Arthroscopy of the Foot and Ankle

Arthroscopy is a minimally-invasive procedure which allows access to the joints of the body for diagnosis and treatment through small portals (incisions that allow access to the joints for the placement of cameras and instruments). Tendoscopy is a similar procedure that allows for evaluation of the tendons of the foot and ankle. Arthroscopy and tendoscopy of the foot and ankle has advanced significantly due to the improvement in technology and surgical techniques, allowing for less invasive surgery and quicker recoveries for many conditions. Dr. Vora is an instructor in the treatment of foot and ankle arthroscopy and tendoscopy and as such, teaches other foot and ankle surgeons and orthopaedic surgeons on the minimally-invasive treatment of such conditions.

Minimally invasive foot and ankle surgery
Many of the commonly performed foot and ankle surgical procedures traditionally required large, extensive incisions to allow for exposure of the injury and necessary surgical treatment. With the improvement in technology and surgical techniques, many of the procedures that were traditionally performed through open, large incisions can now be performed arthroscopically or through small minimally-invasive incisions which may lead to improved outcomes and quicker recoveries. The ankle joint, subtalar joint (joint under the ankle joint) and other joints of the foot and ankle now can be evaluated using small poke hole incisions in the skin to allow for the placement of a small camera and a separate poke hole to place instruments into the joint and treat the abnormality present. Some procedures are ankle arthroscopy for the treatment of cartilage defects, fusions (gluing together of the joint) of the ankle joint and hindfoot joints without any large incisions, percutaneous minimally-invasive Achilles tendon repairs, and many other techniques. Whenever possible, Dr. Vora prefers utilizing minimally-invasive techniques in order to speed recovery and allow patients to get back on their feet quickly.
 

Ankle arthroscopy
Ankle arthroscopy is a procedure that can be performed as an outpatient which allows for an extensive evaluation of the entire ankle joint and can be utilized for the treatment of many of the most common problems of the ankle joint. These include osteochondral lesions of the ankle (cartilage “chip” fractures of the ankle), soft tissue scarring of the ankle, evaluation of joint to assure appropriate alignment of the joint with the treatment of fractures of the foot and ankle, ankle arthrodesis (fusion of the ankle joint), removal of loose bodies and fragments, and many other conditions. This procedure is minimally invasive, usually associated with minimal pain, and can lead to quicker recovery than may be associated with open procedures. Usually two poke hole incisions are necessary approximately 5 mm in length along the front of the ankle joint and in some scenarios when further evaluation of the back of the ankle joint is necessary, a third 5 mm incision is placed in the back outside part of the ankle. These poke holes allow for the placement of the camera to view the joint, instruments to treat the ankle joint abnormalities, and appropriate exposure to the abnormalities allowing appropriate access and avoiding damage to the normal structures of the ankle. This procedure can be performed under a regional anesthetic (leg numbed) and twighlight anesthesia. The associated recovery is dependent upon the type of abnormality being treated. Most patients can immediately walk on the ankle after surgery, while other require a period of non-weight bearing to allow the bone or condition being treated to heal appropriately. The pain associated with this type of procedure is generally minimal and allows patients to return to activity and work relatively quickly. Dr. Vora is an instructor in the treatment ankle arthroscopy and tendoscopy and as such, teaches other foot and ankle surgeons and orthopaedic surgeons on the minimally-invasive treatment of this condition and is one of his special interests. Dr. Vora is currently performing studies evaluating the outcomes after many arthroscopically treated conditions of the ankle.
 

Subtalar arthroscopy
Subtlalar arthroscopy (arthroscopy of the joint under the ankle joint) is a procedure that can be performed as an outpatient which allows for an extensive evaluation of the subtalar joint and can be utilized for the treatment of many of the most common problems of this joint. These include osteochondral lesions of the subtalar joint (cartilage “chip” fractures of the ankle), soft tissue scarring of the joint, evaluation of joint to assure appropriate alignment of the joint with the treatment of fractures of the foot (i.e. calcaneus fracture), subtalar arthrodesis (fusion of the subtalar joint), removal of loose bodies and fragments, and many other conditions. This procedure is minimally invasive, usually associated with minimal pain, and can lead to quicker recovery than may be associated with open procedures. Usually two poke hole incisions are necessary approximately 5 mm in length along the side of the foot. These poke holes allow for the placement of the camera to view the joint, instruments to treat the subtalar joint abnormalities, and appropriate exposure to the abnormalities allowing appropriate access and avoiding damage to the normal structures of the joint. This procedure can be performed under a regional anesthetic (leg numbed) and twighlight anesthesia. The associated recovery is dependent upon the type of abnormality being treated but generally immediate weight bearing is allowed. The pain associated with this type of procedure is also generally minimal. Dr. Vora is experienced in performing this procedure for patients who meet the appropriate criteria and is an instructor in the treatment of arthroscopy of this joint and teaches other foot and ankle surgeons and orthopaedic surgeons on the minimally-invasive treatment of this joint.
 

Tendoscopy of the foot and ankle
Tendoscopy of the foot and ankle is a minimally-invasive procedure that can be utilized to look at the tendons of the foot and ankle through two small poke hole incisions in the skin and passing a camera and a probe into the tendon lining to examine the tendons thoroughly. This can help diagnose problems of the tendons when this is suspected clinically but other testing has not been able to reveal a tendon tear. This is also a very useful procedure to treat “scar tissue” surrounding an intact tendon, allowing the area surrounding the tendon to be cleaned surgically with a shaver without the need to create any large open incisions, minimizing complications and expediting the recovery. This has been a procedure that has been particularly beneficial for certain areas of the foot and ankle such as around the peroneal tendons and the Achilles tendon. Dr. Vora is experienced in performing this procedure for patients who meet the appropriate criteria and is an instructor in the treatment of tendoscopy and teaches other foot and ankle surgeons and orthopaedic surgeons on the minimally-invasive treatment of tendons of the foot and ankle utilizing this technique.