Complications of Ankle Arthroscopy

Of over 4500 ankle arthroscopies recently surveyed by the Arthroscopy Association of North America, only one complication (an infection) was reported. Nerve injury, vascular injury, or reflex sympathetic dystrophy were not reported. The ankle’s anatomy is complex and there are many structures that can be damaged by imprecise portal placement. A review of our experience with 53 consecu-tive ankle arthroscopies found nine complications for a rate of 17%. There were three permanent dorsal sensory nerve injuries, two synovial fistulas, three wound infec-tions, and one reflex sympathetic dystrophy. A literature review found other reported complications to include in-strument breakage, synovitis, painful scars and nodules, and fibula fracture. Complications occur with ankle ar-throscopy more frequently than previously reported, and the average or beginning ankle arthroscopist should ex-pect a higher rate of surgical complication than has been previously reported. Ankle arthroscopy provides diagnostic information not available by conventional clinical and radiographic examinations or minimally invasive operative options, about such varied conditions as ankle loose bodies, talar dome fractures, osteochondral defects of the tibial plafond, posttraumatic adhesions, synovitis, and ante-rior oste~phytes.~,’ Ankle arthroscopy is a demanding procedure and due to the complex anatomy of the ankle, there may be a greater potential for complication than with other joints such as the knee.2 The close association of many anatomical structures on both the anterior and posterior aspects of the ankle increases the likelihood of damag