Cadaveric Study on the Safety of Medial versus Anterocentral Portals in Ankle Arthroscopy: A Comparative Analysis.

INTRODUCTION

The medial midline portal and anterocentral both are not standard portals for ankle arthroscopy, but they provide a wide field of vision.

AIMS

The aim of this study was to compare anatomical safety between medial midline and anterocentral portal in arthroscopy in respect to the least injury to adjacent structures.

MATERIALS AND METHODS

20 cadaveric ankles were dissected and related anatomical structures were measured from anterocentral and medial midline portals.

RESULTS

The dorsalis pedis artery (DPA) was at a mean distance of 10.08 mm, the deep peroneal nerve was at 16.20 mm, the tibialis anterior tendon was at 2.41 mm, and the extensor hallucis longus (EHL) tendon was at 2.62 mm from the medial midline portal. The EHL tendon was injured in two specimens during portal placement. The anterocentral portal was placed at a mean distance of 2.38 mm from the DPA, 7.09 mm from the superficial peroneal nerve, and 4.12 mm from the deep peroneal nerve.

CONCLUSION

Our study demonstrated that the anterocentral portal is safer than the medial midline portal for ankle arthroscopy. While there is a high risk of tendon injury in the medial midline portal.