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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