TY - JOUR
T1 - Editorial Commentary: How Far Can the Arthroscope Reach in the Ankle Joint?
AU - Dahmen, Jari
AU - Kerkhoffs, Gino M. M. J.
AU - van Bergen, Christiaan J. A.
N1 - Publisher Copyright: © 2021 Arthroscopy Association of North America
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Surgical access to pathology of the talar dome (e.g., osteochondral lesions of the talus) can be limited because of the ankle joint congruity. When considering arthroscopic treatment, anterior arthroscopy with the ankle in plantar flexion or posterior arthroscopy with the ankle in dorsiflexion is used. The surgeon should carefully assess different clinical and radiologic aspects to plan the optimal operative approach. Meticulous physical examination, including ankle range of motion and possible palpation of a talar lesion, in combination with exact lesion localization on computed tomography or magnetic resonance imaging usually provide sufficient preoperative information. Most lesions with the anterior border localized on or anterior to the midline of the talus are accessible by anterior arthroscopy. In the case of preoperative doubt concerning the intraoperative accessibility, a computed tomography scan of the ankle in full plantarflexion is used to mirror arthroscopic reachability. Intraoperative surgical tricks to increase accessibility to the lesion may consist of an adjunct soft-tissue distraction device, reduction of the distal tibial rim, and treating the lesion from anteriorly to posteriorly, thereby gaining further exposure to the lesion throughout the procedure.
AB - Surgical access to pathology of the talar dome (e.g., osteochondral lesions of the talus) can be limited because of the ankle joint congruity. When considering arthroscopic treatment, anterior arthroscopy with the ankle in plantar flexion or posterior arthroscopy with the ankle in dorsiflexion is used. The surgeon should carefully assess different clinical and radiologic aspects to plan the optimal operative approach. Meticulous physical examination, including ankle range of motion and possible palpation of a talar lesion, in combination with exact lesion localization on computed tomography or magnetic resonance imaging usually provide sufficient preoperative information. Most lesions with the anterior border localized on or anterior to the midline of the talus are accessible by anterior arthroscopy. In the case of preoperative doubt concerning the intraoperative accessibility, a computed tomography scan of the ankle in full plantarflexion is used to mirror arthroscopic reachability. Intraoperative surgical tricks to increase accessibility to the lesion may consist of an adjunct soft-tissue distraction device, reduction of the distal tibial rim, and treating the lesion from anteriorly to posteriorly, thereby gaining further exposure to the lesion throughout the procedure.
UR - http://www.scopus.com/inward/record.url?scp=85101560571&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.arthro.2021.01.020
DO - https://doi.org/10.1016/j.arthro.2021.01.020
M3 - Editorial
C2 - 33485942
SN - 0749-8063
VL - 37
SP - 1258
EP - 1260
JO - Arthroscopy : the journal of arthroscopic & related surgery
JF - Arthroscopy : the journal of arthroscopic & related surgery
IS - 4
ER -