Comparative performance of ankle arthroscopy with and without traction

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures

Background:

• Ankle arthroscopy is a key diagnostic and therapeutic tool.
• Traditionally, traction was essential due to the narrow ankle joint space.
• Evolving noninvasive traction techniques offer alternatives to older invasive methods.

Purpose of the Study:

• To prospectively compare ankle arthroscopy with and without noninvasive traction.
• To evaluate the ease of visualization of anatomical structures using Ferkel's criteria.

Main Methods:

• 103 patients underwent ankle arthroscopy, first with traction, then without.
• An independent observer scored visualization using the 21-point Ferkel's criteria.
• Adequate visualization scored one point; inadequate visualization was defined by excessive force or cartilage damage.

Main Results:

• Noninvasive traction improved visualization of most anterior ankle structures (>90%), except the anterior compartment and lateral gutters.
• Ankle dorsiflexion enhanced visualization of the anterior compartment and lateral gutters.
• Traction arthroscopy showed superior visualization of central and posterior ankle structures (mean score 18.5 vs. 11.2).

Conclusions:

• Noninvasive traction facilitates complete visualization during ankle arthroscopy.
• Ankle dorsiflexion improves visualization of specific anterior structures.
• The study recommends using noninvasive traction for ankle arthroscopy procedures.