Ankle Arthroscopy in a Hanging Position Combined with Hindfoot Endoscopy for the Treatment of Concurrent Anterior and Posterior Impingement Syndrome of the Ankle

Decompression of Posterior Ankle Impingement With Concomitant Anterior Ankle Pathology by Posterior Ankle Arthroscopy in the Supine Position

“…However, the anterior compartment of the ankle joint is difficult to access with this endoscopic approach. 22 Combined anterior and posterior approaches are needed when there is anterior ankle pathologies together with posterior ankle impingement. Different solutions have been proposed, including change of patient position during the operation, combined anterior arthroscopy and posterior arthrotomy with the patients in the supine position, 23 posterior ankle endoscopy and anterior ankle arthroscopy with the knee flexed with the patient in prone position, 24,25 or combined anterior ankle arthroscopy and posterior ankle endoscopy with the patient in the prone position, knee flexed, and ankle distracted.…”

“…Different solutions have been proposed, including change of patient position during the operation, combined anterior arthroscopy and posterior arthrotomy with the patients in the supine position, 23 posterior ankle endoscopy and anterior ankle arthroscopy with the knee flexed with the patient in prone position, 24,25 or combined anterior ankle arthroscopy and posterior ankle endoscopy with the patient in the prone position, knee flexed, and ankle distracted. 22 Change of the patient's position during the operation would increase the risks of intraoperative wound contamination. 22 Posterior arthrotomy to deal with the posterior ankle impingement would increase the risk of wound problems.…”

“…22 Change of the patient's position during the operation would increase the risks of intraoperative wound contamination. 22 Posterior arthrotomy to deal with the posterior ankle impingement would increase the risk of wound problems. 22,23 During combined arthroscopic approaches with the patient in prone position, the arthroscopic orientation can be confusing as the joint is upside down.…”

“…22 Posterior arthrotomy to deal with the posterior ankle impingement would increase the risk of wound problems. 22,23 During combined arthroscopic approaches with the patient in prone position, the arthroscopic orientation can be confusing as the joint is upside down. 22,24,25 Moreover, a special hanging system for ankle distraction is needed.…”

“…22,23 During combined arthroscopic approaches with the patient in prone position, the arthroscopic orientation can be confusing as the joint is upside down. 22,24,25 Moreover, a special hanging system for ankle distraction is needed. 22 The minimally invasive approach described in this report has the following advantages:…”