CHAPTER 33: Arthroscopy of the Ankle and Foot
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Arthroscopy of the Ankle and Foot: A Comprehensive Guide, Summaries of Medicine
A comprehensive overview of arthroscopy as a minimally invasive technique for diagnosing and treating ankle and foot pathologies. It covers the history, indications, classification of pathology, imaging techniques, conservative and surgical treatment options, common pathologies, complications, and outcomes. Well-structured and informative, making it a valuable resource for students and professionals in the field of orthopedics.
Typology: Summaries
2024/2025
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CHAPTER 33: Arthroscopy of the Ankle and Foot
- (^) Overview: Arthroscopy is a minimally invasive technique useful for diagnosing and treating ankle and foot pathologies.Benefits over arthrotomy: less dissection, less recovery time, reduced postoperative pain/swelling.
- (^) Challenges: Requires significant skill due to 2D-to-3D interpretation, magnification variations, and working with indirect visualization.
- (^) Slide 4: Indications
- (^) Primary soft tissue pathology:
- Hemorrhagic/chronic synovitis, fibrous bands, meniscoid lesions, impingement syndromes.
- (^) Osseous/Osteochondral Pathology:
- Osteophytes, avulsion injuries, osteochondral defects.
- (^) Other: Assists in fracture reduction, lateral ankle instability, and arthrodesis
Slide 5: Classification of Pathology
- Berndt and Hardy Classification: 1.Subchondral compression. 2.Partial fragment detachment. 3.Complete fragment (not displaced). 4.Displaced fragment.
- Modified Outerbridge Grading:
- Grades I-IV of chondromalacia.
- (^) Slide 7: Pathology - Hemorrhagic and Chronic Synovitis
- (^) Characteristics: Hyperplasia, hyperemia, often secondary to trauma (e.g., hemophilic synovitis).
- (^) Treatment: Arthroscopic synovectomy.
- (^) Slide 8: Radiographic and Advanced Imaging
- (^) Imaging Studies:
- MRI/CT to identify osteochondral defects, synovitis, and cartilage pathology.
- (^) Contrast studies enhance visualization of intra-articular lesions.
- (^) Slide 10: Conservative Treatment
- (^) Options:
- NSAIDs for inflammation.
- (^) Diagnostic injections (lidocaine, corticosteroids).
- (^) Physical therapy to maintain mobility.
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- (^) Slide 11: Surgical Treatment - Portal Placement
- (^) Ankle Arthroscopy:
- (^) Anteromedial and anterolateral portals are common.
- (^) Posterior portals for subtalar joint access.
- (^) Careful consideration of neurovascular structures (IDCN, sural nerve)(Chapter 33_ Arthroscopy…).
- (^) Slide 13: Treatment of Common Pathologies
- (^) Soft Tissue Lesions: Removal of fibrous bands, synovial resections for impingement syndromes.
- (^) Osteophyte Excision: Osteoplasty with motorized shaver or osteotome.
- (^) Osteochondral Lesions: Debridement and treatment of articular defects.
- (^) Slide 14: Arthrofibrosis
- (^) Causes: Post-traumatic, post-surgical scarring.
- (^) Treatment: Aggressive arthroscopic debridement with shavers, supplemented with thermoablation(Chapter 33_ Arthroscopy…).