Ankle arthroscopy in children

Area of Science:

• Orthopaedic Surgery
• Paediatric Orthopaedics
• Sports Medicine

Background:

• Ankle arthroscopy is increasingly used for chronic and post-traumatic ankle conditions.
• Magnetic resonance imaging (MRI) may under-diagnose anterior soft tissue impingement in paediatric patients.
• Retrospective analysis of paediatric ankle arthroscopy outcomes is warranted.

Purpose of the Study:

• To evaluate the outcomes of ankle arthroscopy in children with post-traumatic ankle pathology.
• To compare the diagnostic accuracy of MRI with arthroscopic findings for impingement lesions.

Main Methods:

• Retrospective analysis of 23 children undergoing ankle arthroscopy for post-traumatic pathology (March 2005 - September 2007).
• Indications included failed non-operative treatment or significant osteochondral defects (OCD).
• MRI findings were compared with arthroscopic visualization of OCDs and impingement lesions.

Main Results:

• Arthroscopy revealed osteochondral defects (OCDs) in 12 cases and impingement lesions in 17 ankles.
• MRI correctly identified impingement in only 1 of 8 cases.
• At 3 months, 18 patients reported complete symptom relief; at 1 year, the mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 87.5.

Conclusions:

• Ankle arthroscopy demonstrates successful outcomes in paediatric patients, comparable to adult series.
• MRI is insensitive for diagnosing soft tissue impingement of the ankle in children.
• Arthroscopy is a valuable tool for diagnosing and treating paediatric ankle pathology.