The Foot and Ankle Clinic

Arthroscopic joint debridement

What is it?   |  In principle how does it work?   |  What does the inside of a "salvageable" joint look like?   |   When/in whom is it likely to be useful?   |  How likely is it to improve my pain?   |   How long will it last?   |  Why not a permanent operation now if the long term effects are not predictable?   |  Will it effect any other operations later?   |   What are the potential complications?   |  The operation

 

What is arthroscopic joint debridement?
This is minimally invasive surgery to the lining of the ankle joint (the area predominantly effected by arthritis).
Go to the "Ankle Arthroscopy Section" for a full description of the operative technique, reasons for minimally invasive surgery to the ankle and the post-operative course.

In principle how does it work?
It works by removing areas of loose, mechanically redundant cartilage (joint lining) and inflamed tissue (synovitis) from the joint.
Occasionally there may be "spurs" of bone (osteophytes) at the front of the joint which "dig" at the front of the ankle when walking. These can also be removed as can loose fragments of bone within the joint, which can cause the joint to jar or "give way".

talar osteophyte(arrow)

Talar osteophyte(arrow)

What does the inside of a "salvageable" joint look like?
Dgx1

When/in whom is arthroscopic joint debridement likely to be of use?
This is a procedure really likely to be of use only in mild to moderate arthritic cases. It is not a precise science advising when one is in this category. The typical patient has symptoms which are not too severe, probably limited to pain when putting weight through the joint, and there is some reasonable joint space left on weight bearing x-rays.

early ankle arthritis with sclerosis

an osteophyte(spur)

A case of early ankle arthritis with sclerosis (thickening of the bone around the joint) (1), and an osteophyte (spur) (2).

How likely is this procedure to improve my pain?
Approximately 75% chance of improving pain. It is important to be clear that the operation is unlikely to leave the patient free of all pain, but is likely to improve things significantly.
It is also important to realise that there is a risk, of the order of 15%, that arthritic symptoms can be worsened to the extent that a fusion is required.

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