Abstract
Objective: The purpose of this study is to evaluate the prognosis of arthroscopic ankle treatment. Also we will formalise the relationship between the arthroscopic treatment and time for a further major ankle surgery
Patients and Methods: Consecutive Case Series study using prospectively gathered database. Between January 1997 to December 2000, Eighty consecutive patients (80 ankles) having ankle arthroscopy with the finding of Osteoarthritis (OA) or impingement were identified and their outcome at five years ascertained.
Arthroscopic procedure involved pre operative skin markings. Ankle distraction is used. An anterior approach used with standard Anteromedial and antero-lateral portals.
Treatment: debridement of osteochondral lesions, removal of loose bodies, curettage, drilling, synovec-tomy, and abrasion of the subchondral bone. All ankle joints had wash out.
Results: Results were examined using Kaplan Meier survival analysis. Statistical analysis of the results was done using Chi squared test.
Fifty five (69%) patients had soft tissue impingement, and 25 (31%) patients had osteoarthritic degenerative changes.
Seven (9%) patients had further major surgery and 6 (8%) had repeat arthroscopy.
The surgery was required for 7 arthritic ankles (7/25).
Survivorship: Survival analysis
28% of osteoarthritic patients progress to major ankle surgery, within 5 years of arthroscopic treatment. None of patients with impingement symptoms required further major surgery.
No statistical significance between those under 50 and those over 50 years in OA group
Conclusion: Arthroscopically treated impingement Ankles has an excellent prognosis, while osteoarthritic ankles have less favoured prognosis, with high proportion requiring further major surgery. Age does not affect prognosis in O.A group. Arthroscopy for OA, is likely to fail within 18 months.
Correspondence should be addressed to Mr Bimal Singh, BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE
