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Recon > Foot & Ankle Arthroscopy > Flashcards

Foot & Ankle Arthroscopy Flashcards

1
Q

What is arthroscopy?

A

Minimally invasive surgical procedure on a joint

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2
Q

What is one of the most common indication for ankle arthroscopy?

A

Osteochondral lesions

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3
Q

What are two important reasons for ankle arthroscopy?

A
  • Preservation of soft tissue envelope: accelerated return to daily activities and athletic endeavors
  • Diagnostic arthroscopy: more sensitive than pre-operative physical examination and imaging re: chronic instability
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4
Q

Define anterior portals

A

Portals oriented along the anterior joint line

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5
Q

What are the three anterior portals?

A
  • anterolateral
  • anteromedial
  • anterocentral
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6
Q

Describe the anterolateral portal

A

Lateral to peroneus tertius
Medial to lateral malleolus

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7
Q

Describe the anteromedial portal

A

Medial to tibialis anterior

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8
Q

What are the two most common ankle portal?

A

Anterolateral portal
Anteromedial portal

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9
Q

Describe anterocentral portal

A

Lateral to the EHL

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10
Q

Which portal is not recommended?

A

Anterocentral portal

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11
Q

Which portal do you typically start with?

A

Anteromedial

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12
Q

Which posterior portal is the safest and most common?

A

Posterolateral portal

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13
Q

Are anterior or posterior portals utilized more?

A

Anterior portals

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14
Q

What are the safest and most common portals ?

A
  • Anteromedial
  • anterolateral
  • posterolateral
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15
Q

What should you be aware of with anteromedial portal?

A
  • saphenous nerve/vein
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16
Q

What do you have to be aware of with the anterolateral portal?

A

Superficial peroneal nerve

17
Q

What do you have to be aware of with the posteriorlateral portal?

A
  • branches of the sural nerve
  • small saphenous vein
18
Q

How are the associated complications from ankle arthroscopy?

A

49% of complications are related to nerve injury at portals

19
Q

What is the purpose of the 21 point exam?

A

To establish reproducible and thorough intro-articular examination of the ankle

20
Q

How many points are there on the anterior, central and posterior exam?

A

8-point anterior exam
6-point central exam
7-point posterior exam

21
Q

What are the 8 anterior points via the anteromedial portal?

A
  1. Deltoid ligament
  2. Medial gutter
  3. Medial talus
  4. Central talus and central overhang
  5. Lateral talus
  6. Trifurcation with the talus, tibia and fibula, including AITFL
  7. Lateral gutter, including ATFL
  8. Anterior gutter
22
Q

What are 6 central points via the anteromedial portal?

A
  1. Medial talus
  2. Central talus
  3. Lateral talus
  4. PITFL
  5. Transverse tibiofibular ligament
  6. Capsular reflection of the FHL
23
Q

What are thee 7 posterior points via the anteromedial portal?

A
  1. Medial gutter
  2. Medial talus
  3. Central talus
  4. Lateral talus
  5. Tall fibular articulation
  6. Lateral gutter
  7. Posterior gutter
24
Q

What are some indications for arthroscopy?

A
  • symptomatic tenosynovitis
  • small tears
25
Q

Absolute contraindications for arthroscopy?

A
  • tendon injury requiring open resection
  • infection
  • severe edema
26
Q

Relative contraindications for arthroscopy?

A
  • extensive scarring
  • poor tissue quality
  • vascular compromise
27
Q

What is Tenosynovitis

A

Inflamed tissue
Typically results from repetitive and/or prolonged activity, trauma or anatomic factors: enlarged peroneal tubercle, low lying breves muscle, peroneus quartus

28
Q

Reasons for subluxing peroneals?

A
  • Peroneal instability
  • superior peroneal retinaculum compromise
  • lack of space during DF and eversion
  • flat or convex peroneal groove
  • space occupying process
  • low lying muscle belly
  • peroneus quartus
29
Q

Describe 1st portal placement?

A
  • 2cm distal to fibular tip
  • proximal to peroneal tubercle
30
Q

Describe the 2nd portal placement

A
  • 5-10cm proximal to the tip of the fibula
  • trans-illuminate, 18 gauge needle
  • primary working portal

Recon (10 decks)

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