Ankle arthroscopy is a low-traumatic, highly informative endoscopic examination that allows to reliably determine the cause of the development of pathological changes in the joint. It can be carried out only for diagnostic purposes or supplemented with therapeutic measures. It is used to detect, assess the prevalence and severity of traumatic injuries, degenerative-dystrophic and inflammatory changes, pathologies of rheumatic origin. It is performed under general or local anesthesia after standard preoperative preparation for planned intervention.
Indications and contraindications
Indications for diagnostic arthroscopy in traumatology are hemarthrosis (accumulation of blood in the joint), recurrent effusion (repeated accumulation of fluid), pain of unknown origin and other pathological symptoms, the cause of which cannot be established by non-invasive (clinical examination, radiography, CT of the ankle joint, MRI) methods. Contraindications to diagnostic ankle arthroscopy are the patient’s serious condition, acute infectious diseases, pustules, wounds and abrasions in the area of the affected limb segment.
Methodology of conducting
The intervention is performed after a standard preoperative examination. The operation is performed under local anesthesia, less often – under conduction or general anesthesia. The ankle joint consists of two chambers – anterior and posterior, therefore, for its complete examination, as a rule, several punctures are required. There is a technique according to which all areas of the joint are examined from the anterior approaches. During diagnostic puncture of the joint, the following accesses to the joint are used: anterior, anterior median, anterior, posterior and posterior. The most informative and secure is the front-facing access.
Depending on the chosen technique, a puncture on the anterior surface of the joint is combined with an anterior or posterior access. Post-internal access is rarely used, since vessels and nerves are located in this area. To improve visibility, additional stretching and various special styling are used. A liquid (saline solution) is injected into the joint during the study. At the end of the operation, the liquid is removed. Single stitches are applied to the skin in the area of punctures. The patient is immediately allowed to give a full load on the limb. Working capacity is usually restored 2-3 days after surgery.
