Arthroscopic ankle debridement: 5-year survival analysis

Little information exists regarding the long term prognosis following ankle arthroscopy, particularly in avoiding further major surgery. The purpose of this study is to evaluate the prognosis of arthroscopic ankle treatment. We also investigated the relationship between the arthroscopic treatment and time for a further major ankle surgery. In this consecutive case series study using a prospectively collected database, 80 consecutive patients (80 ankles) having ankle arthroscopy with the finding of osteoarthritis or impingement were identified and their outcome at five years was ascertained. Fifty five (69%) patients had soft tissue impingement, and 25 (31%) patients had osteoarthritic degenerative changes. Seven (9%) patients had further major surgery and 6 (8%) had repeat arthroscopy. The surgery was required for 7 arthritic ankles among which, however, survival analysis showed no significant difference between those under 50 and those over 50 years. Twenty-eight percent of osteoarthritic patients progressed to major ankle surgery, within 5 years of arthroscopic treatment. None of the patients with impingement symptoms required further major surgery. In conclusion, arthroscopically treated impingement ankles were found to have an excellent prognosis, while osteoarthritic ankles had a less favoured prognosis, with a high proportion requiring further major surgery. Age did not appear to affect the prognosis in the osteoarthritic group.