Ankle arthroscopy is performed through two portals opened on the anterolateral and anteromedial part of ankle joint. Prof.Dr.Şeref Aktaş, while performing ankle arthroscopy may open additional portals as needed. The size of a portal is about 1 cm. Ankle arthroscopy is performed under either general anesthesia or spinal / epidural anesthesia.
Ankle Cartilage Problems
The talar osteochondral lesion (osteochondritis dissecans) can be seen and treated with arthroscopic surgery. Prof.Dr.Şeref Aktaş removes the damaged cartilage parts with arthroscopic tools called curette, shaver and artrocare. Then if the lesion is under 1 cm, the subchondral bone is drilled to promote bleeding and vascularisation so that a new cartilage can be formed. If the osteokondral lesion is bigger than 1.5 cm then a tube shaped ostechondral greft taken from knee joint is used to fill the osteochondral defect area. This procedure is called mosaicplasty.
Cartilage Tissue Transfer
Sometimes, the patient is not suitable for mosaicplasty or the osteochondral lesion is way bigger. Then, autolog cartilage tissue transfer can be planned. In this procedure, a small sample of cartilage is taken from patiens own knee cartilage. It is cultured using stem cell technology within 4-6 weeks. Finally, newly produced autologous cartilage tissue is transferred to the osteochondral defect area. This final procedure can be done by either arthroscopy or open surgery. Surgical preference is made depending on the size of the cartilage tissue transferred. This recent development in cartilage surgery have become popular and routine in our practise.So far, the only drawback lookk the cost of the whole procedure.
Ankle arthroscopy is also used in synovitis, antrarticular fractures, intraarticular loose bodies, arthrofibrosis, and ankle impingement diseases.
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Key Words: Talus, osteochondritis dissecans, ankle arthroscopy, ankle impingement disease, ankle arthrofibrosis, ankle impingement disease.