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. 2012 Aug;20(8):1420-31.
doi: 10.1007/s00167-012-2063-x. Epub 2012 Jun 5.

Complications in ankle arthroscopy

Maartje Zengerink  1 , C Niek van Dijk
Affiliations

Complications in ankle arthroscopy

Maartje Zengerink et al. Knee Surg Sports Traumatol Arthrosc. 2012 Aug.

Abstract

Purpose: To determine the complication rate for ankle arthroscopy.

Methods: A review of a consecutive series of patients undergoing ankle arthroscopy in our hospital between 1987 and 2006 was undertaken. Anterior ankle arthroscopy was performed by means of a 2-portal dorsiflexion method with intermittent soft tissue distraction. Posterior ankle arthroscopy was performed by means of a two-portal hindfoot approach. Complications were registered in a prospective national registration system. Apart from this complication registry, patient records, outpatient charts and operative reports were reviewed. Patients with a complication were asked to visit our hospital for clinical examination and assessment of permanent damage and persisting complaints.

Results: An overall complication rate of 3.5% in 1,305 procedures was found. Neurological complications (1.9%) were related to portal placement. Age was a significant risk factor for the occurrence of complications. Most complications were transient and resolved within 6 months. Complications did not lead to functional limitations. Residual complaints did not influence daily activities.

Conclusions: Our complication rate is less than half of what has been reported in literature (3.5 vs 10.3%). The use of the dorsiflexion method for anterior ankle arthroscopy can prevent a significant number of complications. Posterior ankle arthroscopy by means of a two-portal hindfoot approach is a safe procedure with a complication rate that compares favourably to that of anterior ankle arthroscopy.

Level of evidence: Retrospective prognostic study, Level II.

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Figures

Fig. 1
Fig. 1
Introduction of arthroscope in fully dorsiflexed position. The foot leans against the surgeons’ belly
Fig. 2
Fig. 2
Dorsiflexed ankle without distraction. The asterisk indicates that the nerves and vessels are relaxed in a protective subcutaneous layer and with a considerable anterior working space in front of them. They are therefore less prone to be injured
Fig. 3
Fig. 3
Distracted ankle. The small arrows point at the nerves and vessels that are under tension in this position. In a distracted ankle, they are more vulnerable to iatrogenic injury
Fig. 4
Fig. 4
Opening of shaver. In the anterior working space of the dorsiflexed ankle, the opening of the shaver should always point towards the joint. This prevents iatrogenic damage to neurovascular structures
See this image and copyright information in PMC

Comment in

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