Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic ReviewEvidence-Based Indications for Ankle Arthroscopy
Section snippets
Methods
A comprehensive review of the literature was performed (in August 2008) by use of the PubMed database and key words “ankle” and “arthroscopy,” revealing 560 articles. The current generally accepted indications for ankle arthroscopy were also separately searched in the PubMed database along with the key words “ankle” and “arthroscopy.” Non–English language literature without English translation was excluded. The abstracts from these searches were reviewed to isolate literature that described
Results
A summary of the grade of recommendation for or against the current generally accepted indications for ankle arthroscopy is presented in Table 3. Fair evidence-based literature (grade B) exists to support a recommendation for the use of ankle arthroscopy in the treatment of ankle impingement (Table 4, Table 5) and OCL (Table 6, Table 7) and for ankle arthrodesis (Table 8, Table 9). A summary of key articles describing all the current generally accepted indications for ankle arthroscopy is
Discussion
Orthopedic surgeons are always searching for ways to improve on current methods so as to provide maximal benefit for each intervention while minimizing its impact. Such benefits have been anticipated with ankle arthroscopy and in some instances have been realized. Compared with open arthrotomy, arthroscopy has the potential to shorten recovery times and limit surgical morbidity. Because of perceived benefits, surgeons have been quick to adopt ankle arthroscopy for a number of current generally
Conclusions
A comprehensive review of the literature has provided predominantly Level III and IV evidence with far fewer Level I and II trials. This has allowed grade B recommendations for the use of ankle arthroscopy for the treatment of ankle impingement and osteochondral lesions and for ankle arthrodesis. Ankle arthroscopy for loose bodies, ankle instability, septic arthritis, and arthrofibrosis is supported by a grade C recommendation. The use of arthroscopy for ankle OA is not supported by the
Acknowledgment
The authors thank Dr. Annunziato Amendola for his support.
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