Ankle Arthroscopy
at Aster MIMS Kannur
An ankle that keeps giving way, pinches when you squat or remains painful after an injury deserves a careful assessment. Rehabilitation, activity changes and bracing can help many problems. When symptoms persist and the diagnosis supports surgery, options may include arthroscopy, ligament repair or treatment of a cartilage lesion.
Medically reviewed by Dr. Vishnu Baburaj, MS Ortho (PGI Chandigarh), MRCS (UK) · Last updated July 2026
When does the ankle need surgery?
The ankle sprain is the most common sports injury there is, and most heal completely with bracing and physiotherapy. The problem is the ankle that does not: the one that keeps giving way months later, swells after every game, or develops a deep ache that no amount of rest resolves.
Repeated sprains stretch the lateral ligaments beyond their ability to recover. The result is chronic instability, and every giving-way episode risks new damage to the cartilage inside the joint. Sprains can also injure the cartilage directly (osteochondral lesions of the talus) or trigger bone spurs and scar tissue that pinch during movement (impingement).
These are mechanical problems. Physiotherapy is always the first treatment and often succeeds, but when it fails after a proper trial, arthroscopy corrects the mechanics: the ligaments are repaired, impinging tissue is removed, and cartilage lesions are treated, all through keyhole portals.
Brostrom ligament repair
The stretched lateral ligaments are shortened, reattached to bone, and reinforced with local tissue. The repair restores mechanical stability so rehabilitation can rebuild strength and balance on a stable foundation.
Impingement debridement
Bone spurs and thickened scar tissue that pinch at the front or back of the ankle can be removed arthroscopically. The aim is to reduce pain and improve movement; results depend on the cause and any associated cartilage damage.
Cartilage lesion treatment
Osteochondral lesions of the talus are debrided and treated with marrow stimulation to encourage repair tissue. Larger lesions are assessed for cartilage restoration procedures, planned on MRI before surgery.
Ankle conditions we operate on
Chronic Lateral Instability
An ankle that keeps giving way after repeated sprains despite proper rehabilitation. Treated with Brostrom ligament repair to restore mechanical stability.
Anterior Impingement
Footballer's ankle: bone spurs and scar tissue pinching at the front of the joint, painful in squatting and running uphill. Removed arthroscopically.
Posterior Impingement
Pain at the back of the ankle on pointing the foot, often involving an extra bone (os trigonum). Common in dancers and kicking athletes.
Osteochondral Lesions
Damage to the cartilage and underlying bone of the talus after a sprain or fracture, causing deep pain, swelling, and catching. Treated arthroscopically.
Synovitis & Loose Bodies
Inflamed joint lining and free fragments of cartilage or bone that cause swelling, catching, and locking. Removed through the arthroscope.
Sports Ankle Injuries
Combined injuries in athletes: instability with cartilage damage or impingement. Assessed as a whole and treated in a single arthroscopic procedure where possible.
From assessment to return to sport
Assessment
Clinical examination tests ligament laxity, impingement, and balance. Weight-bearing X-rays and MRI assess the ligaments, cartilage, and any impinging bone. If rehabilitation has not yet been properly tried, that comes first.
Keyhole surgery
Through 2 to 3 small portals, the joint is inspected, impinging tissue is removed, cartilage lesions are treated, and unstable ligaments are repaired. Most procedures are completed as day-care surgery under regional anaesthesia.
Protection & early rehab
A boot or brace protects the ankle for 2 to 6 weeks depending on the procedure. Physiotherapy begins early: swelling control and gentle motion first, then progressive strengthening and the balance retraining that protects against re-injury.
Return to sport
After ligament repair, running and sport are reintroduced in stages once healing, strength, balance and movement control are sufficient. Returning to competitive sport takes several months and sometimes longer. Cartilage treatment or other associated procedures may change the plan. Clearance is based on assessment, not the calendar alone.
From the published literature
Dr. Vishnu's published research on this topic
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Ankle Sprain and Chronic Lateral Ankle Instability: Optimizing Conservative Treatment
Dr. Vishnu's published work on getting non-surgical treatment of ankle sprains and chronic instability right, the first-line approach described on this page.
30+ peer-reviewed publications · 450+ citations · H-index 13 · View all research
Ankle surgery FAQ
Do ankle sprains need surgery?
The vast majority do not. Most ankle sprains heal with rest, bracing, and physiotherapy focused on strength and balance. Surgery is considered when the ankle keeps giving way despite 3 to 6 months of proper rehabilitation (chronic lateral instability), or when an associated injury such as a cartilage lesion or impingement is causing ongoing pain.
What is chronic ankle instability?
After repeated sprains, the lateral ligaments of the ankle can heal in a stretched, incompetent position. The ankle then gives way on uneven ground, during sport, or even on stairs, and each giving-way episode risks further cartilage damage. When rehabilitation fails to restore stability, the ligaments are repaired and reinforced surgically (Brostrom repair), restoring confidence in the ankle.
What is ankle impingement?
Impingement is the pinching of bone spurs or thickened soft tissue at the front or back of the ankle during movement. Anterior impingement (sometimes called footballer's ankle) causes pain when the foot is pushed upward, as in squatting, running uphill, or kicking. Posterior impingement causes pain on pointing the foot, common in dancers. Arthroscopic removal may help when symptoms persist despite non-operative treatment, but the benefit depends on the cause and any associated cartilage damage.
What is an osteochondral lesion of the talus?
It is an injury to the cartilage and underlying bone of the talus, the bone at the centre of the ankle joint, often caused by a sprain or fracture. It produces deep ankle pain, swelling, and sometimes catching or locking. Small lesions are treated arthroscopically with debridement and marrow stimulation to encourage repair tissue; larger lesions may need cartilage restoration procedures.
Is ankle arthroscopy a day-care procedure?
Most ankle arthroscopies are day-care or single-night procedures. The keyhole portals are small, post-operative pain is manageable with regional anaesthesia and oral medication, and patients go home with a boot or brace and a clear physiotherapy plan.
When can I return to sport after ankle ligament surgery?
After ligament repair, the ankle is protected while it heals, followed by progressive physiotherapy. Running and sport are introduced once healing, strength, balance and movement control are sufficient. Returning to competitive sport takes several months and sometimes longer. Cartilage treatment or other associated procedures can change the plan; your surgeon and physiotherapist guide clearance.
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