Pain after ankle sprain: treatment by arthroscopy

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Most ankle sprains or distortions heal without sequelae after 4 to 6 weeks. In some cases, however, pain and discomfort persist beyond three months, and finally bring the patient to the consultation of an orthopedic specialist.

The causes can be various:

• pain rather on the outer side of the ankle: persistent inflammatory tissue in front of the ankle joint (most common)

• pain rather on the front of the ankle especially when climbing: osteophyte (bone beak) at the edge of the tibia

• diffuse pain, internal or external: osteochondritis dissecans (detachment of a piece of bone affecting the articular surface)

• pain accompanied by loosening of the ankle and/or a feeling of instability: ligament insufficiency.

If there is still no improvement after a sufficiently long physiotherapy treatment (between 9 and 27 sessions), it is necessary to discuss doing an arthroscopy of the ankle. Like knee arthroscopy, ankle arthroscopy is performed under general or epidural anesthesia, introducing the camera and instruments through small incisions on either side of the ankle. This technique makes it possible to inspect the joint, then, if necessary, to resect the inflammatory tissue which encumbers the joint, to remove a bony beak, or other surgical gestures.

Rehabilitation is generally simple, without long immobilization, with the help of a pair of crutches for one to two weeks, and physiotherapy until complete recovery.