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Ankle Arthroscopy: No-Distraction and Dorsiflexion Allows Advanced Techniques
Infographic
Ankle Arthroscopy: No-Distraction and Dorsiflexion Allows Advanced Techniques Miki Dalmau-Pastor, Ph.D., and Jordi Vega, M.D.
Abstract: Ankle dorsiflexion arthroscopic technique with distraction at a surgeon’s discretion is the current standard for ankle arthroscopy in most parts of the world. Reasons favoring the use of dorsiflexion during anterior ankle arthroscopy are based on the insertion of the anterior ankle joint capsule, which happens at a distance from the articular surfaces: this allows a large and safe anterior working area during dorsiflexion; ankle dorsiflexion also reduces the tension of anterior neurovascular structures and moves them away from the anterior aspect of the ankle, which protects them from damage during performance of the arthroscopic procedure; in addition, a lower rate of complications has been reported when dorsiflexion without distraction is being used for ankle arthroscopy. Nevertheless, intermittent ankle distraction can still be used during ankle arthroscopic procedures, but with just a few indications. In this infographic, authors explore and present the current indications for distraction in ankle arthroscopy as well as the broader indications for performing ankle dorsiflexion arthroscopic technique.
Bibliography de Leeuw PA, Golanó P, Clavero JA, van Dijk CN. Anterior ankle arthroscopy, distraction or dorsiflexion? Knee Surg Sports Traumatol Arthrosc 2010;18:594-600. Golanó P, Vega J, Pérez-Carro L, Götzens V. Ankle anatomy for the arthroscopist. Part I: the portals. Foot Ankle Clin 2006;11:253-273.
From the University Barcelona, Hospitalet de Llobregat, Barcelona, Spain. The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material. Received October 14, 2019; accepted October 14, 2019.
Vega J, Dalmau-Pastor M, Malagelada F, Fargues-Polo B, Peña F. Ankle arthroscopy: an update. J Bone Joint Surg Am 2017;99:1395-1407. Zengerink M, van Dijk CN. Complications in ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc 2012;20:1420-1431.
Address correspondence to Jordi Vega, M.D., University Barcelona, Feixa LLarga SN, Hospitalet de Llobregat, Barcelona 08907, Spain. E-mail: [email protected] Ó 2019 by the Arthroscopy Association of North America 0749-8063/191262/$36.00 https://doi.org/10.1016/j.arthro.2019.10.013
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 35, No 12 (December), 2019: pp 3171-3172
3171
Ankle Arthroscopy: No-Distraction and Dorsiflexion Allows Advanced Techniques Miki Dalmau-Pastor, Ph.D., and Jordi Vega, M.D.
Abstract: Ankle dorsiflexion arthroscopic technique with distraction at a surgeon’s discretion is the current standard for ankle arthroscopy in most parts of the world. Reasons favoring the use of dorsiflexion during anterior ankle arthroscopy are based on the insertion of the anterior ankle joint capsule, which happens at a distance from the articular surfaces: this allows a large and safe anterior working area during dorsiflexion; ankle dorsiflexion also reduces the tension of anterior neurovascular structures and moves them away from the anterior aspect of the ankle, which protects them from damage during performance of the arthroscopic procedure; in addition, a lower rate of complications has been reported when dorsiflexion without distraction is being used for ankle arthroscopy. Nevertheless, intermittent ankle distraction can still be used during ankle arthroscopic procedures, but with just a few indications. In this infographic, authors explore and present the current indications for distraction in ankle arthroscopy as well as the broader indications for performing ankle dorsiflexion arthroscopic technique.
Bibliography de Leeuw PA, Golanó P, Clavero JA, van Dijk CN. Anterior ankle arthroscopy, distraction or dorsiflexion? Knee Surg Sports Traumatol Arthrosc 2010;18:594-600. Golanó P, Vega J, Pérez-Carro L, Götzens V. Ankle anatomy for the arthroscopist. Part I: the portals. Foot Ankle Clin 2006;11:253-273.
From the University Barcelona, Hospitalet de Llobregat, Barcelona, Spain. The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material. Received October 14, 2019; accepted October 14, 2019.
Vega J, Dalmau-Pastor M, Malagelada F, Fargues-Polo B, Peña F. Ankle arthroscopy: an update. J Bone Joint Surg Am 2017;99:1395-1407. Zengerink M, van Dijk CN. Complications in ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc 2012;20:1420-1431.
Address correspondence to Jordi Vega, M.D., University Barcelona, Feixa LLarga SN, Hospitalet de Llobregat, Barcelona 08907, Spain. E-mail: [email protected] Ó 2019 by the Arthroscopy Association of North America 0749-8063/191262/$36.00 https://doi.org/10.1016/j.arthro.2019.10.013
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 35, No 12 (December), 2019: pp 3171-3172
3171