The Incidence of Complications After Posterior Hindfoot Endoscopy

Winona Health Podiatry, Winona, Minnesota, U.S.A.. Electronic address: .
Arthroscopy The Journal of Arthroscopic and Related Surgery (Impact Factor: 3.21). 12/2013; 29(12):2049-54. DOI: 10.1016/j.arthro.2013.08.036
Source: PubMed


The purpose of this systematic review was to determine the incidence of complications after posterior hindfoot endoscopy.
Ovid/Medline and Google Scholar were systematically searched for pertinent references to be included. In addition, we hand-searched common American and European orthopaedic and podiatric surgical journals for relevant articles. Articles considered for inclusion were published in peer-reviewed journals, described complications after posterior hindfoot endoscopy using a standard 2-portal technique, and involved 25 or more patients treated.
We identified 335 potentially relevant publications, of which 5 met our inclusion criteria. A total of 452 ankles (452 patients) were included in this study. Overall, 17 complications (3.8%) occurred, with only 8 (1.8%) requiring additional treatment or operative intervention.
The endoscopic approach for the treatment of hindfoot and ankle pathology is safe with a low incidence of complications. However, additional studies with prospective designs should be undertaken to determine the long-term patient outcomes using validated scoring systems.
Level IV, systematic review of Level III and IV studies.

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    ABSTRACT: To study the safety and efficiency of posterior arthroscopic ankle arthrodesis. Ten fresh-frozen human lower leg specimens without evidence of previous surgery to the foot and ankle were selected. Arthroscopic debridement of the tibiotalar joint was performed in all specimens using a standardized protocol. Anatomical dissections were regarded the gold standard for safety analysis. To evaluate the efficacy of the posterior ankle arthroscopic arthrodesis, the debrided articular tibiotalar parts were resected and subsequently analysed using Image-analysis software, Image J (Wayne Rasband, National Institutes of Health, Bethesda, MD). In none of the specimens, iatrogenic damage was detected during the anatomical dissection following the posterior ankle arthroscopic procedure. A total talar joint surface area of 95 % and total tibial joint surface area of 96 % was addressed during the arthroscopic debridement. The posterior ankle arthroscopic arthrodesis can be regarded safe and is also highly effective in the debridement of cartilage, resulting in optimal biology for fusion to occur. Therefore, this new arthroscopic technique potentially will diminish existing non-union rates for the fusion of the ankle joint.
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    ABSTRACT: Background Posterior ankle and hindfoot arthroscopy finds an increasing acceptance as treatment option for intraarticular and extraarticular pathologies. The purpose of this study was to address the efficacy of posterior ankle and hindfoot endoscopy in athletes. Materials and Methods Seventeen patients with a mean age of 27.9 ± 4.3 years treated by posterior ankle and hindfoot endoscopy were included into this retrospective study. The average duration of follow-up was 5.4 ± 1.3 years. Clinical outcomes were assessed with use of a visual analogue scale (VAS) for pain and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. Furthermore, preoperative and postoperative levels of sports activity were analyzed. Results The preoperative diagnoses were painful os trigonum, posterior ankle impingement, flexor hallucis longus tendinits and peroneal tendon impingement in 9, 4, 3, and 1 cases, respectively. There were no intraoperative complications. The average VAS score for pain decreased significantly from 5.6 ± 0.9 (range, 4 – 7) preoperatively to 0.6 ± 1.0 (range, 0 – 4) postoperatively (p < 0.001). The average AOFAS hindfoot score increased significantly from 60.7 ± 11.1 (range, 36 – 72) preoperatively to 92.4 ± 10.3 (range, 61 – 100) postoperatively (p < 0.001). All patients had sports activities at the latest follow-up, 13 patients (76.5%) returned to their sports activity level they had before onset of hindfoot symptoms. Conclusions Posterior ankle and hindfoot arthroscopy in athletes is associated with a low risk of intraoperative and postoperative complications and leads to significant pain relief, good functional results, and return to sports activities. Level of Evidence IV
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