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1.
Oper Orthop Traumatol ; 35(6): 397-402, 2023 Dec.
Article in German | MEDLINE | ID: mdl-37857816

ABSTRACT

THE PROBLEM: Cementless medial unicondylar knee prostheses with mobile inlays have proved to be successful and are increasingly being used worldwide; however, there is a risk of fracture of the medial tibial plateau in the postoperative healing phase. THE SOLUTION: In most cases we observed split fractures starting from the keel of the implant. These can be treated with a small posteromedial locking plate, whereby the upper screws are inserted through the keel slot and then interlocked. This achieves an optimally strong bond between the implant and the screws and a stable construct. SURGICAL TECHNIQUE: A longitudinal skin incision is made at the level of the keel slot. A radial T­plate is placed subcutaneously. The plate is fixed with a lag screw in the middle section. The compression usually closes the fracture gap. Then three locking cortical bone screws are inserted through the keel slot in the transverse section of the plate. Distal fixation by locking or standard screws. POSTOPERATIVE MANAGEMENT: Immediate pain-adapted partial weight bearing, unrestricted mobility. Healing of the fracture and full weight bearing mostly achieved after 4 weeks.


Subject(s)
Arthroplasty, Replacement, Knee , Knee Prosthesis , Tibial Fractures , Humans , Treatment Outcome , Fracture Fixation, Internal , Tibial Fractures/diagnostic imaging , Tibial Fractures/surgery , Bone Plates
2.
Oper Orthop Traumatol ; 33(5): 456-462, 2021 Oct.
Article in German | MEDLINE | ID: mdl-34110435

ABSTRACT

OBJECTIVE: Establish a safe technique for high tibia osteotomy. INDICATIONS: Varus deformity of proximal tibia, high tibia osteotomy indicated. CONTRAINDICATIONS: Correct placement of retractor not possible. SURGICAL TECHNIQUE: Skin incision (6-8 cm) over the medial tibia. Dissection of the Pes anserinus tendons and the medial collateral ligament. Partial release of the distal medial collateral ligament by subperiosteal stripping of the distal part of the ligament. Incision of the gastrocnemius fascia posterior to the medial collateral ligament. Dissection of a soft tissue tunnel between periosteum of the tibia and popliteus muscle. Insertion of retractor, fluoroscopic adjustment in frontal plane according to the planned level of osteotomy. POSTOPERATIVE MANAGEMENT: Postoperative protocol according to the osteotomy technique and implant used. RESULTS: No bleeding complications since introduction of retractor in 22 cases. No changes in standard technique or incision necessary due to use of retractor.


Subject(s)
Osteotomy , Tibia , Humans , Knee Joint , Ligaments, Articular , Tendons , Tibia/diagnostic imaging , Tibia/surgery , Treatment Outcome
3.
Knee Surg Sports Traumatol Arthrosc ; 29(3): 889-899, 2021 Mar.
Article in English | MEDLINE | ID: mdl-32458033

ABSTRACT

PURPOSE: There has been a recent resurgence in interest in posterolateral instabilities of the knee joint. As this terminology comprises a large variety of pathologies, confusion and ambiguity in communication between surgeons and allied health professionals are generated. Consequently, accurate classification criteria are required to account for thorough preoperative diagnostics, surgical decision-making, and a standardized scientific documentation of injury severity. METHODS: A working group of five knee surgeons, who retrospect more than 2000 reconstructions of the posterolateral corner (PLC) at the minimum, was founded. An advanced PubMed search was conducted to identify key definitions. After defining an accurate diagnostic work-up, popular consensus was reached on definitions and covariates for a novel classification, rating of injury severity, and the resulting surgical decision-making. RESULTS: Three columns (lateral instability, cruciate ligament involvement, and relevant covariates), each ranging from A to D with increasing severity and assigning a number of points, were needed to meet the requirements. The generated terminology translated into the Posterolateral Instability Score (PoLIS) and the added number of points, ranging from 1 to 18, depicted the injury severity score. CONCLUSION: The presented classification may enable an objective assessment and documentation of the injury severity of the inherently complex pathology of injuries to the lateral side of the knee joint. LEVEL OF EVIDENCE: V.


Subject(s)
Clinical Decision-Making , Joint Instability/classification , Joint Instability/diagnosis , Knee Injuries/classification , Knee Injuries/diagnosis , Adult , Documentation , Humans , Injury Severity Score , Joint Instability/surgery , Knee Injuries/surgery , Knee Joint/surgery , Ligaments, Articular/injuries , Ligaments, Articular/surgery , Retrospective Studies
4.
PLoS One ; 15(12): e0244557, 2020.
Article in English | MEDLINE | ID: mdl-33378331

ABSTRACT

BACKGROUND: The supplemental screw technique was introduced for salvage of lateral hinge fracture in medial open-wedge high tibial osteotomy (owHTO). The efficacy of its use in protection of lateral hinge fracture and corresponding biomechanical behaviors remained unclear. The current study was aimed to clarify if a supplemental screw can provide better protection to lateral hinge in biomechanical perspective. MATERIALS: An in vitro biomechanical test was conducted. Tibial sawbones, commercial owHTO plates and a cannulated screw were utilized for preparing the intact, owHTO, and owHTO with cannulated screw insertion specimens. A "staircase" dynamic load protocol was adopted for axial compressive test with increasing load levels to determine structural strength and durability by using a material testing system, while a motion capture system was applied for determining the dynamic changes in varus angle and posterior slope of the tibia plateau with various specimen preparation conditions. RESULTS: Type II lateral hinge fracture were the major failure pattern in all specimens prepared with owHTO. The insertion of a supplemental cannulated screw in medial owHTO specimens reinforced structural stability and durability in dynamic cyclic loading tests: the compressive stiffness increased to 58.9-62.2% of an intact specimen, whereas the owHTO specimens provided only 23.7-29.2% of stiffness of an intact specimen. In view of tibial plateau alignment, the insertion of a supplemental screw improved the structural deficiency caused by owHTO, and reduced the posterior slope increase and excessive varus deformity by 81.8% and 83.2%, respectively. CONCLUSION: The current study revealed that supplemental screw insertion is a simple and effective technique to improve the structural stability and durability in medial owHTO.


Subject(s)
Osteotomy/instrumentation , Tibia/surgery , Tibial Fractures/surgery , Biomechanical Phenomena , Bone Screws , Humans , Models, Biological , Tibia/physiopathology , Tibial Fractures/physiopathology
5.
Z Orthop Unfall ; 158(5): 532-533, 2020 Oct.
Article in English, German | MEDLINE | ID: mdl-32838435

ABSTRACT

ACL insufficiency can be caused by different reasons. Elevated posterior tibial slope is a deformity which is discussed to have relevant influence on the outcome of ACL surgery. A increased posterior tibial slope of 12° or more leads to significant more ACL insufficiency. The surgical therapy of this pathology is a high tibial extension osteotomy. Publications ashowing a clinical follow up and results of this surgery are rare. In this video the technique of a closed wedge high tibial extension osteotomy is shown. Osteosynthesis is performed with two screws and an anklestable plate osteosynthesis. An arthroscopy with bone graft filling of the femoral ACL tunnel is performed first, followed by filling of the tibial tunnel in an open approach.


Subject(s)
Tibia , Arthroscopy , Humans , Knee Joint/diagnostic imaging , Knee Joint/surgery , Osteoarthritis, Knee , Osteotomy , Tibia/diagnostic imaging , Tibia/surgery
6.
Oper Orthop Traumatol ; 32(4): 367-384, 2020 Aug.
Article in German | MEDLINE | ID: mdl-32725290

ABSTRACT

OBJECTIVE: Restoration of anatomy of the joint surface of the tibial plateau in posttraumatic deformity. INDICATIONS: Malunions of the tibial plateau with significant intra-articular depression and/or steps. CONTRAINDICATIONS: Local or systemic infection, critical soft tissues in the area of planned incisions; advanced osteoarthritis of the knee; loss of meniscus in the involved compartment; motoric or neurophysiological impairment hindering normal knee function. SURGICAL TECHNIQUE: Malunion after posteromedial split fracture: posterior approach in prone position, osteotomy of the former fragment following the fracture lines, anatomical reduction of the fragment in extended position of the knee using the implant as reduction tool, fixation by posterior plate. Malunion after lateral and posterolateral split/depression fracture: Lateral approach with fibula head osteotomy in lateral decubitus position, intra-articular osteotomy of depressed fragments, autologous bone graft, lateral or posterolateral plate osteosynthesis. Osteosynthesis of fibula head with small fragment lag screw or tension-band. POSTOPERATIVE MANAGEMENT: Walking with crutches starting from day 1 after surgery. Partial weight-bearing until radiographic healing of the osteotomies, usually 4-6 weeks. No limitation of range-of-motion. RESULTS: A series of 23 patients had lateral corrective osteotomy after lateral tibial plateau fracture. Mean follow-up was 13 years (range 2-26 years). Two patients had early poor results. In all, 17 patients (74%) scored excellent in the Lysholm/Gillquist score, 3 patients good, 1 patient average and 2 patients poor.


Subject(s)
Osteotomy , Tibial Fractures , Fracture Fixation, Internal , Humans , Knee Joint , Tibia/surgery , Treatment Outcome
7.
J Knee Surg ; 30(8): 735, 2017 10.
Article in English | MEDLINE | ID: mdl-28854443
8.
9.
J Knee Surg ; 30(5): 409-420, 2017 06.
Article in English | MEDLINE | ID: mdl-28591931
10.
J Knee Surg ; 30(5): 386-392, 2017 06.
Article in English | MEDLINE | ID: mdl-28591932
11.
J Knee Surg ; 30(5): 385, 2017 06.
Article in English | MEDLINE | ID: mdl-28645135
12.
Int J Orthop Trauma Nurs ; 25: 42-47, 2017 May.
Article in English | MEDLINE | ID: mdl-28256419

ABSTRACT

BACKGROUND: The postoperative treatment after a standard surgical intervention such as knee arthroplasty, proximal tibial osteotomy or supracondylar osteotomy, can have an important impact on the overall treatment outcome. In most cases, outcomes are positively effected by patients receiving physiotherapy and occupational therapy. Basic movements and range of motion need to be learnt. Self-responsible behaviour, which is similar to exercise programs in sports, needs to be supported. However, in most cases the transfer of training techniques into successful and desired postoperative care is not simple. A training technique needs to be developed which is self-explanatory, effective, encouraging for and accessible to the patient. OBJECTIVES: The purpose of this study was to describe and evaluate an easy and effective technique to support regular physiotherapy in early postoperative rehabilitation using a sphygmomanometer device. Measurements were undertaken relating to handling, training results and motivation. DESIGN: This was a descriptive study. METHODS: Forty one patients were instructed to undertake extension exercises of the knee in the early postoperative phase. A sphygmomanometer cuff was rolled out and placed just below the popliteal fossa, and inflated to 20 mmHg. In this position the patients were prompted to push the knee down with the maximum available power. The quadriceps muscle of the leg is activated when patients extend the knee using two thirds of their maximum power, and then followed by one third of their maximum power. This exercise sequence was carried out three times for 5 seconds. The results were documented by using a patient questionnaire. RESULTS: Thirteen patients indicated that they felt highly motivated while undertaking the training program. One patient reported poor motivation due to inconvenient handling (preparing the cuff by closing the valve screw or calculating the target value) and six patients reported that the method of handwritten recording of training sessions needed to be improved. There were no technical problems. The training results were rated as being predominantly good. Due to the variation in individual ability in extending the knee, comparison of the overall values obtained could not be done. CONCLUSION: The use of a sphygmomanometer device is cheap and feasible technique in postoperative independent knee extension training.


Subject(s)
Arthroplasty, Replacement, Knee , Osteoarthritis, Knee/rehabilitation , Patient Satisfaction , Sphygmomanometers , Exercise Therapy , Female , Humans , Male , Middle Aged , Osteoarthritis, Knee/nursing , Osteoarthritis, Knee/surgery , Range of Motion, Articular , Recovery of Function
13.
Knee Surg Sports Traumatol Arthrosc ; 22(10): 2452-7, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24781275

ABSTRACT

PURPOSE: To compare clinical and radiological outcomes of static and dynamic medial patellofemoral ligament (MPFL) reconstruction techniques. METHODS: In a retrospective, matched-paired, cohort analysis, 30 patients surgically treated for recurrent lateral patellar dislocation were divided into two groups of 15 patients matched for inclusion and exclusion criteria. The static technique group underwent rigid fixation of the gracilis tendon at the anatomic femoral MPFL insertion and the superomedial border of the patella; the dynamic technique group underwent detachment of the gracilis tendon at the pes anserinus with fixation to the proximal medial patellar margin via tunnel transfer obliquely through the patella. Kujala, Lysholm, and Tegner scores; pain level; and pre- and postoperative radiographic changes of patellar height, patellar tilt, and bisect offset were compared. RESULTS: No significant between-group differences were found in mean Kujala, Tegner, Lysholm, or visual analogue scale scores or radiographic parameters. One case of resubluxation was observed in the dynamic group. All but one patient in each group would have been willing to undergo the procedure again. CONCLUSIONS: Both techniques provided satisfactory short-term outcomes. LEVEL OF EVIDENCE: III.


Subject(s)
Arthroplasty/methods , Ligaments, Articular/surgery , Patellar Dislocation/surgery , Patellofemoral Joint/surgery , Adolescent , Adult , Female , Femur/surgery , Humans , Male , Patella/surgery , Plastic Surgery Procedures/methods , Retrospective Studies , Tendons/transplantation , Young Adult
14.
Int Orthop ; 38(1): 55-60, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24022738

ABSTRACT

PURPOSE: Nicotine abuse and obesity are well-known factors leading to common post-operative complications. However, their influence on the outcome after high tibial osteotomy is controversial. Thus, the aim of this study was to evaluate their effect on the clinical outcome with particular regard to bone non-union and local complications. METHODS: The functional outcome after open-wedge high tibial osteotomy using the TomoFix® plate was assessed by means of the 12-item Oxford knee score in a multicentre study. In addition the intra- and post-operative complications were determined. RESULTS: Of 533 eligible patients, 386 were interviewed after a mean follow-up of 3.6 years. The median Oxford knee score was 43 points (max. 48 points). Six per cent of these patients experienced at least one local post-operative complication. Patients with a body mass index (BMI) of up to 25 and between 25 and 30 had a higher mean score by 3.5 and 1.8 points, respectively, compared with those having a BMI of more than 30 showing a score of 37.5. No correlation was observed between smoking and the functional outcome. Smoking habits, BMI, the absolute patient weight and the interaction term between smoking and BMI were not significant with reference to the complication rate. CONCLUSIONS: This study reveals favourable mid-term results after high tibial osteotomy in varus osteoarthritis even in patients who smoked and obese patients. The indication in patients with a BMI above 30 should be handled with care due to the slightly inferior outcome, although the complication rate was not increased in these patients.


Subject(s)
Obesity/complications , Osteoarthritis, Knee/surgery , Osteotomy/adverse effects , Tibia/surgery , Tobacco Use Disorder/complications , Adolescent , Adult , Aged , Aged, 80 and over , Body Mass Index , Bone Plates , Follow-Up Studies , Humans , Incidence , Middle Aged , Osteotomy/methods , Postoperative Complications/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
16.
Knee Surg Sports Traumatol Arthrosc ; 21(1): 213-9, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22810885

ABSTRACT

PURPOSE: The purpose of this study was to examine the incapacity of work related to work load according to the classification that has been introduced by the REFA Association and the clinical outcome after open wedge HTO with autologous bone graft from the iliac crest. METHODS: A total of 32 patients who were employed and able to work at the time of the surgery as well as treated with an open wedge HTO with the LC-DCP and autologous bone wedges from the iliac crest could be included in the radiological and clinical examination (77 months, SD ± 19). Postoperative duration of the incapacity of work and subjective ratings were based on the information provided by the patients themselves. The German classification that has been established by the REFA Association was used to classify the work load. Several clinical scores were used for clinical assessment. RESULTS: The duration of incapacity of work (median, 87 days; range, 14-450) demonstrated a relation to work load according to REFA. The Lysholm score, the HSS score and the score according to Lequesne augmented by 19.2 ± 16.8 (p < 0.0001), 15.6 ± 13.2 (p < 0.0001) and -6.0 ± 5.1 (p < 0.0001), respectively. The Tegner score gained from median 3 (range, 1-5) to 4 (range, 1-8). CONCLUSION: In this study, a relation was found between work load divided into different categories according to the classification established by the REFA Association and the duration of incapacity of work after open wedge HTO. An improvement of all clinical scores was observed. Typical neurological complications after autologous bone transplantation from the iliac crest were observed in 19% of our patient population. LEVEL OF EVIDENCE: IV.


Subject(s)
Genu Varum/surgery , Ilium/transplantation , Knee Joint/surgery , Osteoarthritis, Knee/surgery , Osteotomy/rehabilitation , Return to Work , Tibia/surgery , Adult , Female , Follow-Up Studies , Genu Varum/complications , Genu Varum/diagnostic imaging , Genu Varum/rehabilitation , Health Status Indicators , Humans , Knee Joint/diagnostic imaging , Male , Middle Aged , Osteoarthritis, Knee/complications , Osteoarthritis, Knee/diagnostic imaging , Osteoarthritis, Knee/rehabilitation , Osteotomy/methods , Radiography , Recovery of Function , Retrospective Studies , Self Report , Tibia/diagnostic imaging , Transplantation, Autologous , Treatment Outcome , Workload
17.
Knee Surg Sports Traumatol Arthrosc ; 21(1): 170-80, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22744433

ABSTRACT

PURPOSE: Open-wedge valgus high tibial osteotomy is a well-established procedure in the management of medial osteoarthritis of the knee. In recent years, improved osteotomy and fixation methods have led to an increased use of this technique. The aim of this study was to identify predictive parameters for the clinical outcome after valgus high tibial osteotomy. METHODS: A multicentre case series involving retrospective capture of baseline data and prospective outcome assessment of patients with knee OA who underwent an osteotomy using Tomofix(®) plate was conducted. Functional outcome was assessed using Oxford 12-item Knee Score. RESULTS: Before surgery, the majority of patients had grade III (52%) and grade IV (33%) lesions according to Outerbridge classification. Three hundred and eighty-six of 533 eligible patients were interviewed for follow-up after an average of 3.6 years. The mean Oxford Knee Score was 43 points. Six per cent experienced at least one local postoperative complication. There was a tendency towards lower score results in patients with a higher preoperative degree of the medial cartilage lesion. No correlation between patient age and the Oxford Knee Score was observed. CONCLUSION: Being male, being operated by an experienced surgeon, having no intake of pain medication at follow-up and having no postoperative complication are positive predictors of the Oxford Knee Score up to 5 years after surgery. This study reveals favourable midterm results after valgus high tibial osteotomy in varus osteoarthritis, even in older patients with high degree of cartilage damage. LEVEL OF EVIDENCE: II.


Subject(s)
Bone Plates , Knee Joint/surgery , Osteoarthritis, Knee/surgery , Osteotomy/methods , Tibia/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Health Status Indicators , Humans , Knee Joint/physiology , Linear Models , Male , Middle Aged , Multivariate Analysis , Osteotomy/instrumentation , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Recovery of Function , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
18.
Knee Surg Sports Traumatol Arthrosc ; 21(7): 1540-5, 2013 Jul.
Article in English | MEDLINE | ID: mdl-22766688

ABSTRACT

PURPOSE: Visualization and surgery of tears in the posterior medial meniscus are difficult in tight knees. Iatrogenic chondral lesions might cause serious morbidity, and residual tears may result in inadequate symptom relief. We evaluated the clinical and radiological results of superficial medial collateral ligament (MCL) release during arthroscopic medial meniscectomy in tight knees. METHODS: Eighteen patients [median age: 43 years (22-59); median follow-up: 8.3 months (6-12)] who underwent arthroscopic meniscectomy were included in the study. Patients with ligamentous injuries, severe chondral damage or meniscal repairs were excluded. Preoperatively, anteroposterior knee radiographs were obtained with 11-kg valgus stress using a specialized instrument. During the operation, if opening of the medial knee in 30° flexion under 11-kg valgus stress was inadequate, controlled release of the posterior portion of the MCL was performed using a 16-gauge needle. Intraoperative valgus stress was monitored using a specially designed lateral support with mounted load cell. MCL injury was evaluated both with magnetic resonance imaging (MRI) and valgus stress radiographs, which were obtained in the 1st week and 3rd and 6th months postoperatively to monitor healing of the elongated MCL. RESULTS: In all patients, meniscectomy could be performed with adequate visualization of the posterior medial meniscus and without iatrogenic chondral injury. The median medial joint space width on valgus stress radiographs was 7.1 mm preoperatively and 9.1, 8.0 and 7.2 mm in the 1st week, and 3rd and 6th months, respectively (p < 0.0001). On MRI, the injured structure was the posterior two-thirds of the MCL. Median Lysholm score, which was 42 points before the operation, had increased to 94 points at the final follow-up (p = 0.0002). CONCLUSION: Controlled release of the MCL in tight knees allowed easier handling in posterior medial meniscus tears and a better understanding of tear configurations, avoiding iatrogenic chondral lesions. The MCL injury healed uneventfully. LEVEL OF EVIDENCE: IV.


Subject(s)
Arthroscopy/methods , Collateral Ligaments/surgery , Menisci, Tibial/surgery , Adult , Collateral Ligaments/diagnostic imaging , Collateral Ligaments/injuries , Female , Humans , Injury Severity Score , Magnetic Resonance Imaging , Male , Menisci, Tibial/diagnostic imaging , Middle Aged , Radiography , Range of Motion, Articular , Tibial Meniscus Injuries
19.
Knee Surg Sports Traumatol Arthrosc ; 21(1): 189-96, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22773064

ABSTRACT

PURPOSE: The purpose of the study was to determine the interrater reliability as well as the correlation of mediCAD(®) and PreOPlan(®) in deformity analysis and digital planning of osteotomies. METHODS: Digital radiographs were obtained from 81 patients planned to undergo an open wedge high tibial osteotomy. The JPEG files of the radiographs were imported to landmark-based software. Deformity analysis and planning of correction were performed by 1 experienced and 2 unexperienced observers. Osteotomy planning was aimed at correction to the predefined mechanical tibiofemoral angle of 3° valgus leg alignment. The interrater reliability of measurements was assessed using intraclass correlation coefficients (ICCs) and the confidence interval. RESULTS: The ICC of PreOPlan(®) was from 0.841 (mechanical lateral distal femur angle) to 0.993 (wedge-angle) and from 0.896 (joint line convergence angle) to 0.995 (mechanical tibiofemoral angle) of mediCAD(®). The ICC of height of wedge-base was 0.979 with PreOPlan(®) and 0.969 with mediCAD(®). Comparing PreOPlan(®) and mediCAD(®), the ICC of the height of wedge-base of the observers was 0.966, 0.956 and 0.969, respectively. CONCLUSIONS: The results show a high interrater reliability of digital planning software. Experience of the observer had no influence on results. Furthermore, a high interrater reliability and correlation of digital planning specific parameters was found. Surgeons need to master limb geometry measurements and osteotomy planning on digital radiographs as digital planning reports are used for intercolleagual correspondence, teaching purposes and as medicolegal documents. The digital planning software tested agrees with the actual demands and could be recommended for deformity analysis and planning of osteotomies. LEVEL OF EVIDENCE: Diagnostic studies, Level I.


Subject(s)
Genu Varum/diagnostic imaging , Knee Joint/diagnostic imaging , Osteoarthritis, Knee/diagnostic imaging , Osteotomy/methods , Preoperative Care/methods , Software , Tibia/diagnostic imaging , Anatomic Landmarks/diagnostic imaging , Genu Varum/surgery , Humans , Knee Joint/surgery , Observer Variation , Osteoarthritis, Knee/surgery , Preoperative Care/instrumentation , Radiography , Tibia/surgery
20.
Foot Ankle Surg ; 17(2): 79-84, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21549977

ABSTRACT

BACKGROUND: The aim of this study was to investigate the outcome after arthroscopic procedures for treatment of posterior ankle impingement. METHODS: From June 2006 to April 2009 36 patients were treated by hindfoot arthroscopy. Indication was posterior ankle impingement due to symptomatic os trigonum or osteophytes. Pain on the VAS was evaluated pre- and postoperatively. Minimum follow-up was 6 months. RESULTS: 30 patients were available for follow-up. Follow-up averaged 9.7 months (range 6-14 months). Pain measured on the VAS improved significantly from 7.2 points to 1.3 points. One superficial (3.3%) and one deep wound infection (3.3%) occurred, 6.6% of our patients complained about impaired sensitivity of the sural nerve, and 6.6% required resurgery. CONCLUSIONS: Hindfoot arthroscopy is an elegant surgical technique in treatment of posterior ankle impingement. The minimally invasive procedure allows for low complication rates.


Subject(s)
Ankle Joint/surgery , Arthroscopy/methods , Joint Diseases/surgery , Follow-Up Studies , Humans , Osteophyte/surgery , Pain Measurement , Postoperative Complications
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