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Arthroscopic Tarsometatarsal Arthrodesis

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Presentation on theme: "Arthroscopic Tarsometatarsal Arthrodesis"— Presentation transcript:

1 Arthroscopic Tarsometatarsal Arthrodesis
Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S.  Arthroscopy Techniques  Volume 5, Issue 6, Pages e1311-e1316 (December 2016) DOI: /j.eats Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

2 Fig 1 Arthroscopic tarsometatarsal arthrodesis of the right foot: dorsoplantar view (A), oblique view (B), and lateral view (C). Preoperative radiographic assessment showed degenerative changes (arrowheads) of the medial and middle columns of the Lisfranc joint without significant foot deformity. Arthroscopy Techniques 2016 5, e1311-e1316DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

3 Fig 2 Arthroscopic tarsometatarsal arthrodesis of the right foot. The patient is in supine position. Dorsoplantar (A) and medial (B) clinical photographs show the locations of the tarsometatarsal portals. (MC, medial cuneiform bone; MP, medial portal; MT1, first metatarsal; MT2, second metatarsal; MT3, third metatarsal; P12, junction portal between the first and second tarsometatarsal articulations; P23, junction portal between the second and third tarsometatarsal articulations; P34, junction portal between the third and fourth tarsometatarsal articulations.) Arthroscopy Techniques 2016 5, e1311-e1316DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

4 Fig 3 Arthroscopic tarsometatarsal arthrodesis of the right foot. The patient is in supine position. Fusion of the first tarsometatarsal articulation. (A) The first tarsometatarsal arthroscopy is performed through the medial (MP) and P12 portal. (B) P12 portal is the viewing portal. The articular cartilage is denuded with a small arthroscopic osteotome via the medial portal. (C) Medial portal is the viewing portal. Microfracture of the subchondral bone is performed with an arthroscopic awl via the P12 portal. (MC, medial cuneiform bone; MT1, first metatarsal; P12, junction portal between the first and second tarsometatarsal articulations.) Arthroscopy Techniques 2016 5, e1311-e1316DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

5 Fig 4 Arthroscopic tarsometatarsal arthrodesis of the right foot. The patient is in supine position with a triangular supporting frame under the knee. Fusion of the second tarsometatarsal articulation. (A) A needle (arrow) is inserted into the second tarsometatarsal under fluoroscopy. (B) The second tarsometatarsal arthroscopy is performed through the P12 and P23 portals. The needle (arrow) serves as a landmark of the second tarsometatarsal joint during the arthroscopy. (C) P12 is the viewing portal. The dorsal capsule of the second tarsometatarsal joint (TMT2) is resected by an arthroscopic shaver (AS) via the P23 portal. The needle (arrow) marks the second tarsometatarsal joint. (P12, junction portal between the first and second tarsometatarsal articulations; P23, junction portal between the second and third tarsometatarsal articulations.) Arthroscopy Techniques 2016 5, e1311-e1316DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

6 Fig 5 Arthroscopic tarsometatarsal arthrodesis of the right foot. The patient is in supine position with a triangular supporting frame under the knee. Fusion of the third tarsometatarsal articulation. (A) The third tarsometatarsal arthroscopy is performed through the P23 and P34 portals. (B) P23 portal is the viewing portal. The joint is debrided with an arthroscopic shaver via the P34 portal. (LC, lateral cuneiform; MT3, the third metatarsal; P23, junction portal between the second and third tarsometatarsal articulations; P34, junction portal between the third and fourth tarsometatarsal articulations.) Arthroscopy Techniques 2016 5, e1311-e1316DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

7 Fig 6 Arthroscopic tarsometatarsal arthrodesis of the right foot. The patient is in supine position. Dorsoplantar (A) and medial (B) clinical photographs of the foot 8 weeks after the operation. The dorsoplantar (C) and oblique (D) radiographs taken 8 weeks after the operation show that the operation site healed. Arthroscopy Techniques 2016 5, e1311-e1316DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions


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