLORE THE BLOG ON THE BIOLOGICAL TREATMENTS AVAILABLE)