2.1 μm Holmium:YAG Arthroscopic Laser Surgery of the Ankle

Abstract

The development of arthroscopic surgical techniques for the ankle joint has lagged behind that of other joints such as the knee and the shoulder. The combination of tight ligamentous restraints, highly congruous joint surfaces, and complex curved surfaces makes arthroscopic instrumentation of the ankle joint more difficult than that of the relatively capacious knee joint or the relatively lax shoulder joint. Two major innovations during the 1980s contributed to the more widespread application of arthroscopic surgical techniques to the ankle joint. First, Guhl popularized the use of joint distraction techniques, which facilitated the passage of instruments in the joint. Since the original description of his technique utilizing threaded pins placed in the tibia and calcaneus, the use of distraction has evolved to utilize either a noninvasive or an invasive form. We have found that noninvasive means of joint distraction are sufficient in approximately 90% of arthroscopic surgical cases. The second major advance has been the development of high resolution, small diameter, wide angle arthroscopes.