If ankle arthritis is diagnosed when damage is mild to moderate, surgeons may perform a procedure called debridement to “clean out” any bone spurs or fragments of cartilage from the joint. Bone spurs, or osteophytes, can develop in arthritic joints when cartilage breaks down and bone rubs against bone. This friction prompts the body to create more bone to repair the damage; without cartilage to act as a buffer, the new bone spur rubs against soft tissues in the joint, causing even more pain.
Surgeons can remove bone spurs as well as stray pieces of cartilage or other soft tissue from the ankle joint using either arthroscopic surgery, which is a minimally invasive technique, or a traditional open surgery, which requires a larger incision. This decision is made by you and your surgeon, and it depends on how much bone or tissue needs to be removed from the ankle. If bone spurs or other fragments are small, an arthroscopic approach is likely to be appropriate.
In an arthroscopic procedure, a surgeon inserts a thin, flexible arthroscope—an instrument equipped with a camera and a light source—through a small incision in the ankle. The camera broadcasts images of the inside of the joint onto a monitor that a surgeon uses to guide small surgical instruments to the arthritic joint through a second small incision. The surgeon then uses these instruments to remove bone spurs or other tissue that may be irritating the joint and causing pain.
If your diagnostic X-rays indicate that the bone spurs are too big to remove arthroscopically, the surgeon performs an open procedure to access the arthritic joint directly.
Regardless of the surgical approach, debridement can lessen pain and improve the range of motion in the ankle by removing bone and tissue that interferes with the function of the joint.
Debridement is performed under general anesthesia, which means you are asleep, or spinal anesthesia, which blocks pain signals below the waist while you are awake, depending on your preference. Most people can return home using crutches on the day of surgery and must wear a splint for one or two weeks to keep the ankle stable. Your doctor schedules a follow-up appointment 10 to 14 days after surgery to ensure that your ankle is healing well.
The total recovery time after ankle debridement depends on how old you are, whether the procedure was arthroscopic or open, and how much bone or other material was removed.