Arthroscopic Debridement After Total Ankle Arthroplasty

Residual pain due to impingement after ankle arthroplasty can be addressed with arthroscopic debridement. Literature focusing on the effectiveness of arthroscopic debridement after total ankle arthroplasty (TAA) is scarce. The authors report a case series of 12 patients complaining of anterior or posterior impingement pain, 11 of which were in the absence of malalignment which were treated by arthroscopy.

Of the 106 TAAs performed between 2003 and 2012, a total of 12 subjects reported postoperative pain resulting from anterior or anteromedial impingement, medial and/or lateral gutter impingement, posterior impingement, and/or ankylosis. All patients were reviewed on a regular basis through chart review, clinical examination, and radiologic evaluation. The average time to final follow-up was 58.8 months. The average period from the original TAA to the arthroscopic debridement was 38.2 months.

The median AOFAS hindfoot score was significantly (P < .05) improved from 64.6 preoperatively to 73.5 postoperatively. Eight subjects reported good pain relief after the arthroscopic debridement, and partial pain relief was reported by 4 subjects. Three patients with painful ankylosis had no improvement in the total range of motion of the TAA implant after the arthroscopic debridement.

The results suggest that arthroscopic debridement in patients with residual pain due to impingement syndromes after TAA was effective in 8 of the 12 cases at 2 years' follow-up. However, the results suggest that arthroscopic debridement in the presence of painful ankylosis associated with or without impingement syndromes results only in partial pain relief and does not improve the range of motion.

Level IV, case series.