Arthroscopy of the ankle joint

Ankle arthroscopy has become a standard procedure for a variety of indications. Joint distraction is applied by many authors. A recent retrospective multicentre study provoked the following questions. Is there an indication for diagnostic arthroscopy? Can arthroscopic surgery of the ankle joint be routinely performed without joint distraction? Does the range of motion increase after arthroscopic treatment of an anterior impingement syndrome? A series of 122 consecutive patients were prospectively studied in a protocol that included preoperative history taking, physical examination, and standardized follow-up at 4 months and 2 years postoperative. Excellent and good results of arthroscopic treatment were obtained in 84% of impingement lesions, in 88% of osteochondral defects, and in 88% of loose body removal. In patients in whom no definite preoperative diagnosis was made and for whom diagnostic arthroscopy was performed, only 26% benefitted from the procedure. Treatment of anterior impingement lesions resulted in a subjective feeling of increase in range of motion in 66% of the patients. In 20% of patients, however, the dorsiflexion at 2-year follow-up increased > or = 5 degrees. The arthroscopic procedures could be performed without the use of joint distraction in 98% of the cases. Arthroscopic surgery of the ankle joint is a successful procedure in treatment of impingement lesions, osteochondral defects, and removal of loose bodies. It is beneficial to perform the procedure without joint distraction. There is only limited indication for diagnostic arthroscopy.