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Arthroscopy of the ankle joint

Arthroscopy of the ankle joint

This complicated hinge joint is responsible for raising and lowering the foot and is stressed with every step. Above the ankle joint the foot is connected to the tibia (shinbone). Arthroscopy (endoscopy) of the ankle joint is today an indispensable part of treatment methods. It can be used for diagnosis and treatment.
Indication
The indications for ankle arthroscopy can be subdivided into diseases of the joint membrane (synovia), of the ligaments, and of the cartilage, and into damage to the cartilage.

Synovia
Diseases of the joint membrane, such as occur after injuries to the ankle or to independently arising disease (pigmented villonodular synovitis), can be treated by arthroscopy. Regardless of the underlying disease, joint mucous membrane (synovectomy) is usually removed. If there is joint inflammation with pus, the joint is rinsed out.
Meniscoid syndrome
Narrowing (impingement) of the ankle joint with painful restrictions on movement often occurs after injuries. The concept of “meniscoid” is used for a thickened folding of the mucous membrane between the tibia (shin bone) and the fibula (calf bone) as a result of ligament injuries to the ankle joint. Results of arthroscopic treatment of the impingement are very promising, with good to very good results in 75-90% of patients.  

Football Joint and Football Nose
These terms refer to typical changes of the ankle joint in athletes, in particular in soccer players in an advanced stage of their career. Radiologic changes show up on the ankle bone (talus) and front shinbone (tibia) in the form of bony protuberances. Under arthroscopy, a thickened and villiform inflamed mucous membrane of the joint is found next to the bony protuberances (osteophytes). The osteophytes are removed under arthroscopy with resulting improved joint movement.  

Osteochondral injury
Injury to the bone or cartilage is an acute disease that often occurs after a sprain of the ankle joint. Smaller fragments of cartilage are removed. Larger fragments are either screwed in again or removed, and the underlying bones are bored through (microfracture).

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