Advancements in ankle arthroscopy

Area of Science:

• Orthopedics
• Sports Medicine
• Surgical Innovation

Background:

• Arthroscopic ankle surgery has advanced significantly over the last three decades.
• The procedure has transitioned from a purely diagnostic method to a versatile therapeutic intervention.
• Current techniques offer broad applicability for various ankle pathologies.

Purpose of the Study:

• To review the advancements and current techniques in arthroscopic ankle surgery.
• To highlight the evolution of arthroscopic ankle surgery from diagnostic to therapeutic.
• To describe the approaches for managing anterior and posterior ankle pathologies.

Main Methods:

• Utilizing anterior working portals with the ankle in dorsiflexion or plantar flexion.
• Employing anteromedial and anterolateral portals for anterior ankle problems like impingement syndrome.
• Applying posterior approaches, including a two-portal hindfoot endoscopic technique for posterior compartment issues.

Main Results:

• Most anterior ankle pathologies, including osteochondral defects, are accessible via anterior portals.
• Posteriorly located osteochondral defects can be effectively treated using posterior approaches.
• The prone position with a two-portal hindfoot endoscopic technique provides excellent access to the posterior ankle.

Conclusions:

• Arthroscopic ankle surgery is a well-established therapeutic modality.
• Anterior and posterior ankle structures are readily accessible with current arthroscopic techniques.
• Routine ankle distraction is often unnecessary for successful arthroscopic ankle procedures.