Tonogai Ichiro, Hayashi Fumio, Tsuruo Yoshihiro, Sairyo Koichi
Department of Orthopedics (IT, FH, KS) and.
Department of Anatomy and Cell Biology (YT).
Foot Ankle Spec. 2018 Feb;11(1):72-76. doi: 10.1177/1938640017733099. Epub 2017 Sep 27.
Ankle arthroscopy is an important diagnostic and therapeutic tool. Arthroscopic ankle surgery for anterior ankle impingement or osteochondral lesions (OCLs) is mostly performed with a 30° arthroscope; however, visualization of lesions is sometimes difficult. This study sought to compare ankle joint visualization between 70° and 30° arthroscopes and clarify the effectiveness of 70° arthroscopy. Standard anterolateral and anteromedial portals were placed with 4-mm 70° or 30° angled arthroscopes in a fresh 77-year-old male cadaveric ankle. The medial ligament and surrounding tissue were dissected via a medial malleolar skin incision. Kirschner wires were inserted into the distal tibia anterior edge; 5-mm diameter OCLs were created on the medial talar gutter anteriorly, midway, and posteriorly. The talar dome and distal tibia anterior edge were visualized using both arthroscopes. The 70° arthroscope displayed the anterior edge of the distal tibia immediately in front of the arthroscope, allowing full visualization of the posterior OCL of the medial talar gutter more clearly than the 30° arthroscope. This study revealed better ankle joint visualization with the 70° arthroscope, and may enable accurate, safe, and complete debridement, especially in treatment of medial talar gutter posterior OCLs and removal of anterior distal tibial edge bony impediments.
Level IV, Anatomic study.
踝关节镜检查是一种重要的诊断和治疗工具。用于前踝撞击或骨软骨损伤（OCLs）的关节镜下踝关节手术大多使用30°关节镜进行；然而，病变的可视化有时很困难。本研究旨在比较70°和30°关节镜下踝关节的可视化情况，并阐明70°关节镜检查的有效性。在一具77岁男性新鲜尸体踝关节上，通过标准的前外侧和前内侧入路放置4毫米70°或30°角的关节镜。通过内踝皮肤切口解剖内侧韧带及周围组织。将克氏针插入胫骨远端前缘；在内侧距骨沟的前部、中部和后部制造直径5毫米的OCLs。使用两种关节镜观察距骨穹顶和胫骨远端前缘。70°关节镜可直接显示关节镜前方的胫骨远端前缘，与30°关节镜相比，能更清晰地全面观察内侧距骨沟后部的OCLs。本研究表明70°关节镜能更好地观察踝关节，尤其在治疗内侧距骨沟后部OCLs和去除胫骨远端前缘骨质障碍时，可能实现准确、安全和彻底的清创。
IV级，解剖学研究。
