title: Ankle surgery: focus on arthroscopy.
abstract: BACKGROUND
  The ankle joint can be affected by several diseases, with clinical presentation varying from mild pain or swelling to inability, becoming in some cases a serious problem in daily life activities. Arthroscopy is a widely performed procedure in orthopedic surgery, due to the low invasivity compared to the more traditional open field surgery. The ankle joint presents anatomical specificities, like small space and tangential view that make arthroscopy more difficult.
  
  
  METHODS
  From 2000 more than 600 ankle arthroscopies were performed at our institution. The treated pathologies were mostly impingement syndrome and osteochondral lesions, and in lower percentage instabilities and ankle fractures.
  
  
  RESULTS
  In the impingement, the AOFAS scores at FU showed an increase compared to scores collected preoperatively, with improvement of symptoms in most of the cases, good or excellent results in 80 % of cases. In ligament injuries, AOFAS score significatively improved at the maximum follow-up. In fractures all patients had an excellent AOFAS score at maximum follow-up, with complete return to their pre-injury activities. In osteochondral injuries, the clinical results showed a progressive improvement over time with  the different performed procedures. Control MRI and bioptic samples showed a good regeneration of the cartilage and bone tissue in the lesion site.
  
  
  CONCLUSIONS
  The encouraging obtained clinical results, in line with the literature, show how the arthroscopic technique, after an adequate learning curve, may represent a precious aid for the orthopedic surgeon and for the patient's outcome.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Clinical Orthopaedic and Traumatology Unit I, Rizzoli Orthopaedic Institute, Bologna, Italy, marco.cavallo@ior.it.
authors.forename: M
authors.initials: M
authors.lastname: Cavallo
authors.forename: S
authors.initials: S
authors.lastname: Natali
authors.forename: A
authors.initials: A
authors.lastname: Ruffilli
authors.forename: R
authors.initials: R
authors.lastname: Buda
authors.forename: F
authors.initials: F
authors.lastname: Vannini
authors.forename: F
authors.initials: F
authors.lastname: Castagnini
authors.forename: E
authors.initials: E
authors.lastname: Ferranti
authors.forename: S
authors.initials: S
authors.lastname: Giannini
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods* / Q000706:statistics & numerical data; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D003646:Debridement; D050723:Fractures, Bone / Q000601:surgery / Q000628:therapy; D006801:Humans; D007594:Joint Loose Bodies / Q000601:surgery; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D010027:Osteotomy; D011859:Radiography; D012189:Retrospective Studies; D013628:Talus / Q000293:injuries / Q000601:surgery; D013978:Tibial Fractures / Q000601:surgery / Q000628:therapy; D054457:Tissue Scaffolds; D055815:Young Adult
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