After a posttraumatic ankle pathology, for initial-mild stage of osteoarthritis as rigid ankle, several surgical options can be performed. These include arthroscopic debridement, resurfacing, and osteotomies.
Arthroscopy has been practiced in recent years, especially in young patients after post-traumatic disorders. The goal of arthroscopic debridement is the removal of the fibrous adhesions, synovectomy, removal of osteophytes, and loose bodies if present, assessment and treatment of osteochondral lesion and eventually capsulectomy.
Contraindications are bony or fibrous ankyloses, bone deformities, major axial deviations, neurovascular deficit, and active infections.
Several studies suggested that treatment and prognosis are dependent on the stage of ankle osteoarthritis. Posttraumatic ankle arthritis can be a very disabling condition, and therefore, adequate treatment is helpful.
While some disputes exists regarding arthroscopic debridement of early ankle osteoarthritis and impingement, there is evidence to support benefit of the treatment. By allowing direct, minimally invasive visualization and manipulation of intra-articular structures, ankle arthroscopy offers an important surgical option for the properly selected patient.
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Clinical case of posttraumatic ankle in a 46-year-old man. Weight-bearing Rx and MRI was performed in preoperative. This video shows ankle debridement with partial removal of anterior tibial osteophyte and microfracture for symptomatic medial OCL (MP4 321,407 kb)
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