Arthroscopy and Endoscopy of the Foot and Ankle: Indications for New Techniques
ABSTRACT The scope of arthroscopy and endoscopy of the foot and ankle is expanding. New techniques are emerging to deal with diverse ankle pathology. Some of the conditions that can be dealt with arthroscopically are as follows: hallux valgus deformity, lesser toe deformity, first metatarsophalangeal instability, cock-up deformity of the big toe, peroneal tendon instability, lateral ankle and subtalar instability, hindfoot deformity or arthrosis, first metatarsocuneiform hypermobility, Lisfranc joint arthrosis, various stages of posterior tibial tendon insufficiency, foot and ankle arthrofibrosis, late complications after calcaneal fracture, acute and chronic Achilles tendon rupture, insertional Achilles tendinopathy, entrapment of the first branch of the lateral plantar nerve, Freiberg's infarction, flexor digitorum longus tenosynovitis, flexor hallucis longus pathology, calcaneonavicular coalition or "too-long" anterior process of the calcaneus, and ganglions. With sound knowledge regarding the indications, merits, and potential risks of new techniques, they will be powerful tools in foot and ankle surgery.
- SourceAvailable from: Jorge Javier Del Vecchio
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- "Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago     . "
ABSTRACT: Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.01/2015; 2015:1-4. DOI:10.1155/2015/823107
- "Endoscopic decompression of the Achilles has been described for retrocalcaneal bursitis and Achilles insertional tendinopathy.22,23 This technique allows for posterior decompression and bursectomy, but it is inadequate for debridement of larger calcific deposits or an inferior bony ridge; furthermore, repair of the Achilles detachment through this technique does not provide sufficient strength.22 It is best suited for the younger running athlete with isolated retrocalcaneal bursitis and a relatively small Haglund prominence. "
Article: Heel Pain in the Athlete[Show abstract] [Hide abstract]
ABSTRACT: Heel pain, a relatively common problem in the athlete, can present a diagnostic and therapeutic dilemma. The purpose of this article is to review treatment techniques for common causes of heel pain in the athlete. Articles in the English literature through August 2008 were selected and reviewed in the context of the management of heel pain in the athlete. Clinical and surgical photographs are presented as an illustration of preferred techniques and pertinent pathologic findings. Although nonoperative treatment remains the mainstay for most painful heel pathologies, a number of surgical interventions have shown encouraging results in carefully selected patients. The management of heel pain in the athlete requires diagnostic skill, appropriate imaging evaluation, and a careful, initially conservative approach to treatment. Surgical treatment can be successful in carefully selected patients.Sports Health A Multidisciplinary Approach 09/2009; 1(5):427-34. DOI:10.1177/1941738109338357
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ABSTRACT: Die Arthroskopie des oberen Sprunggelenks hat sich seit Jahren zu einem standardisierten Routineverfahren sowohl in arthroskopisch tätigen Abteilungen an Kliniken als auch im ambulanten Bereich entwickelt. Eine profunde Kenntnis der arthroskopischen Anatomie und eine sichere Zugangsanlage ermöglichen ein risikoarmes Operieren. Die meisten Pathologien finden sich ventral, die dorsalen Zugänge werden nur im Einzelfall benötigt. Over the years arthroscopy of the ankle joint has developed into a standard technique in arthroscopic clinics as well as in outpatient units. A profound knowledge of the arthroscopic anatomy in combination with the safe creation of a portal makes low-risk surgical operations possible. Most pathological forms can be found in the ventral aspect and a dorsal portal is rarely needed.Arthroskopie 05/2009; 22(2):94-101. DOI:10.1007/s00142-008-0488-5