Gramajo F, Toledo I, Vázquez L, Masquijo I, Masquijo J

Language: Spanish
References: 30
Page: 4-10
PDF size: 200.58 Kb.

ABSTRACT

Introduction: Arthroscopy has become an important tool in the evaluation and treatment of ankle disorders in adults. However, information on the efficacy and safety of this procedure applied to ankle pathologies in children and adolescents is scarce. The aim of this study is to review the indications and complications of ankle arthroscopy in a cohort of patients ≤ 18 years. Material and methods: Demographic information patients treated between January 2010 and January 2019 was collected from a database. The records were reviewed to analyze indications, demographic data, previous treatment, characteristics of the procedure, complications, and additional procedures. Complications were classified with an adaptation of the Clavien-Dindo system for arthroscopic ankle surgery (CDS-AAS). Data obtained from patients ≤ 18 years (group A) were compared with a cohort of patients > 18 years treated in the same period (group B). Results: One-hundred-thirty-one ankle arthroscopies were analyzed. Nineteen patients (22 ankles) had ≤ 18 years with an average age of 14.7 ± 2.6 years, and 112 patients (112 ankles) > 18 years (mean age 36.2 ± 12.4 years). Surgery was indicated predominantly in females in individuals ≤ 18 years (68.4 versus 23.2%, p ≤ 0.001). The main indications in group A were juvenile osteochondritis dissecans of the talus (JOCDT), and chronic ankle instability (86%). No statistically significant differences were observed in the complication rate (9% in group A and 10.7% in group B, p = 0.84). In group A, there are two CDS-AAS type 2. In group B, four patients present CDS-AAS type 3, and eight CDS-AAS type 2. No major complications such as septic arthritis, vascular injury or permanent neurological damage occur in any group. Conclusions: In our series, the main indications in patients ≤ 18 years were JOCDT and chronic ankle instability. The overall incidences of complications were similar in the 2 groups. Most of these complications had minimal morbidity and resolved without the need for surgery. Innovation in the development of specific instruments for children, associated with improvements in technique and postoperative management, could decrease complications.

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EVIDENCE LEVEL

III (Estudio comparativo)