Abstract
Arthroscopy has become increasingly common for diagnosis and treatment of ankle joint pathology. The four most common portals used for ankle arthroscopy are the anteromedial (AM), anterolateral (AL), posteromedial (PM), and posterolateral (PL). And anatomy of neurovascular structures (NVS) along the ankle can significantly vary. The distance of NVS was compared to anatomic landmarks of ankle arthroscopic portals to verify safe zones for scope insertion. Twenty-six fresh-frozen cadavers were utilized, with dissection of standard anatomic landmarks and NVS. Portals were made and verified with a 2.7 mm arthroscope.
Highlights
Arthroscopy has become increasingly common for diagnosis and treatment of ankle joint pathology [1,2,3]
The greatest inconsistency was noted between the peroneus tertius (AL portal) and IMDN
A meta-analysis of ten cadaveric studies analyzing the neurovascular and tendinous structures at risk in ankle arthroscopy by Yammine, et al reported a total of 14 nerve injuries; ten of those injuries were to the SPN, with 6 of the injuries incurred through the AL portal [5]
Summary
Arthroscopy has become increasingly common for diagnosis and treatment of ankle joint pathology [1,2,3]. The four most common portals used for ankle arthroscopy are the antero-medial (AM), anterolateral (AL), posteromedial (PM), and postero-lateral (PL). All of these run close to neurovascular structures (NVS), making them susceptible to injury during insertion [3,4]. The foot and ankle specialist should be familiar with all relevant structures circumferentially across the ankle joint, as well as their relative distance to one another. Allowing for greater reproducibility when placing portals for ankle arthroscopy
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