Ankle joint arthroscopy: indications and real expectations

Rapid progress in ankle joint arthroscopy can be observed lately. Number of indications as well as surgeons performing arthroscopy in ankle pathologies increase constantly. Operative arthroscopy is indicated in the ankle soft tissues impingement (synovial hypertrophy, intraarticular adhesions, meniscoid lesions, overgrown scars around ligaments) in order to clear the cartilage and reduce pathologic tissues, also to extract loose bodies, excise osteophytes (bone lesion impingement), osteochondral lesions of talus and/or tibia, and finally ankle arthritis. In this study indications for operative arthroscopy of talocrural joint are presented. In the years 2002-2005 ankle joint arthroscopy was performed in 23 patients of the Children Orthopedics Clinic in Poznan. The indications were: osteochondral lesions of talus and/or tibia in 7 cases (30%), synovitis in rheumatoid arthritis in 4 (17%), frozen ankle after a fracture or arthritis in 4 (17%), joint instability in 3 (13%), soft tissues or bone ankle impingement in 2 (8%), degenerative changes grade II in another 2 patients (8%) and diagnostic/explorative in 1(4%)case. Arthroscopy improved significantly function and healing of the cartilage lesions in either anterior or posterior ankle joint impingement. Least improvement was observed in severe degeneration and in arthritis.