Arthroscopic techniques in ankle surgery.

SURGICAL OBJECTIVE

Arthroscopy of the ankle joint is one of the standard procedures for treating many pathologies of the ankle joint. Ventral and posterior arthroscopy can be performed. The aim is to gain an overview of the joint using minimal incisions. There are many indications to perform ankle arthroscopy.

INDICATIONS

Arthroscopy can be used diagnostically to check the cartilage status or the ligamentous apparatus. In traumatology, arthroscopy can be used to check for intra-articular damage or step formation following osteosynthesis. Arthroscopy can also be performed for cartilage therapy, ligament reconstruction or to support arthrodesis of the ankle joint.

CONTRAINDICATIONS

Absolute contraindications are rare. The most important contraindication is noncompliance. Relative contraindications include acute infection, severe vascular disorders, complex regional pain syndrome (CRPS), osteopenia or coagulation disorders. Nicotine consumption and obesity should be discussed critically with the patient.

POSTOPERATIVE MANAGEMENT

Postoperative treatment depends on the addressed concomitant pathology. Suture material can be removed 14 days postoperatively. If an isolated arthroscopy is performed (e.g., diagnostic, arthrolysis, exclusion of infection), the authors recommend pain-adapted full weight-bearing, possibly in a lower leg orthosis until the wound has healed properly.

RESULTS

The results of arthroscopy depend on the pathology addressed. The primary advantage is a significantly reduced risk of wound healing disorders due to small incisions.