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Ankle arthroscopy: 23 Hour Unit

Welcome

At Mater Health Services we understand that being in hospital can be a very stressful experience. This booklet aims to alleviate some of your concerns in keeping with our Mission to offer compassionate, quality care that promotes dignity while responding to patients’ needs. It explains briefly the events that may occur during your visit and the things to expect when you are discharged from the hospital.

Each person may require different treatments. This booklet is intended as a guide only.

If you have any questions about your treatment please ask your doctor or nurse. Our pastoral care team offers a caring support network to all patients. The dedicated members of this team will visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.

Ankle arthroscopy

When an ankle problem fails to respond to physiotherapy, medication or other non-surgical treatments, an ankle arthroscopy is performed. An arthroscopy can be both diagnostic, where a diagnosis can be made to find out what is wrong with the ankle joint, and therapeutic, where correction of the injury or problem is made within the ankle joint.

Two or three puncture wounds are made around the ankle and an arthroscope is inserted through these wounds to allow the surgeon to see and operate inside the joint. Both soft tissue and bone can be operated on.

Expected length of hospital stay

The day following your surgery you will be transferred anytime from 7 am to the Transit Lounge then discharged at the pre-arranged time.

After your operation

  • You will stay in the recovery room, in the theatre suite, after your operation while you waken from the anaesthetic. You will be transferred on your bed to your room in the Day Procedure Unit.
  • You will have a dressing over your wound. It may be necessary for you to have a drain in place to remove excess fluid from the site of your operation
  • Your nurse will take frequent observations of your vital signs (e.g. temperature, pulse, blood pressure) dressings/drains and wound (colour, warmth, sensation and pulses) for several hours after the surgery. As you become fully recovered, these become less frequent but remain regular until you leave hospital.
  • Immediately following your surgery, you will be resting in bed. When you feel well enough you will be assisted the first time you get out of bed. You will be instructed on how much weight-bearing you can do according to your doctor’s orders.

The following exercises help prevent complications such as chest infections and blood clots in your legs. You should do these every hour that you are awake while resting in bed.

Breathing exercises: take five long and slow deep breaths. Each breath should be deAnkle Arthroscopyeper than the previous breath. Think about getting the air to the very bottom of your lungs.

Circulation exercises: on your unaffected side firmly move your ankle up and down to stretch and contract your calf muscle. On the side which had the arthroscopy move as much as is comfortable.

  • About four hours after you return to the ward, your nurse will assist you to have a wash.
  • You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.
  • If you have pain or nausea, please tell your nurse as there are medications which can be given to relieve this. It is important to be comfortable.
  • The drip (IV) is necessary to maintain your fluid intake. This will be removed when you are tolerating adequate amounts of oral fluids.

In preparation of going home

  • Your nurse will discuss your follow-up appointment and any discharge arrangements that have been made with you.
  • Discharge information will be given to you and your nurse will discuss this with you. If you have any questions, please do not hesitate to ask.
  • A full assessment will be made prior to transferring you to the Transit Lounge in preparation for discharge to ascertain your condition is safe for you to go home.
  • You will be transferred to the Transit Lounge anytime from 7 am, the morning following your surgery. This is where you will wait for your transportation home. Those picking you up will find the Transit Lounge:
    • on the fourth floor of Mater Hospital Brisbane
    • just inside the ambulance entrance
    • opposite the waiting area for the Emergency Department.
  • It is still recommended to perform deep breathing, coughing and leg exercises while you are resting in bed.
  • You will recommence your normal medications.
  • Please tell the nursing staff if you have any pain so that they may give you medication to help relieve it.

What to expect

Recovery from your ankle arthroscopy takes place in the 23 hour unit as well as in your home.

  • Once you have recovered from the anaesthetic you will be encouraged to be active and move as soon as possible. This reduces complications developing of joint stiffness and deep vein thrombosis.
  • It is normal to take ankle physiotherapy exercises, walk up and down stairs and cover a gentle distance just a few hours after surgery.
  • By the time you are ready to go home you will:
    • have a simple wound dressing and a bandage over your ankle
    • be eating an drinking normally
    • be walking unaided
    • have your pain controlled on mild pain medication.

What you can do

  • Eat well by maintaining a high-calorie, high-protein diet for optimal wound healing (meat, eggs, cheese , milk and soya-beans).
  • Weight bear as directed by your doctor.
  • Look after your wound by looking for signs of redness, excess swelling or drainage; follow your doctor’s instructions regarding dressing and wound care. Swelling of foot or wound may persist for several months.
  • Elevate leg for first 48 hours. Place leg in correct alignment.
  • Maintain personal hygiene while keeping your dressings dry (hint: place your foot in a plastic bag and tape this securely to your leg).
  • Maintain home exercise program as instructed.

What to avoid

  • keeping on your feet for a prolonged period of time
  • avoid putting anything down your cast if you have one.

Contacts

Please contact either your General Practitioner (GP); the Mater Hospital Brisbane Procedure Unit on 07 3163 8496; or the Mater Hospital Brisbane Emergency Department on telephone 07 3163 8111, IMMEDIATELY if you experience any of the following after discharge:

  • fever and chills
  • increased redness, swelling or drainage at the wound site.
  • increased pain that is unrelieved by pain medication
  • swelling unrelieved by elevating leg for at least one hour
  • Problems relating to your cast:
    • toes are cool, swollen, have a change in colour or decrease in sensation
    • is redness and irritation of the skin at edges of, and pressure points, in the cast
    • increase in drainage or foul odour from the wound.

Post ankle arthroscopy exercises

Day of surgery

  • Keep your operated leg elevated as much as possibleankle
  • Commence hourly exercises—toe wriggling, thigh squeezes and bottom squeezes.

Plantar and dorsiflexion

Lying on your back point your toes down then pull your toes back towards you.

Inversion/eversion

Lying on your back, turn the soles of your feet towards each other, then turn your feet away from each other while keeping your knees facing the ceiling.

Walking

Attempt to walk with as much weight through your leg as you are allowed. Usually you are allowed to take full weight through your leg—if not, crutches may be necessary. Place the heel of your operated leg down on the ground before the toes.

towelDay one and two

Continue with the above exercises as well as a calf stretch using a towel.

  • Sit with one leg straight out in front of you. Put a towel around your foot. Push down into the towel against resistance. Hold for five seconds.
  • Gently pull the towel back and feel the stretch in your calf. 
  • Hold for 15 seconds.

Day three

Change your exercise routine to three to four sessions per day, performing a minimum of 30 repetitions of each exercise every session.

Keep walking to a minimum for the first four to five days.

If your ankle becomes more tender and swollen, ease back on your walking and use cold packs regularly. Contact the hospital/ward if swelling does not settle.

No sport, running or squatting until you have consulted your doctor or physiotherapist. Gradually increase your level of activity.

Day five

Daily dressing, apply a layer of tubi-grip over your ankle.

balance

Balance exercises

Stand on your operated leg while keeping your eyes open, trying to keep your balance for as long as possible.

Continue standing on your operated leg progressing now to closing your eyes, trying to keep your balance for as long as possible.

Safe use of crutches

Standing

To stand place your crutches forward and in a straight line, lean on your hands and your un-operated leg.

Walking

Non-weight bearing: with your crutches forward, lean on your hands and swing your body through to land on your un-operated foot.

Partial weight bearing: your surgeon will let you know when to start taking some weight through your operated leg.

Sitting

To sit move backward to the chair until it can be felt by your un-operated leg. Slide the crutches out and hold them in one hand. Hold the arm of the chair with your other hand and gently sit. Place your operated leg on a stool when sitting to prevent swelling.

Stairs

Never vary this sequence when using the stairs:

Going up the stairs: un-operated leg—operated leg—crutches

Going down the stairs: crutches—operated leg—un-operated leg

Be careful to place the crutches well apart and in the middle of the stair. Use the handrail with two crutches under one arm whenever possible.

Note: Never lean or take weight through your armpits—always through your hands.

Seek medical advice immediately if you develop pins and needles in your hands or fingers. Remember, if your doctor wants you to use crutches he does so for a good reason—follow his advice strictly.

All crutches are the property of Mater Hospital Brisbane. Returning them promptly, when you no longer require them, allows this service to continue for others.

Acknowledgments

Staff of Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Q 4101

Mater Hospital Brisbane

Raymond Terrace, South Brisbane Q 4101

Telephone: 07 3163 8111

Mater South Bank campus

© 2010 Mater Misericordiae Ltd. ACN 096 708 922

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420004
Last modified 08/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 04/8/2015
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