A Pertinent Guide To Basic Ankle Arthroscopy

Author(s): 
By Jesse B. Burks, DPM
One may also evaluate numerous other intraarticular problems based on the patient’s particular pathology. Using distraction devices, both invasive and noninvasive, can enhance access to different areas of the ankle joints. However, be aware that these devices can increase complications associated with this procedure as well.4 When employing the two-portal technique, you may need to exchange the camera between portals to evaluate the joint completely. Hand instruments include varying forceps, probes and knives. Surgeons often use power instruments in arthroscopic ankle procedures with the most common instrument being a shaver. A shaver can significantly reduce the amount of time needed to thoroughly debride an inflamed joint. Closure of the incisions is based on preference. Often, one may not suture one portal, leaving it open or steri-stripped in order to allow drainage of excess fluid. In Conclusion Post-op care following ankle arthroscopy is based on the type of pathology you are treating. In simple diagnostic procedures with debridement, I usually allow full weightbearing and encourage active range of motion. In more extensive procedures, including chondroplasty or cartilage transfer, non-weightbearing is vitally important to the surgical success. Although arthroscopy may have lower complication rates than comparable open procedures, there are potential problems that you should keep in mind. Neurovascular, tendinous and cartilaginous damage have all been reported as well as infections, painful scarring and broken equipment.5,6,7 My own complication rate seems to increase when I use invasive distraction devices. Ankle arthroscopy is a versatile surgical tool for both diagnosis and treatment of articular disorders. When it is used effectively, it can provide many patients with a quicker recovery and less perioperative morbidity than many traditional surgical approaches. Dr. Burks is a Fellow of the American College of Foot And Ankle Surgeons, and is board-certified in foot and ankle surgery. Dr. Burks practices in Little Rock, Ark. Editor’s Note: For previous “Surgical Pearls” columns, check out the archives at www.podiatrytoday.com.
 

 

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References 1. Mintz DN, Tashjian GS, Connell DA, Deland JT, O’Malley M, Potter HO: Osteochondral lesions of the talus: a new magnetic resonance grading system with arthroscopic correlation. Arthroscopy 19(4): 353-359, 2003. 2. Seeber PW, Staschiak VJ: Diagnosis and treatment of ankle pain with the use of arthroscopy. Clin Pod Med Surg 19(4): 509-517, 2002. 3. Wharbach GP, Stewart JD, Lambert EW, Anderson C: Arthroscopy in the lateral decubitus position. Foot Ankle Int 24(8): 597-599, 2003. 4. Waseem M, Barrie JL: A new distraction method in difficult ankle arthroscopy. J Foot Ankle Surg 41(6): 412-413, 2002. 5. Guhl JF: New concepts (distraction) in ankle arthroscopy. Arthroscopy 4:160-167, 1988. 6. Lundeen RO: Review of diagnostic arthroscopy of the foot and ankle. J Foot Surg 26(1):33-36, 1987. 7. Small NC: Complications in arthroscopic surgery performed by experienced arthroscopists. Arthroscopy 4:215-221, 1988. Additional References 8. Lundeen RO: Arthroscopic evaluation of traumatic injuries to the ankle and foot. Part I: Acute injuries. J Foot Surg 28(6): 499-511, 1989. 9. Lundeen RO: Arthroscopic evaluation of traumatic injuries to the ankle and foot. Part II: Chronic posttraumatic pain. J Foot Surg 29(1): 59-71, 1990. 10. Young GG, Janis LR: Ankle arthroscopy: a retrospective study. J Foot Surg 29(3): 233-243, 1990. 11. Tagaki K: The arthroscope. J JPN Orthop Assoc 14:349-411, 1939. 12. Burman MS: Arthroscopy or direct visualization of joints – and experimental cadaver study. J Bone Joint Surg 13:669-695, 1931.

 

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