Siddiqui Mashfiqul A, Chong Keen Wai, Yeo William, Rao Mohana S, Rikhraj Inderjeet S
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Foot Ankle Spec. 2010 Aug;3(4):167-71. doi: 10.1177/1938640010372959. Epub 2010 Jun 7.
The subtalar joint is complex. With the advent of smaller diameter arthroscopes, subtalar arthroscopy has become an important diagnostic and therapeutic tool for subtalar joint disorders. The objective of this study was to evaluate the outcome of patients who underwent arthroscopy for subtalar joint disorders using a 2.4-mm zero-degree arthroscope. In this prospective study, 6 patients who underwent subtalar arthroscopy from September 2008 to January 2009 in the authors' institution were included. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scores were recorded preoperatively and at 3 and 6 months postoperatively. Mean +/- SD age was 45.5 +/- 16.2 years (range, 27.5-63.2). Postoperative diagnosis included arthrofibrosis, osteoarthritis, and osteochondral disease of the subtalar joint. Mean +/- SD AOFAS scores improved from 49.67 +/- 18.83 (range, 22-76) to 67.33 +/- 14.92 (range, 53-91) at 3 months (P = .03) and 75 +/- 19.74 (range, 54-100) at 6 months (P = .004). Subtalar arthroscopy using the 2.4-mm zero-degree arthroscope shows promising results in the diagnosis and treatment of subtalar pathologies. Patients have a significant improvement in their AOFAS hindfoot scores as early as 3 months and continue to improve subsequently. Usage of the zero-degree arthroscope allows the "instrumentation hand" to maneuver more easily in space and perform the operative procedure without getting in the way of the "camera hand." It can also save on inventory costs for centers that already have the zero-degree arthroscope. The role of specialized imaging is still unclear. Diagnosis of sinus tarsi syndrome should be historical with direct visualization of the joint revealing exact etiology.
距下关节结构复杂。随着直径更小的关节镜的出现，距下关节镜检查已成为诊断和治疗距下关节疾病的重要工具。本研究的目的是评估使用2.4毫米零度关节镜进行距下关节疾病关节镜检查的患者的治疗效果。在这项前瞻性研究中，纳入了2008年9月至2009年1月在作者所在机构接受距下关节镜检查的6例患者。记录术前以及术后3个月和6个月时的美国矫形足踝协会（AOFAS）后足评分。平均年龄±标准差为45.5±16.2岁（范围27.5 - 63.2岁）。术后诊断包括关节纤维性变、骨关节炎和距下关节骨软骨疾病。AOFAS评分平均±标准差在术后3个月时从49.67±18.83（范围22 - 76）提高到67.33±14.92（范围53 - 91）（P = 0.03），在6个月时提高到75±19.74（范围54 - 100）（P = 0.004）。使用2.4毫米零度关节镜进行距下关节镜检查在距下关节病变的诊断和治疗中显示出良好的效果。患者的AOFAS后足评分早在3个月时就有显著改善，随后继续提高。零度关节镜的使用使“操作手”在空间中更容易操作，并且在进行手术过程中不会妨碍“摄像手”。对于已经配备零度关节镜的中心，还可以节省库存成本。特殊成像的作用仍不明确。跗骨窦综合征的诊断应基于病史，同时直接观察关节以明确确切病因。
