Arthroscopy of the ankle

General

Arthroscopy of the ankle joint includes the endoscopic diagnosis of this joint by inspecting all joint structures in keyhole technique. Only small incisions are necessary to insert the required instruments into the ankle joint. Arthroscopy of the ankle joint is being used more and more frequently for therapy and only less frequently for pure diagnostics due to the many possible applications, since magnetic resonance imaging largely fulfils this task.

Arthroscopy of the ankle joint is an invasive procedure for imaging the ankle joint cavity and the structures there. Compared to open surgery of the ankle joint, arthroscopy of the ankle joint offers, for example, the advantage of less pain after surgery. During arthroscopy of the upper ankle (Articulatio talocruralis), the cartilage-covered distal joint surfaces of the tibia (tibia), fibula (fibula) and the upper joint surface of the talus (ankle bone) can be assessed.

In addition, the outer and inner ligaments as well as the anterior and posterior syndesmosis ligaments can be viewed and assessed. The lower ankle joint is divided into an anterior (Articulatio subtalaris) and a posterior joint chamber (Articulatio talocalcaneonavicularis). The two chambers are separated by the ankle-heelbone ligament (Lig.

talocalcaneum interosseum), which can also be viewed during arthroscopy. In the anterior articular chamber, the articular surfaces of the os naviculare (scaphoid), the lower articular surfaces of the talus (talocalcaneum) and the anterior articular surfaces of the calcaneus can be assessed. At the bottom of the anterior joint chamber is the acetabular ligament covered with cartilage, which can also be viewed during arthroscopy.

In the posterior joint chamber, the upper joint surface of the calcaneus and the posterior joint surface of the ankle bone articulate with each other. The joint capsule of the lower ankle joint is reinforced by various ligament structures. The pathological changes in the articular cavity of the ankle detected by arthroscopy do not necessarily correlate with the symptoms or functional limitations of the patient.

Indication

If the MRI image of the ankle joint is not clear, an arthroscopy of the ankle joint can be performed for purely diagnostic purposes. An arthroscopy of the ankle can also be used for therapeutic purposes, as it is possible to repair instabilities of the ankle joint during the procedure, for example due to damaged tendons or ligaments. Free joint bodies can be fixed, diseases and damage to the cartilage can be treated and inflamed, purulent joints can be rinsed. Another possible application is for diseases of the joint mucosa and arthrosis of the ankle. Arthroscopy of the ankle joint is increasingly used because of its many therapeutic possibilities.

Arthrosis ankle joint

Arthroscopy of the ankle joint is indicated, for example, in case of arthrosis of the ankle. In many cases, arthrosis of the ankle joint is caused by a previous fracture injury, which heals in a defective position. If the so-called “buckling” in the upper ankle joint not only causes an injury to the ligamentous apparatus, but also a luxation fracture of the malleolar fork, arthrosis of the upper ankle joint can be the result.

After a fracture of the calcaneus, arthrosis of the lower ankle joint can gradually develop as a result of malalignment after the bone has healed. In the case of bone fractures in the area of the ankle joint, care must therefore be taken to ensure that the fragments involved are correctly positioned. Thus, arthrosis of the upper ankle joint does not only affect older patients, but can of course also occur without a previous injury due to normal signs of age of the cartilage and joint surfaces. Patients with osteoarthritis of the ankle often complain of pain when climbing stairs or uphill. The painful restriction of movement worsens over time, so that an accompanying malposition in the ankle joint can develop.