Ankle arthroscopy is not performed in many centres. However the particular requirements and specific injury patterns of military personnel mean that I have extensive experience of these procedures. Two small cuts are made on the front of the ankle and a camera inserted. Good views can be obtained of any cartilage damage or wear and tear – these can be trimmed or microfractured. Sometimes bits of joint lining (synovial tissue) can get stuck in the ankle and cause sharp stabbing pains – these may also be trimmed. Again I will take pictures (or a video if you wish) of everything I see and do in your ankle. At the end of the procedure, you will have two stitches in the ankle, the ankle will be filled with local anaesthetic and a bandage applied. You can go home that day. A few days off work is best to recover.

If your ankle is unstable and physiotherapy has not helped, an ankle ligament reconstruction may be performed.

An MRI scan will usually have been performed and this will tell me how many of the (three) ligaments have been damaged. After discussion with you, we can then plan to repair these in an anatomical manner (A Brostrom-Gould repair). You will be in a plaster for three weeks and a brace for another three weeks if I perform such a repair. The results are generally good, especially when the repair is performed early as significant recurrent inversion injuries cause excessive joint wear.