title: Trends in Ankle Arthroscopy and Its Use in the Management of Pathologic Conditions of the Lateral Ankle in the United States: A National Database Study.
abstract: OBJECTIVE
  This study aimed to investigate current trends in ankle arthroscopy across time, sex, age, and region of the United States as well as the use of ankle arthroscopy in the management of lateral ankle instability.
  
  
  METHODS
  Patients who underwent ankle arthroscopy and those who underwent ankle arthroscopy and lateral ankle ligament repair or peroneal retinacular repair from 2007 through 2011 were identified using the PearlDiver national database. These searches yielded volumes of unique patients, sex and age distribution, and regional volumes of patients. Χ-square linear-by-linear association analysis was used for comparisons, with P < .05 considered significant.
  
  
  RESULTS
  We identified 15,366 ankle arthroscopy procedures in the database from 2007 to 2011. Over the 5-year study period, there was a significant increase in the overall number of ankle arthroscopies being performed, from 2,814 in 2007 to 3,314 in 2011 (P < .0001). Female patients had ankle arthroscopy more frequently than did male patients (P = .027). The majority of patients who had ankle arthroscopy were between the ages of 30 and 49 years. The use of ankle arthroscopy during lateral ligament repair procedures increased from 37.2% in 2007 to 43.7% in 2011 (P < .0001). The incidence of combined ankle arthroscopy and peroneal tendon retinacular repair increased 50%, from 2.8/100 ankle arthroscopies in 2007 to 4.2/100 ankle arthroscopies in 2011 (P < .0001).
  
  
  CONCLUSIONS
  The incidence of ankle arthroscopy increased significantly from 2007 to 2011, outpacing shoulder, knee, and elbow arthroscopy. Ankle arthroscopy was performed more frequently in female patients and most commonly in patients younger than 50 years. The use of ankle arthroscopy in the surgical management of lateral ankle instability also increased significantly. The incidence of concomitant ankle arthroscopy and lateral ligament repair increased significantly, as did the incidence of concomitant ankle arthroscopy and repair of peroneal tendon subluxation.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Werner
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: M Tyrrell
authors.initials: MT
authors.lastname: Burrus
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Venkat
authors.initials: V
authors.lastname: Perumal
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.. Electronic address: fwg7d@virginia.edu.
authors.forename: F Winston
authors.initials: FW
authors.lastname: Gwathmey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000842:Ankle / Q000601:surgery*; D016512:Ankle Injuries / Q000601:surgery; D001182:Arthroscopy / Q000706:statistics & numerical data / Q000639:trends*; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D013708:Tendon Injuries / Q000601:surgery; D014481:United States; D055815:Young Adult