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Scoping Out a Rear View of the Ankle Joint

The ankle is a unique and complex joint. Getting inside the ankle to repair or remove tissue is often a challenge for doctors, especially when they need to work from the back of the ankle. Nerves and blood vessels can be damaged easily in this part of the ankle. Making a large incision to open up and visualize the back of the joint is one way to avoid damage.

Doctors around the world are trying to find an easier way to solve this problem. The arthroscope may help find an answer. An arthroscope is a slender instrument that can be inserted into a joint. It has a tiny TV camera on the end that allows the doctor to see inside the joint and perform the needed repairs.

Doctors in the Netherlands and Italy are working together to find a safe way to enter the back of the ankle joint using an arthroscope. They are using cadavers to practice first. Cadavers are human bodies preserved for study.

Using a cadaver gives the doctor the chance to insert instruments and then open the joint to see where the instruments are located. The doctors can then measure how close the instrument gets to nearby nerves or blood vessels. Researchers use this method to give other doctors specific directions. They can describe where and how to place surgical instruments for the safest approach and best results.

These authors found a place to insert the arthroscope in an area along the inside edge of the back of the ankle. According to the authors, this spot provides safe clearance of the arthroscope from the nerves and vessels.

Francesco Lijoi, MD, et al. Posterior Arthroscopic Approach to the Ankle: An Anatomic Study. In Arthroscopy. January 2003. Vol. 19. No. 1. Pp. 62-67.

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