Arthroscopy of the ankle joint

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Arthroscopy

Background:

• Ankle arthroscopy is a common procedure for various conditions.
• Joint distraction is frequently used, but its necessity is debated.
• Previous studies raise questions about diagnostic arthroscopy and the role of joint distraction.

Purpose of the Study:

• To evaluate the efficacy of ankle arthroscopy for specific indications.
• To determine if ankle arthroscopy can be routinely performed without joint distraction.
• To assess the impact of arthroscopic treatment for anterior impingement on range of motion.

Main Methods:

• Prospective study of 122 consecutive patients undergoing ankle arthroscopy.
• Included preoperative assessment, physical examination, and standardized follow-up at 4 months and 2 years.
• Data collected on outcomes for impingement lesions, osteochondral defects, loose bodies, and diagnostic procedures.

Main Results:

• High success rates: 84% for impingement, 88% for osteochondral defects, 88% for loose body removal.
• Diagnostic arthroscopy yielded benefits in only 26% of cases without a preoperative diagnosis.
• Ankle arthroscopy performed without joint distraction in 98% of cases.
• Subjective improvement in range of motion reported by 66% of patients with anterior impingement; objective increase in dorsiflexion by >= 5 degrees in 20%.

Conclusions:

• Ankle arthroscopy is a successful treatment for impingement, osteochondral defects, and loose bodies.
• Performing ankle arthroscopy without joint distraction is feasible and beneficial.
• The indication for diagnostic ankle arthroscopy is limited, especially when a preoperative diagnosis is established.