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Posterior ankle arthroscopy: an anatomic study.

David F Sitler1, Annunziato Amendola, Christopher S Bailey

  • 1Fowler Kennedy Sport Medicine Clinic, Univeristy of Western Ontario, London, Canada. dsitler@nmscd.med.navy.mil

The Journal of Bone and Joint Surgery. American Volume
|May 11, 2002
PubMed
Summary
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This cadaver study shows that posterior ankle arthroscopy in the prone position is safe, visualizing over half the talar dome without significant neurovascular injury. Further clinical trials are recommended to confirm these findings.

Area of Science:

  • Orthopedic Surgery
  • Anatomy

Background:

  • Ankle arthroscopy traditionally uses anterior portals with patients supine.
  • Limited research exists on posterior portal ankle arthroscopy, especially with patients prone.

Purpose of the Study:

  • To assess the safety and effectiveness of posterior portal ankle arthroscopy with the limb in the prone position.

Main Methods:

  • Used 13 fresh-frozen cadaver specimens.
  • Established posterolateral and posteromedial portals for arthroscopy.
  • Measured visualized talar dome extent and proximity of portals to neurovascular structures via MRI and dissection.

Main Results:

  • An average of 54% of the talar dome was visualized.
  • Cannulae were an average of 3.2 mm from the sural nerve and 6.4 mm from the tibial nerve.

Related Experiment Videos

  • Distances to other structures like the posterior tibial artery and flexor hallucis longus tendon were also measured, showing minimal average proximity.
  • Conclusions:

    • Posterior ankle arthroscopy in the prone position appears safe for introducing instruments without major neurovascular damage.
    • Limited clinical trials are suggested to validate these cadaveric findings.