Ankle arthroscopy: outcome in 79 consecutive patients.

Abstract

Seventy-nine consecutive ankle arthroscopies were analyzed at a minimum 2-year follow-up to evaluate the risks and benefits of the procedure. All arthroscopies were performed over a 2-year period by a single surgeon using the same nonskeletal traction technique. Forty-four arthroscopies were performed for therapeutic reasons only, whereas 35 were performed for both diagnostic and therapeutic purposes. Clinical examination with visual analog scores were used for assessment preoperatively and postoperatively. The diagnoses were osteochondral lesions of the talus in 21; post-ankle fracture scarring in 14, osteoarthritis and chondromalacia in 11, anterior bony impingement in 14; anterolateral soft tissue impingement or synovitis in 15; miscellaneous diagnosis in 4. Overall, 63 of 79 patients benefited in some way from the procedure. There were diagnostic benefits in 27 of 35 (77%) of ankles in which the diagnosis was clarified by the arthroscopy. In those ankles in which the procedure was performed for therapeutic purposes only, 36 of 44 (82%) of the patients benefited. Those patients with an underlying diagnosis of osteoarthritis of the ankle, posttraumatic chondromalacia and arthrofibrosis, or who were on disability and worker's compensation benefits, had poor results, whereas patients with a localized osteochondral lesion of the talus, localized bony or soft tissue impingement, or localized lateral plica had the best results. There were three significant neurological complications from ankle arthroscopy in this series. Two patients developed a postoperative partial deep peroneal nerve neuropraxia, and one patient had superficial peroneal nerve irritation at the site of the anterolateral portal. Ankle arthroscopy appears to be a relatively low-risk procedure with substantial benefits, particularly in localized disease of the ankle joint. Skeletal distraction was not used in any of these cases.