Arthroscopic debridement of the ankle in synovitis

J Med Life. 2023 Aug;16(8):1235-1239. doi: 10.25122/jml-2023-0117.

Abstract

Inflammation and hypertrophy of the ankle joint's synovial lining can occur due to various causes. Chronic pain and degenerative changes may be due to synovitis causing clinical manifestations through traction on the joint capsule. The failure of conservative treatment for at least six months indicates arthroscopic debridement, which can provide significant pain relief without the morbidity of extensive surgical exposures. This study was therefore conducted to establish the functional results of arthroscopic debridement of the ankle joint in synovitis. Fifteen patients with chronic ankle pain who had not responded to conservative treatment for approximately six months were included in the study. Arthroscopic debridement was performed using a shaver blade, followed by a postoperative ankle physiotherapy regimen. Patients were assessed preoperatively and postoperatively using the AOFAS, FADI, and VAS scores, with a mean follow-up period of 26 months. There was a significant improvement in the final clinical outcomes of the patients. The post-operative VAS score improved to 2.20±0.56 (2-4) (p-value=0.001), the AOFAS score was 86±8.25 (65-98) (p-value-0.001), and the FADI Score was 86.93±7.35(70-96) (p-value=0.001). Thirteen patients (86.67%) achieved outstanding or good results, while two had fair results, according to Meislin's criterion. One patient reported a superficial wound infection, which subsided with antibiotic therapy. The study findings indicate that arthroscopic ankle debridement is an efficient method to treat persistent ankle discomfort induced by synovitis, and it has a low postsurgical complications rate, quicker recovery, and less joint stiffness.

Keywords: AOFAS: American Orthopaedic Foot and Ankle Society; FADI: Foot and Ankle Disability Index; Meislin's criterion; NSAIDs: Nonsteroidal Anti-Inflammatory Drugs; VAS: Visual Analogue Scale; arthroscopic debridement; synovial lining; synovitis.

MeSH terms

  • Ankle Joint / surgery
  • Ankle* / surgery
  • Debridement / methods
  • Humans
  • Pain
  • Retrospective Studies
  • Synovitis* / etiology
  • Synovitis* / surgery
  • Treatment Outcome