Complications of ankle arthroscopy.

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures

Background:

• Ankle arthroscopy is a common procedure for diagnosing and treating ankle conditions.
• The complex anatomy of the ankle presents risks for iatrogenic injury during arthroscopic surgery.
• Previous reports suggest a low complication rate for ankle arthroscopy.

Purpose of the Study:

• To evaluate the actual complication rate of ankle arthroscopy.
• To compare institutional complication rates with previously reported literature.
• To inform surgeons, especially those new to the procedure, about potential risks.

Main Methods:

• Review of a single institution's experience with 53 consecutive ankle arthroscopies.
• Analysis of reported complications including nerve injury, infection, and other adverse events.
• Comparison with a survey of over 4500 ankle arthroscopies by the Arthroscopy Association of North America.

Main Results:

• The institutional review identified nine complications in 53 procedures, a rate of 17%.
• Specific complications included permanent dorsal sensory nerve injuries, synovial fistulas, wound infections, and reflex sympathetic dystrophy.
• The Arthroscopy Association of North America survey reported only one infection in over 4500 procedures, with no nerve or vascular injuries.
• Literature review identified additional complications such as instrument breakage and fibula fracture.

Conclusions:

• Complications associated with ankle arthroscopy occur more frequently than previously suggested by large surveys.
• Beginning or average ankle arthroscopists should expect a higher complication rate than reported in limited surveys.
• Careful portal placement is crucial to avoid damaging the ankle's complex structures.