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ankle Arthroscopy

Jesús Vilá-Rico, Enrique Sánchez-Morata, Elena Vacas-Sánchez, Cristina Ojeda-Thies
Injuries of the distal tibiofibular syndesmosis are commonly overlooked or mismanaged, and chronic instability is a debilitating condition leading to premature joint degeneration. Several methods of treatment have been described, mainly screw fixation, arthrodesis, or ligament reconstruction. Most clinical evidence is limited to case series, mainly screw fixation, and there is a general paucity of evidence regarding ligament reconstruction, which is considered to be more anatomic and to restore joint biomechanics...
February 2018: Arthroscopy Techniques
Yusuke Tsuyuguchi, Tomoyuki Nakasa, Masakazu Ishikawa, Yasunari Ikuta, Mikiya Sawa, Masahiro Yoshikawa, Nobuo Adachi
Ankle arthroscopy is a minimally invasive technique for ankle joint treatment. However, injury to the intermediate dorsal cutaneous nerve (IDCN) and the medial dorsal cutaneous nerve (MDCN) is a common complication during anterior portal placement. To prevent injuries, methods such as palpating the nerves topographically and marking the nerves by transilluminating the skin with an arthroscope have been proposed. Easier and more definitive methods of identifying the IDCN and MDCN should result in a reduction of complications...
February 2018: Arthroscopy Techniques
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo, Koichi Sairyo
Arthroscopy is an important and minimally invasive diagnostic and therapeutic tool. However, the risk of injury to the neurovascular structures around the portals exists during arthroscopy of the ankle. In the present study, we measured the distance between each portal and the adjacent neurovascular structures with the foot in plantarflexion and dorsiflexion in the Japanese population. Standard anterolateral (AL), anteromedial, posterolateral (PL), and posteromedial portal positions were identified in 6 fresh adult cadaveric feet...
March 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Lorena Bejarano-Pineda, Annunziato Amendola
Participation in sports activity has increased significantly during the last several decades. This phenomenon has exposed orthopedic sports medicine surgeons to new challenges regarding the diagnosis and management of common sport-related injuries. Arthroscopy is becoming more commonly used in many of the surgical procedures for these injuries and carries the risk of complications. Wound and nerve complications make up the bulk of complications in most procedures. This article describes these complications associated with the common surgical procedures related to foot and ankle sport-related injuries and how to address and prevent them...
April 2018: Clinics in Sports Medicine
Adam E M Eltorai, Wesley M Durand, Jack M Haglin, Lee E Rubin, Arnold-Peter C Weiss, Alan H Daniels
Understanding trends in reimbursement is critical to the financial sustainability of orthopedic practices. Little research has examined physician fee trends over time for orthopedic procedures. This study evaluated trends in Medicare reimbursements for orthopedic surgical procedures. The Medicare Physician Fee Schedule was examined for Current Procedural Terminology code values for the most common orthopedic and nonorthopedic procedures between 2000 and 2016. Prices were adjusted for inflation to 2016-dollar values...
March 1, 2018: Orthopedics
Graham A Hamilton, Matthew D Doyle, Francesca M Castellucci-Garza
The indications for arthroscopy have expanded over the years. Arthroscopic-assisted open reduction internal fixation in the setting of acute trauma is gaining popularity with foot and ankle surgeons. It serves to facilitate direct visualization of fracture fragments and allows for precise articular reduction with minimal soft tissue insult. Current evidence reports a high incidence of chondral injury with ankle fractures. Arthroscopy performed at the time of open reduction internal fixation allows for joint inspection and potential treatment of these posttraumatic defects...
April 2018: Clinics in Podiatric Medicine and Surgery
Ryan B Rigby, Ryan T Scott
Acute deltoid injuries may occur with ankle fractures. They are often left to heal without repair, possibly leading to chronic medial ankle instability. Stress radiographs identify the need for surgical repair of fractures or soft tissue damage. Gravity stress views have benefits over manually stressing the ankle. MRI can explore the extent of medial soft tissue injuries. Arthroscopy can evaluate and potentially treat deltoid injuries. Interposition of the deltoid may preclude adequate fracture reduction. Except with deltoid tear, fractures should be reduced and fixated, then the deltoid assessed...
April 2018: Clinics in Podiatric Medicine and Surgery
Ned Amendola
No abstract text is available yet for this article.
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
Daniel D Bohl, Rachel M Frank, Simon Lee, Kamran S Hamid, George B Holmes, Johnny Lin, Simon Lee
BACKGROUND: The saline load test has been used to evaluate for traumatic arthrotomy in orthopaedics. The purpose of this study was to determine the volume of saline required to detect traumatic arthrotomy of the ankle. METHODS: Forty-two patients undergoing elective ankle arthroscopy were prospectively enrolled. For each patient, a standard 4-mm anteromedial portal was established. Next, an 18-gauge needle was inserted at the site of the anterolateral portal. Sterile saline was slowly injected through the needle until saline extravasated from the anteromedial portal...
February 1, 2018: Foot & Ankle International
Min Wei, Yang Liu
OBJECTIVE: To evaluate the clinical effects of arthroscopic microfracture on osteochondral lesions of the talus. METHODS: Total 42 patients with osteochondral lesions of the talus, who were collected in our department from January 2011 to December 2013. The patients were 35.9 years old on average, including 28 males and 14 females. There were 34 patients who had injury histories. The debridement and microfracture were performed under arthroscopy. The function of ankle was assessed according to AOFAS Ankle Hindfoot Scale...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alessio Bernasconi, Nazim Mehdi, François Lintz
Ankle arthrodesis is still considered the gold standard in the treatment of advanced painful ankle osteoarthritis. More than 3 decades ago, it was performed under arthroscopy; thereafter, many authors have reported excellent results and a low complication rate. Despite the significant improvements in surgical techniques, nonunion remains a problematic and relatively frequent event. This is one of the reasons the research is constantly active in this field. Ten years ago, a fibular resection during ankle arthrodesis was, for the first time, described in the literature as a means to correct malalignment in varus cases...
October 2017: Arthroscopy Techniques
John J Kellett, Gregory A Lovell, David A Eriksen, Matthew J Sampson
Literature on the various techniques for imaging injuries to the ankle syndesmosis to determine the most appropriate imaging modality for diagnosing syndesmosis ligament disruption and instability was reviewed using the following data sources: Pubmed, Google scholar, SportsDiscus, E-journals and PLOSone. Search terms used were: syndesmosis paired with injury, imaging, radiology, X-ray, stress X-ray, arthrography, ultrasound, nuclear medicine scan, CT scan, MRI and arthroscopy. Articles were selected by reading abstracts and the full article if indicated...
February 5, 2018: Journal of Medical Imaging and Radiation Oncology
Rachael J Da Cunha, Sydney C Karnovsky, William Schairer, Mark C Drakos
PURPOSE: To delineate the prevalence of chondral lesions, in particular full-thickness talar dome lesions, with concurrent arthroscopy in acute ankle fracture open reduction-internal fixation (ORIF) and evaluate the impact on clinical outcomes. METHODS: We conducted a retrospective chart review of prospectively collected registry data at our institution from 2012 to 2016. Consecutive patients who underwent acute ankle fracture ORIF with concurrent arthroscopy were identified...
February 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Atsushi Teramoto, Hiroaki Shoji, Yuzuru Sakakibara, Tomoyuki Suzuki, Kota Watanabe, Toshihiko Yamashita
PURPOSE: The purpose of this study was to evaluate the relationship between the lateral malleolus view under ankle arthroscopy and the anterior talofibular ligament (ATFL) attachment site. METHODS: Seven normal ankles from Thiel-embalmed cadavers were investigated. Ankle arthroscopy was performed using a 2.7 mm-diameter, 30-degree, oblique-viewing endoscope. An antero-medial portal (AM), a medial midline portal (MML), and an antero-central portal (AC) were created in order, and the ankle arthroscope was inserted...
January 22, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Eun Hae Park, Kwang-Bok Lee
RATIONALE: A nondisplaced chip fracture can be missed on MRI. Opposed-phase imaging from mDixon MRI produces an interesting artifact called black boundary artifact. This artifact can provide better contrast at the fracture line resulting in better depiction of a small chip fracture on MRI. PATIENT CONCERNS: We present a case of small nondisplaced chip fracture at the lateral talar dome that was well delineated only with the aid of a black boundary artifact after using T2-weighted opposed-phase imaging from turbo spin-echo two-point modified Dixon ankle MRI...
December 2017: Medicine (Baltimore)
Chul Hyun Park, Doo Hyung Yoon
BACKGROUND: This study was conducted to evaluate the usefulness of subtalar arthroscopy in the operative treatment of Sanders type 2 calcaneus fractures using a sinus tarsi approach. METHODS: Forty-six Sanders type 2 calcaneal fractures were consecutively treated using a sinus tarsi approach. Intraoperative fluoroscopy was used to evaluate fracture reduction in the first 23 patients (fluoroscopy group), and intraoperative fluoroscopy and subtalar arthroscopy were used in the latter 23 patients (arthroscopy group)...
January 1, 2018: Foot & Ankle International
Silvampatti Ramaswamy Sundararajan, Ramakanth Rajagopalakrishnan, Shanmuganathan Rajasekaran
We report a rare presentation of a ruptured pseudoaneurysm of the lateral plantar artery following tibiotalocalcaneal fusion with a retrograde nail at 1 month after the index surgery. Although case reports of pseudoaneurysms of larger arteries such as the anterior tibial artery and posterior tibial artery after ankle surgery (e.g., ankle arthroscopy, implant removal, Ilizarov application) have been reported, we report a rare complication of a pseudoaneurysm of the lateral plantar artery. We discuss the anatomic considerations of the lateral plantar artery in the foot and the entry point of the retrograde nail to avoid this unusual complication...
December 19, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Brady T Evans, Frances A Tepolt, Emily Niu, Dennis E Kramer, Mininder S Kocher
The purpose of this study was to identify the rates of chondral injury, soft tissue impingement, and bony impingement in pediatric patients undergoing the modified Brostrom procedure with ankle arthroscopy for lateral ankle instability. A retrospective review of all patients undergoing a modified Brostrom procedure with ankle arthroscopy performed by two surgeons at a tertiary care children's hospital between October 2002 and April 2014 was performed. Data were collected regarding demographics, history and initial presentation, nonoperative management, surgical procedure and arthroscopic findings, and clinical follow-up...
January 2018: Journal of Pediatric Orthopedics. Part B
Richard D Ferkel
Recalcitrant osteochondral lesions of the talus present a difficult problem to the treating surgeon. Anterior and posterior approaches have been studied to facilitate treatment access. Current research highlights the accessibility of an osteochondral lesion to treatment from an anterior or posterior approach and shows the importance of foot position and noninvasive distraction to facilitate treatment. Moreover, it is important to consider that using both anterior and posterior portals, most osteochondral lesions can be well treated with a patient in the supine position...
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Dong Woo Shim, Sungjun Kim, Yeokgu Hwang, Yunjae Lee, Jin Woo Lee, Seung Hwan Han
PURPOSE: To show the effectiveness of magnetic resonance imaging (MRI) for the detection of tram track lesions in the ankle compared with ankle arthroscopy. METHODS: We retrospectively assessed all patients who underwent arthroscopic ankle surgery between January 2013 and July 2015. Patients with anterior impingement spurs were included, but those with an osteochondral lesion or arthritis were excluded. Anterior ankle bony spurs on preoperative weight-bearing radiographs were scored using an impingement classification system...
November 21, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
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