Hindfoot Endoscopy for Posterior Ankle Impingement

Slides:



Advertisements
Similar presentations
Reconstruction of Segmental Bone Defects Due to Chronic Osteomyelitis with Use of an External Fixator and an Intramedullary Nail by Levent Eralp, Mehmet.
Advertisements

Volume os-92(Supplement 1 Part 2):
Anatomic, Transepiphyseal Anterior Cruciate Ligament Reconstruction by Kyle E. Hammond, John W. Xerogeanes, and Dane C. Todd JBJS Essent Surg Tech Volume.
Surgical Technique for Osteocutaneous Pedicle Flap Transfer for Salvage of Transtibial Amputation After Severe Lower-Extremity Injury by Heather A. Vallier,
Effective Treatment of Posttraumatic and Postoperative Edema in Patients with Ankle and Hindfoot Fractures by Manuela Rohner-Spengler, Angela Frotzler,
Is There a Safe Area for the Axillary Nerve in the Deltoid Muscle? by Ozgur Cetik, Murad Uslu, Halil Ibrahim Acar, Ayhan Comert, Ibrahim Tekdemir, and.
Periprosthetic Humeral Fractures After Shoulder Arthroplasty by Sanjay Kumar, John W. Sperling, George H. Haidukewych, and Robert H. Cofield J Bone Joint.
Long-Term Outcome After Surgical Treatment of Unresolved Osgood-Schlatter Disease in Young Men by Harri K. Pihlajamäki, and Tuomo I. Visuri JBJS Essent.
Arthroscopic Treatment of Suprascapular Neuropathy from a Suprascapular Notch Cyst Using a Lateral Subacromial Approach by Justin J. Mitchell, Ryan R.
Intrasheath Subluxation of the Peroneal Tendons by Steven M. Raikin JBJS Essent Surg Tech Volume os-91(Supplement 2 Part 1): March 1, 2009 ©2009.
Evaluation of Skill Level Between Trainees and Community Orthopaedic Surgeons Using a Virtual Reality Arthroscopic Knee Simulator by W. Dilworth Cannon,
Avoiding Complications in the Treatment of Humeral Fractures by Jeffrey O. Anglen, Michael T. Archdeacon, Lisa K. Cannada, and Dolfi Herscovici J Bone.
Computer Navigation for Total Knee Arthroplasty Reduces Revision Rate for Patients Less Than Sixty-five Years of Age by Richard N. de Steiger, Yen-Liang.
Surgical Anatomy of the Supraclavicular Brachial Plexus by Sophia Leung, Dan A. Zlotolow, Scott H. Kozin, and Joshua M. Abzug J Bone Joint Surg Am Volume.
Surgical Repair of Acute and Chronic Tibialis Anterior Tendon Ruptures by V. James Sammarco, G. James Sammarco, Carlo Henning, and Solomon Chaim J Bone.
Painful Ununited Fracture of the Posterior Process of the Talus in an Adolescent Dancer by Hsuan-Kai Kao, and James G. Gamble JBJS Case Connect Volume.
Posterior Ankle and Hindfoot Arthroscopy
Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.
Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.
Gluteus Maximus Avulsion and Closed Degloving Lesion Associated with a Thoracolumbar Burst Fracture by David E. Gwinn, Robert A. Morgan, and Anand R. Kumar.
Posterior Knee Arthroscopy: Anatomy, Technique, Application by Dennis E. Kramer, Michael S. Bahk, Brett M. Cascio, and Andrew J. Cosgarea J Bone Joint.
Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes by Norimasa Iwasaki, Hiroyuki Kato, Jyunichi Ishikawa,
Outcomes of an Anatomic Posterolateral Knee Reconstruction
Scoliosis in Patients with Duchenne Muscular Dystrophy by Lori A. Karol J Bone Joint Surg Am Volume 89(suppl 1): February 1, 2007 ©2007 by The Journal.
Extraperiosteal Plating of Pronation-Abduction Ankle Fractures by Jodi Siegel, and Paul Tornetta JBJS Essent Surg Tech Volume os-90(Supplement 2 Part 1):
Range of Motion of Standard and High-Flexion Posterior Stabilized Total Knee Prostheses by Young-Hoo Kim, Keun-Soo Sohn, and Jun-Shik Kim J Bone Joint.
Effects of Tensioning Errors in Split Transfers of Tibialis Anterior and Posterior Tendons by Stephen J. Piazza, Robert L. Adamson, Matthew F. Moran, James.
Tibialis Anterior Tendon Transfer for Relapsing Idiopathic Clubfoot by Joshua B. Holt, Brian Westerlind, and Jose A. Morcuende JBJS Essent Surg Tech Volume.
Allograft-Prosthesis Composite for Revision of Catastrophic Failure of Total Elbow Arthroplasty by Pierre Mansat, Robert A. Adams, and Bernard F. Morrey.
Arthroscopic Treatment of Osteochondral Talar Defects by Christiaan J.A. van Bergen, Ruben Zwiers, and C. Niek van Dijk JBJS Essent Surg Tech Volume 3(2):e10.
Rapidly Growing Squamous-Cell Carcinoma of the Hand in a Renal Transplant Recipient by James Rose, Samuel Harms, and Jennifer Moriatis Wolf JBJS Case Connect.
Complications Associated with FAST-FIX All-Inside Meniscal Repair by Ryan C. Rauck, Sameer Jain, and David C. Flanigan JBJS Case Connect Volume 5(3):e62.
Carpal Wedge Osteotomy in the Arthrogrypotic Patient by Scott N. Oishi, Christian A. Foy, Lesley Wheeler, and Marybeth Ezaki JBJS Essent Surg Tech Volume.
Thoracolumbar Burst Fractures Treated with Posterior Decompression and Pedicle Screw Instrumentation Supplemented with Balloon-Assisted Vertebroplasty.
Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.
Surgical Treatment of Talar Body Fractures by Heather A. Vallier, Sean E. Nork, Stephen K. Benirschke, and Bruce J. Sangeorzan JBJS Essent Surg Tech Volume.
Dual Growing Rods for the Treatment of Early-Onset Scoliosis by Gregory M. Mundis, Nima Kabirian, and Behrooz A. Akbarnia JBJS Essent Surg Tech Volume.
Treatment of Unicameral Bone Cyst by Hsien-Yang Hou, Karl Wu, Chen-Ti Wang, Shun-Min Chang, Wei-Hsin Lin, and Rong-Sen Yang JBJS Essent Surg Tech Volume.
HINTEGRA Revision Arthroplasty for Failed Total Ankle Prostheses
Posterior Arthroscopic Subtalar Arthrodesis
Surgical Treatment of Femoroacetabular Impingement: Evaluation of the Effect of the Size of the Resection by Rodrigo M. Mardones, Carlos Gonzalez, Qingshan.
Glenohumeral Arthrodesis After Failed Prosthetic Shoulder Arthroplasty by Jason J. Scalise, and Joseph P. Iannotti JBJS Essent Surg Tech Volume os-91(Supplement.
Percutaneous Distal Osteotomy of the Fifth Metatarsal for Correction of Bunionette by Bruno Magnan, Elena Samaila, Manuel Bondi, Ingrid Bonetti, and Pietro.
Surgical Treatment of Main Thoracic Scoliosis with Thoracoscopic Anterior Instrumentation by Peter O. Newton, Vidyadhar V. Upasani, Juliano Lhamby, Valerie.
Single-Leg-Stance Radiographs in the Diagnosis of Pelvic Instability by Jodi Siegel, David C. Templeman, and Paul Tornetta J Bone Joint Surg Am Volume.
Anatomical Reconstruction for Chronic Posterolateral Instability Combined with Posterior Cruciate Ligament Reconstruction by Sung-Jae Kim, Sung-Hwan Kim,
Ilizarov Hip Reconstruction for the Late Sequelae of Infantile Hip Infection by S. Robert Rozbruch, Dror Paley, Anil Bhave, and John E. Herzenberg J Bone.
Supramalleolar Osteotomy in Patients with Varus Ankle Osteoarthritis by Woo-Chun Lee, Jeong-Seok Moon, Kang Lee, Woo Jin Byun, and Sang Hyeong Lee JBJS.
Anterior Cruciate Ligament Reconstruction with a Four- Strand Hamstring Tendon Autograft by Riley J. Williams, Jon Hyman, Frank Petrigliano, Tamara Rozental,
Knee Injury in Patients Experiencing a High-Energy Traumatic Ipsilateral Hip Dislocation by Gary L. Schmidt, Robert Sciulli, and Gregory T. Altman J Bone.
Chondral Resurfacing of Articular Cartilage Defects in the Knee with the Microfracture Technique by Kai Mithoefer, Riley J. Williams, Russell F. Warren,
Management of Capsular Deficiency of the Shoulder by Jon J.P. Warner, Andreas A. Venegas, Janne T. Lehtinen, and John J. Macy J Bone Joint Surg Am Volume.
Prognostic Indicators for Recurrent Symptoms After a Single Corticosteroid Injection for Carpal Tunnel Syndrome by Philip E. Blazar, W. Emerson Floyd,
Computer-Navigated Bone Cutting in the Resection of a Pelvic Bone Tumor and Reconstruction with a Massive Bone Allograft by Pierre-Louis Docquier, Olivier.
Radial Head Arthroplasty with a Modular Metal Spacer to Treat Acute Traumatic Elbow Instability by David Ring, and Graham King JBJS Essent Surg Tech Volume.
Hindfoot Endoscopy for Posterior Ankle Impingement by P.E. Scholten, I.N. Sierevelt, and C.N. van Dijk J Bone Joint Surg Am Volume 90(12): December.
Lower-Extremity Peripheral Nerve Blocks in the Perioperative Pain Management of Orthopaedic Patients by Benjamin E. Stein, Umasuthan Srikumaran, Eric W.
Computer-Assisted Minimally Invasive Total Knee Arthroplasty Compared with Standard Total Knee Arthroplasty by Andrew Quoc Dutton, and Seng-Jin Yeo JBJS.
Does Subacromial Injection of a Local Anesthetic Influence Strength in Healthy Shoulders? by Mazda Farshad, Michèle Jundt-Ecker, Reto Sutter, Martin Schubert,
Pirogoff Amputation for Foot Trauma: An Unusual Amputation Level by F.M. den Bakker, H.R. Holtslag, and J.G.H. van den Brand J Bone Joint Surg Am Volume.
Spontaneous Healing of a Tear of the Anterior Cruciate Ligament. A Report of Two Cases* by MASAHIRO KUROSAKA, SHINICHI YOSHIYA, TOSHIYUKI MIZUNO, and KOSAKU.
Single and Dual-Incision Fasciotomy of the Lower Leg
Arthroscopic Débridement of the Knee for Osteoarthritis in Patients Fifty Years of Age or Older by Eugene K. Wai, Hans J. Kreder, and Jack I. Williams.
Comminuted Fractures of the Radial Head: Comparison of Resection and Internal Fixation by Masayoshi Ikeda, Kazuhiro Sugiyama, Chonte Kang, Tomonori Takagaki,
Temporary Internal Distraction as an Aid to Correction of Severe Scoliosis by Jacob M. Buchowski, David L. Skaggs, and Paul D. Sponseller JBJS Essent Surg.
Correction of Sagittal Plane Spinal Deformities with Unit Rod Instrumentation in Children with Cerebral Palsy by Kirk W. Dabney, Freeman Miller, Glenn.
Time Trade-Off as a Measure of Health-Related Quality of Life: Long Bone Nonunions Have a Devastating Impact by Patrick C. Schottel, Daniel P. O’Connor,
Opening-Wedge High Tibial Osteotomy with a Locked Low- Profile Plate by Werner Kolb, Hanno Guhlmann, Christoph Windisch, Heiko Koller, Paul Grützner, and.
Free Vascularized Fibular Grafting for the Treatment of Postcollapse Osteonecrosis of the Femoral Head by J. Mack Aldridge, Keith R. Berend, Eunice E.
Presentation transcript:

Hindfoot Endoscopy for Posterior Ankle Impingement by C.N. van Dijk, P.A.J. de Leeuw, and P.E. Scholten JBJS Essent Surg Tech Volume os-91(Supplement 2):287-298 October 1, 2009 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Patient position during posterior ankle arthroscopy. Patient position during posterior ankle arthroscopy. During posterior ankle arthroscopy, the patient is placed in a prone position. A tourniquet is applied proximal to the knee (II). The ankle is placed over the distal edge of the operating table with a small triangular support under the distal part of the leg (I). A support is placed at the ipsilateral side of the pelvis to permit slight rotation of the operating table in a safe manner when needed (III). C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

With use of the arthroscope as a guide, the mosquito clamp is moved anteriorly until the bone is reached. With use of the arthroscope as a guide, the mosquito clamp is moved anteriorly until the bone is reached. Both the arthroscope and the clamp are now touching bone. C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

The mosquito clamp remains in position, and the arthroscope is withdrawn slightly. C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Arthroscopic images of a left ankle after penetration of the crural fascia to visualize the lateral aspect of the subtalar joint. Arthroscopic images of a left ankle after penetration of the crural fascia to visualize the lateral aspect of the subtalar joint. A: The shaver is pushed through the crural fascia in a lateral and plantar direction. While the shaver is retracted, the soft tissue anterior to the crural fascia is removed and the opening of the shaver is facing bone. B: The shaver has been retracted, and thus the hole in the fascia can be visualized. C: The arthroscope is pushed through the hole in the crural fascia to visualize the posterolateral aspect of the subtalar joint. PTFL = posterior talofibular ligament. C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Schematic step-by-step overview of arthroscope and instruments for posterior ankle arthroscopy in a left ankle. Schematic step-by-step overview of arthroscope and instruments for posterior ankle arthroscopy in a left ankle. The 4.0-mm arthroscope with an inclination angle of 30° is in the posterolateral portal, with the tip resting on the posterior talar process and pointing in the direction of the first web space with the ankle in slight plantar flexion. First, the shaver is introduced through the posteromedial portal and glides over the arthroscope until it is in contact with the bone. Next, the arthroscope is retracted slightly while the shaver remains in position. The arthroscope is then tilted until the shaver comes into view. The shaver is directed in a lateral and slightly plantar direction, thereby perforating the crural fascia and removing the soft tissue located immediately anterior to the fascia. The opening of the shaver is always pointing toward bone. The shaver is then tilted to remove the soft tissue adjacent to the bone while the arthroscope remains in position. The shaver is retracted. The arthroscope is moved anteriorly. The arthroscope is tilted to enter and view the posterolateral aspect of the subtalar joint. C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Endoscopic images of a left ankle, indicating the different steps to remove a symptomatic os trigonum. Endoscopic images of a left ankle, indicating the different steps to remove a symptomatic os trigonum. A: The red circle in the image is identical to the area as indicated in Figure 4,C. The arthroscope is in the posterolateral portal, and the shaver is introduced through the posteromedial portal. The shaver is situated proximal and just lateral to the Rouvière ligament, thereby lifting its insertion onto the top of the os trigonum (OT) (indicated with arrows). Shaving medially will release the Rouvière ligament from the os trigonum. B: Endoscopic image of the Rouvière ligament. The ligament runs from the distal part of the fibula to insert onto the top of the os trigonum. The insertion of this ligament needs to be detached and the ligament can be partially removed in order to obtain an overview of the posterior ankle compartment. C: The blue circle indicates the attachment of the Rouvière ligament and is a copy of B. The schematic transparent white cover indicates the crural fascia, which is an extension of the Rouvière ligament. It needs to be detached and partially removed to obtain the view seen in D. D: After removal of the Rouvière ligament and crural fascia, the os trigonum (OT) and flexor hallucis longus (FHL) tendon can be recognized. On the medial side, the flexor retinaculum (FR) is attached to the os trigonum. On the medial distal side, the posterior talocalcaneal ligament (PTCL) is attached to the os trigonum and, on the lateral side, the posterior talofibular ligament (PTFL) runs between the os trigonum and the fibula. Proximal to the posterior talofibular ligament, at the level of the ankle joint, the tibial slip and the deep portion of the posterior tibiofibular ligament (transverse ligament) are identified. E: Removal of the os trigonum (OT) requires a (partial) detachment of the posterior talofibular ligament (PTFL), the flexor retinaculum (FR), and the posterior talocalcaneal ligament (PTCL), respectively. The level for each incision is indicated. F: The first step in os trigonum (OT) removal is the partial detachment of the posterior talofibular ligament (PTFL) with an arthroscopic punch. G: Subsequently the flexor retinaculum (FR) and posterior talocalcaneal ligament (PTCL) are released with the arthroscopic punch. H: The os trigonum (OT) as seen after release of the retinaculum of the flexor hallucis longus (FHL) tendon and the posterior talocalcaneal ligament, and partial detachment of the posterior talofibular ligament. I: Detachment of the os trigonum from the talus with use of a 4-mm periosteal elevator. J: View after removal of the os trigonum. C.N. van Dijk et al. J Bone Joint Surg Am 2009;os-91:287-298 ©2009 by The Journal of Bone and Joint Surgery, Inc.