Risks Associated With Posterior Ankle Hindfoot Arthroscopy Complications

Area of Science:

• Orthopaedic Surgery
• Minimally Invasive Procedures
• Foot and Ankle Surgery

Background:

• Posterior ankle and hindfoot arthroscopy (PAHA) is increasingly utilized for various foot and ankle conditions.
• New indications for PAHA continue to emerge in the medical literature.
• Understanding the complication profile of PAHA is crucial for patient safety and surgical planning.

Purpose of the Study:

• To determine the complication rate associated with PAHA in a large patient cohort.
• To identify demographic and surgical variables that may be associated with PAHA complications.
• To specifically investigate factors predicting neurologic complications after PAHA.

Main Methods:

• Retrospective comparative study of 232 patients (251 procedures) undergoing PAHA from December 2009 to July 2016.
• Data collected included demographics, diagnoses, tourniquet use, associated procedures, and complications.
• Univariate and multivariable logistic regression analyses were performed to identify predictors of neurologic complications, with Firth log-likelihood approach for sparse events.

Main Results:

• Overall complication rate was 6.8% (17/251 procedures).
• Neural sensory lesions occurred in 3.98% (10/251) and wound complications in 1.59% (4/251).
• Accessory posterolateral portal use was a significant predictor of neurologic complications (OR 32.19).

Conclusions:

• PAHA demonstrates a 6.8% complication rate, with neural injuries being most common.
• The use of an accessory posterolateral portal is significantly associated with an increased risk of neurologic complications.
• Findings can guide surgeons in patient selection and surgical technique to minimize risks associated with PAHA.