Research Article
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Ardayak Endoskopisi: Preoperatif Endikasyonların Perioperatif Endoskopik Bulgular ile Korelasyonu

Year 2018, Volume: 25 Issue: 1, 63 - 69, 30.03.2018
https://doi.org/10.17343/sdutfd.391224

Abstract

Amaç: Bu çalışmanın amacı, ardayak
endoskopisi ile tedavi edilen patolojilerin değerlendirilmesi ve kombine patolojilerin
oranları ve tiplerinin saptanmasıdır. Çalışmanın bir diğer amacı ise operasyon
öncesi ve ardayak endoskopisi sırasında saptanan bulguların korelasyonudur.

Hastalar ve Metod: 2010-2015
yılları arasında ardayak endoskopisi uygulanan 77 hastanın 81 ayak bileği
değerlendirmeye alınmıştır. Tüm hastaların demografik bilgileri, preoperatif
fizik muayene ve radyolojik bulguları ve operasyon notları gözden
geçirilmiştir. Operasyon öncesi tüm hastalara standart ayak bileği fizik
muayene testleri uygulanmıştır. Yüklenmede ayak bilek ön-arka ve yan direkt
radyografileri alınmıştır. Manyetik rezonans görüntüleme, direkt radyografide
belirgin kemik sıkışması olan hastalar hariç tüm hastalara uygulanmıştır.
Ardayak endoskopisi tüm hastalara genel ya da spinal anestezi altında pron
pozisyonda van Dijk ve ark. tarafından tanımlanmış olan standart posteromedial
ve posterolateral portaller kullanılarak uygulanmıştır.

Sonuçlar: Bu olgu
serisinde en sık saptanan preoperatif endikasyonlar fleksör hallusis
longus  tendinopatisi(%27.1), semptomatik
os trigonum(%22.2) ve insersiyonel aşil tendinopatisi(%20.9) olarak
bulunmuştur. En sık saptanan endoskopik bulgular ise sırası ile fleksör
hallusis longus tendinopatisi(%33.3), semptomatik os trigonum(%19.3) ve
retrokalkaneal bursit(%16.2) olarak saptanmıştır. 16 hastada preoperatif
kombine patoloji saptanmıştır. 32 hastada ise ardayak endoskopisi sırasında
preoperatif endikasyonlara yeni bir endikasyon eklenmiştir.


























Çıkarımlar: Ardayak
endoskopisinin en sık endikasyonları ayak bileği posterior sıkışma sendromu ve
aşil tendon çevresi patolojileri olarak belirtilebilir. Operasyon sırasında
saptanabilecek yeni endikasyonlar ve nadir durumlar konusunda uyanık olmak
gerekmektedir. 

References

  • 10- Galla M, Lobenhoffer P (2011) Technique and results of arthroscopic treatment of posterior ankle impingement. Foot Ankle Surg 17:79–84
  • 11- Guo QW, Hu YL, Jiao C, Ao YF, Tian DX (2010) Open versus endoscopic excision of a symptomatic os trigonum: a comparative study of 41 cases. Arthroscopy 26:384–390
  • 12- Ahn JH, Kim Y-C, Kim H-Y (2013) Arthroscopic versus posterior endoscopic excision of a symptomatic os trigonum: a retrospective cohort study. Am J Sports Med 41:1082–1089
  • 13- Bojanic I, Bergovec M, Smoljanovic T (2009) Combined anterior and posterior arthroscopic portals for loose body removal and synovectomy for synovial chondromatosis. Foot Ankle Int. 30:1120–1123
  • 1- Watanabe M (1972) Selfoc-arthroscope (Watanabe no 24 arthroscope).Monograph. Teishin Hospital, Tokio
  • 2- van Dijk CN, Scholten PE, Krips R (2000) A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy 16:871–876
  • 3- Spennacchio P, Cucchi D, Randelli PS, van Dijk NC. Evidence-based indications for hindfoot endoscopy. Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1386-95.
  • 4- Ogut T, Ayhan E, Irgit K, Sarikaya AI. Endoscopic treatment of posterior ankle pain. Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1355-61.
  • 5- de Leeuw PA, van Sterkenburg MN, van Dijk CN. Arthroscopy and endoscopy of the ankle and hindfoot. Sports Med Arthrosc Rev. 2009 Sep;17(3):175-84.
  • 6- Unal M, Ercan S, Baykal B, Alfidan S. Flexor digitorum accessorius longus tendon as unusual cause of flexor hallucis longus tendon impingement. Medicina dello Sport 2017 June;70(2):222-6
  • 7- Abdelatif NMN (2014) Combined arthroscopic management of concurrent posterior and anterior ankle pathologies. Knee Surg Sports Traumatol Arthrosc 22:2837–2842
  • 8- Calder JD, Sexton SA, Pearce CJ (2010) Return to training and playing after posterior ankle arthroscopy for posterior impingement in elite professional soccer. Am J Sports Med 38:120–124
  • 9- Corte-Real NM, Moreira RM, Guerra-Pinto F (2012) Arthroscopic treatment of tenosynovitis of the flexor hallucis longus tendon. Foot Ankle Int 33:1108–1112

Hindfoot Endoscopy: Correlation of the Preoperative Indications with the Perioperative Endoscopic Findings

Year 2018, Volume: 25 Issue: 1, 63 - 69, 30.03.2018
https://doi.org/10.17343/sdutfd.391224

Abstract

Background: The aim
of this study was to review the disorders treated with hindfoot endoscopy and
investigate the detected ratio and type of combined pathologies. The second aim
was to evaluate the preoperative and peroperative findings before and at the
time of hindfoot endoscopy.

Patients and Methods: 81
hindfoot endoscopies of the 77 patients performed between 2010-2015 were
reviewed. Demographic informations, preoperative physical and radiological
findings and operative data of all patients were noted. Preoperative physical
examination for hindfoot was performed in a standart fashion for all patients. Weight-bearing
anteroposterior and lateral radiographs were taken for all patients. Magnetic
resonance imaging(MRI) was performed to all patients except obvious prescence
of bony impingement. The hindfoot endoscopy was performed to all patients at
prone position under either spinal or general anesthesia with standart
posteromedial and posterolateral portals described as Van Dijk et al.

Results: In this
case series; the most detected preoperative indications were flexor hallucis
longus tendinopathy(27.1%), symptomatic os trigonum(22.2%) as a cause of
posterior ankle impingement and insertional achilles tendinopathy(20.9%). The most
detected endoscopic findings were flexor hallucis longus
tendinopathy(33.3%),  symptomatic os
trigonum(19.3%), and retrocalcaneal bursitis(16.2%).16 patients(19.7%) had
preoperatively detected combined pathologies. In 32 patients(39.5%), a new
indication was added to preoperative indication.


























Conclusion: Posterior
ankle impingement and peri-achilles pathologies are the most seen indications
for this technique. It is important that we all must aware of perioperatively
detected new indications and rare conditions.

References

  • 10- Galla M, Lobenhoffer P (2011) Technique and results of arthroscopic treatment of posterior ankle impingement. Foot Ankle Surg 17:79–84
  • 11- Guo QW, Hu YL, Jiao C, Ao YF, Tian DX (2010) Open versus endoscopic excision of a symptomatic os trigonum: a comparative study of 41 cases. Arthroscopy 26:384–390
  • 12- Ahn JH, Kim Y-C, Kim H-Y (2013) Arthroscopic versus posterior endoscopic excision of a symptomatic os trigonum: a retrospective cohort study. Am J Sports Med 41:1082–1089
  • 13- Bojanic I, Bergovec M, Smoljanovic T (2009) Combined anterior and posterior arthroscopic portals for loose body removal and synovectomy for synovial chondromatosis. Foot Ankle Int. 30:1120–1123
  • 1- Watanabe M (1972) Selfoc-arthroscope (Watanabe no 24 arthroscope).Monograph. Teishin Hospital, Tokio
  • 2- van Dijk CN, Scholten PE, Krips R (2000) A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy 16:871–876
  • 3- Spennacchio P, Cucchi D, Randelli PS, van Dijk NC. Evidence-based indications for hindfoot endoscopy. Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1386-95.
  • 4- Ogut T, Ayhan E, Irgit K, Sarikaya AI. Endoscopic treatment of posterior ankle pain. Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1355-61.
  • 5- de Leeuw PA, van Sterkenburg MN, van Dijk CN. Arthroscopy and endoscopy of the ankle and hindfoot. Sports Med Arthrosc Rev. 2009 Sep;17(3):175-84.
  • 6- Unal M, Ercan S, Baykal B, Alfidan S. Flexor digitorum accessorius longus tendon as unusual cause of flexor hallucis longus tendon impingement. Medicina dello Sport 2017 June;70(2):222-6
  • 7- Abdelatif NMN (2014) Combined arthroscopic management of concurrent posterior and anterior ankle pathologies. Knee Surg Sports Traumatol Arthrosc 22:2837–2842
  • 8- Calder JD, Sexton SA, Pearce CJ (2010) Return to training and playing after posterior ankle arthroscopy for posterior impingement in elite professional soccer. Am J Sports Med 38:120–124
  • 9- Corte-Real NM, Moreira RM, Guerra-Pinto F (2012) Arthroscopic treatment of tenosynovitis of the flexor hallucis longus tendon. Foot Ankle Int 33:1108–1112
There are 13 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

A. Meric Unal

Publication Date March 30, 2018
Submission Date February 7, 2018
Acceptance Date February 12, 2018
Published in Issue Year 2018 Volume: 25 Issue: 1

Cite

Vancouver Unal AM. Hindfoot Endoscopy: Correlation of the Preoperative Indications with the Perioperative Endoscopic Findings. Med J SDU. 2018;25(1):63-9.

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