SLR - June 2012 - Frank A. Luckino III
Reference: Deng D.F., Hamilton, G.A., Lee M., Rush S., Ford L.A., Patel S. (2012). Complications Associated with Foot and Ankle Arthroscopy. The Journal of Foot and Ankle Surgery, 51, 281-284
Scientific Literature Review
Reviewed by: Frank A. Luckino III, DPM
Residency Program: Kaiser Permanente/Cleveland Clinic Foundation
Podiatric Relevance:
Foot and ankle arthroscopy is a relatively new surgical modality that is an effective tool for diagnosis as well as treatment of foot/ankle pathology. This study reviews potential complications associated with this intervention.
Methods:
A multi-center review of complications following hindfoot arthroscopic procedures involving four institutions was undertaken over a three year period. A total of 405 procedures were reviewed with 260 having met inclusion criteria. Surgeries were performed by four different individuals. Arthroscopic intervention was performed as a single procedure, in conjunction with fracture reduction, or for observation of joint cavities following acute trauma. Patients were required to have ≥ six months of follow up. Complications were characterized as nerve injury, infection, deep vein thrombophlebitis, or continued pain.
Results:
Median age of patients was 41.5 years. The most common reason for arthroscopic surgery was secondary to ankle sprain (56.15 percent) and ankle fracture (22.31 percent). There were no statistically significant predictive factors for complication. Complications were more likely when arthroscopy was done in conjunction with other procedures. The overall complication rate was 8 percent. Twenty complications were reported in total. Nerve injury was the most common cause (45 percent) followed by infection (40 percent). There were two reported cases of continued pain and one case of deep vein thrombophlebitis which was non-fatal. Most commonly injured nerves included superficial peroneal nerve (25 percent), deep peroneal nerve (10 percent), and sural/saphenous nerve (5 percent each).
Conclusions:
This study provides evidence that foot and ankle arthroscopy is a relatively safe procedure with relatively few complications. It is important, however, to have a sound understanding of the anatomy and relevant neurovascular structures to prevent any unnecessary post-operative complications.