Open cheilectomy of Ankle
Ankle joints sometimes become painful because of bony spurs, particularly across the front of the joint. Although we often remove these with keyhole surgery nowadays, sometimes they are simply too large to deal with that way. Removing such spurs is called cheilectomy (Greek for removal of lip, in this case the lips of arthritic bone at the edge of the joint). Open cheilectomy is performed through a short (3-4cm) incision at the front of the joint to one side or the other depending on where the spurs are largest. It is usually done under a general anaesthetic supplemented by local anaesthetic to provide good post-operative pain relief. The tendons nerves and blood vessles are gently moved to one side, the bony spurs identified and cut away, ensuring that the joint is free to move without any catching before the end of the operation. A good view of the remainder of the ankle joint is usually obtained providing information about the overall well being (or otherwise) of the rest of the ankle joint.
The wound is usually closed with dissolving sutures and a bandage applied. Part of the aims of such surgery is usually to improve the range of movement, particularly bending upwards such as when crouching. Therefore physiothearpy and exercises are encouraged as soon as possible perhaps limiting these for a week or two until the wound has healed. You will be given precise instructions by your surgeon. Usually weight bearing is permitted from the outset unless other surgery carried out at the same time prevents it. Recovery from the more severe catching pains at the front of the joint is often almost immediate but the duller discomfort consequent to any wear and tear changes and the surgery itself can take several weeks or even a few months to fully settle. With this sort of 'freeing up' surgery early activity and exercises are often the key to success.