Posterior ankle and subtalar arthroscopy: indications, technique, and results

Abstract

Over the decades, arthroscopy has grown in popularity for the treatment of many foot and ankle pathologies. While anterior ankle arthroscopy is a widely accepted technique, posterior ankle/subtalar arthroscopy is still a relatively new procedure. The goal of this review is to outline the indications, surgical techniques, and results of posterior ankle/subtalar arthroscopy. The main indications include: 1) osteochondral lesions (of subtalar and posterior ankle joint); 2) posterior soft tissue or bony impingement; 3) os trigonum syndrome; 4) posterior loose bodies; 5) flexor hallucis longus (FHL) tenosynovitis; 6) posterior synovitis; 7) subtalar (or ankle) joint arthritis; 8) posterior tibial, talar, or calcaneal fractures (for arthroscopic reduction and internal fixation). Although posterior ankle/subtalar arthroscopy has shown to be safe and effective in the treatment of many of the above mentioned conditions, thorough knowledge of the anatomy, correct indications, and a precise surgical technique are essential to produce good outcomes.

Treating Haglund's Deformity with percutaneous Achilles tendon decompression: a case series

“…An adequate bone resection during the calcaneoplasty procedure is essential to reduce painful symptoms 15,16 . The key points to achieve the best As the open approach, the arthroscopic path through the posterior portals is not free from complications [19][20][21] as synovitis, ganglia formations or portal cysts, injuries of the superficial peroneal tendon, Achilles tendon rupture, nor even medial vascular nerve structures and required a significant learning curve.…”

Arthroscopic Management of Posteromedial Ankle Impingement

“…6,[8][9][10][11][12] The ankle usually shows deep soft-tissue induration and localized tenderness; pain is evocable by palpating the medial retromalleolar area while moving the ankle. 2 Posteromedial tenderness on inversion with the ankle in plantar flexion is an important sign to differentiate the ankle pain originating from the tibialis posterior tendon. 6,11 Magnetic resonance imaging has been shown to be an effective investigation in ankle impingement syndromes, 6,7 but it cannot replace careful clinical examination (Fig 1).…”

“…Posteromedial ankle impingement is an uncommon disease in which a severe injury involves the deep posterior fibers of the medial deltoid ligament. 2 We describe an endoscopic approach to deal with posteromedial ankle impingement.…”

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

“…1,7 It is performed through the posteromedial and posterolateral portals at either side of the Achilles tendon with the patient in prone position. 1,2,8,9 It has many advantages over open surgery, including less tissue trauma, less symptomatic scar formation, and quicker recovery. 1,10 However, in case of concomitant ankle pathologies, for example, osteochondral lesion or anterior ankle impingement, requiring anterior ankle arthroscopy, the patient positioning needs to be changed during the operation.…”