Fitzgibbons T C
Department of Orthopaedics, Creighton University School of Medicine, Omaha, Nebraska, USA.
Instr Course Lect. 1999;48:243-8.
The use of the arthroscope in arthritis of the ankle has been well described and there is no question that it is a significant part of the armamentarium for the orthopaedic surgeon dealing with these patients. Unfortunately, those patients with advanced arthritis and loss of joint space do not respond well to traditional arthroscopic debridement, removal of loose bodies, debridement and drilling of osteochondral lesions, and removal of anterior osteophytes. These procedures should only be used on those patients with minimal to no degenerative arthritis. Arthroscopic ankle arthrodesis is becoming more of the accepted primary procedure for most cases of arthritis of the ankle, in my opinion. Some varus or valgus tilting of the tibial talar joint can be accepted if clinical alignment is relatively normal. Significant malalignments cannot be corrected with arthroscopic fusion.
关节镜在踝关节关节炎中的应用已有详尽描述，毫无疑问，它是骨科医生治疗此类患者的重要工具之一。不幸的是，那些患有晚期关节炎且关节间隙变窄的患者，对传统的关节镜清创、清除游离体、清创并钻孔治疗骨软骨损伤以及切除前方骨赘等治疗方法反应不佳。这些手术仅适用于那些轻度至无退行性关节炎的患者。在我看来，关节镜下踝关节融合术正日益成为大多数踝关节关节炎病例被认可的主要手术方法。如果临床对线相对正常，胫距关节出现一些内翻或外翻倾斜是可以接受的。严重的对线不良无法通过关节镜融合术矫正。
