Early functional results of arthroscopic surgery for ankle lesions

摘要

Objectives: We evaluated early functional results of arthroscopic surgery in the treatment of ankle pathologies. Methods: A total of 32 patients (17 males, 15 females; mean age 35 years; range 17 to 54 years) underwent arthroscopic surgery for ankle lesions, which included osteochondritis dissecans (n=21), synovitis (n=6), impingement syndrome (n=4), and synovial chondromatosis. Arthroscopic surgery was performed in the left ankle in 15 patients, and in the right ankle in 17 patients. Osteochondral lesions were assessed by the Berndt-Harty, arthroscopic views by the Ferkel-Cheng classification systems. Preoperative and postoperative functional evaluations were made using the Freiburg ankle scoring system. The mean follow-up was 42 months (range 11 to 84 months). Results: There was no improvement in Freiburg scores within nine weeks in patients with osteochondritis dissecans, whose preoperative mean score was 66. However, at the end of 3.5 months, the Freiburg scores manifested a marked increase to a mean of 88. Functional scores increased from 72 to 90, and from 80 to 95 in patients with synovitis and impingement syndrome, respectively, at the end of nine weeks. The patient with synovial chondromatosis became symptom-free after two months. Complications included breakage of a drill in one patient and development of reflex sympathetic dystrophy in another. Conclusion: Arthroscopic surgery for ankle lesions decreases surgical morbidity and promotes functional improvement, especially in patients with osteochondritis dissecans, synovitis, and impingement syndrome.