Comparison of Neurovascular Structures at Risk During Ankle Arthroscopy: A Cadaveric Study

Area of Science:

• Orthopedic Surgery
• Anatomy
• Surgical Navigation

Background:

• Arthroscopy is a common procedure for ankle joint issues.
• Key portals include anteromedial, anterolateral, posteromedial, and posterolateral.
• Neurovascular anatomy around the ankle can vary significantly.

Purpose of the Study:

• To assess the safety of ankle arthroscopy portals.
• To quantify the distance between neurovascular structures and anatomical landmarks.
• To identify safe zones for arthroscopic scope insertion.

Main Methods:

• Dissection of 26 fresh frozen cadavers.
• Comparison of neurovascular structure distances to standard ankle arthroscopy portals.
• Verification of portal placement using a 2.7-mm arthroscope.

Main Results:

• Anterolateral portal exhibits the highest anatomic variability (1.04 cm margin of error).
• Saphenous nerve and vein are close to the anteromedial portal (1.39 cm and 1.23 cm).
• Peroneus tertius tendon is near the intermediate dorsal cutaneous nerve (0.23 cm).

Conclusions:

• The anterolateral portal has the greatest anatomic variability among common ankle arthroscopy approaches.
• Starting with the anteromedial portal aids visualization of lateral structures.
• This supports a standard protocol for safer portal placement in ankle arthroscopy.