Anatomic lectures on structures at risk prior to cadaveric courses reduce injury to the superficial peroneal nerve, the commonest complication in ankle arthroscopy

F. Malagelada, J. Vega, M. Guelfi, G. Kerkhoffs, J. Karlsson, M. Dalmau-Pastor

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: To assess the effectiveness of cadaveric ankle arthroscopy courses in reducing iatrogenic injuries. Methods: A total of 60 novice surgeons enrolled in a basic cadaveric ankle arthroscopy course were divided into two groups. Group A (n = 32) was lectured on portal placement and use of the arthroscope, whereas group B (n = 28) was in addition lectured on specific portal-related complications. Following the performance of anterior ankle arthroscopy and hindfoot endoscopy, the specimens were dissected and carefully assessed for detection of any iatrogenic injuries. Results: The rate of injury to the superficial peroneal nerve (SPN) was reduced from 25 to 3.6%, in group A compared with B (p = 0.033). Injuries to the peroneus tertius or extensor digitorum longus, the flexor hallucis longus and the tibial nerve or the Achilles tendon were also reduced in group B. Overall, the number of uninjured specimens was 50% (n = 30) and higher in group B (57%) than group A (44%). Lesions to the plantaris tendon, the sural nerve or the posterior tibial artery were more common in group B, however, without reaching statistical significance. Overall, 25 (13.9%) anatomic structures were injured in anterior arthroscopy compared to 18 (5%) in hindfoot endoscopy, out of a potential total of 180 and 360, respectively (p = 0.001). Conclusion: Dedicated lectures on portal-related complications have proven useful in reducing the risk of injury to the SPN, the commonest iatrogenic injury encountered in ankle arthroscopy. Hindfoot endoscopy is significantly safer than anterior ankle arthroscopy in terms of injury to anatomical structures.
Original languageEnglish
Pages (from-to)79-85
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 2020

Cite this

@article{df62da767be3460cb27f02203f13700e,
title = "Anatomic lectures on structures at risk prior to cadaveric courses reduce injury to the superficial peroneal nerve, the commonest complication in ankle arthroscopy",
abstract = "Purpose: To assess the effectiveness of cadaveric ankle arthroscopy courses in reducing iatrogenic injuries. Methods: A total of 60 novice surgeons enrolled in a basic cadaveric ankle arthroscopy course were divided into two groups. Group A (n = 32) was lectured on portal placement and use of the arthroscope, whereas group B (n = 28) was in addition lectured on specific portal-related complications. Following the performance of anterior ankle arthroscopy and hindfoot endoscopy, the specimens were dissected and carefully assessed for detection of any iatrogenic injuries. Results: The rate of injury to the superficial peroneal nerve (SPN) was reduced from 25 to 3.6{\%}, in group A compared with B (p = 0.033). Injuries to the peroneus tertius or extensor digitorum longus, the flexor hallucis longus and the tibial nerve or the Achilles tendon were also reduced in group B. Overall, the number of uninjured specimens was 50{\%} (n = 30) and higher in group B (57{\%}) than group A (44{\%}). Lesions to the plantaris tendon, the sural nerve or the posterior tibial artery were more common in group B, however, without reaching statistical significance. Overall, 25 (13.9{\%}) anatomic structures were injured in anterior arthroscopy compared to 18 (5{\%}) in hindfoot endoscopy, out of a potential total of 180 and 360, respectively (p = 0.001). Conclusion: Dedicated lectures on portal-related complications have proven useful in reducing the risk of injury to the SPN, the commonest iatrogenic injury encountered in ankle arthroscopy. Hindfoot endoscopy is significantly safer than anterior ankle arthroscopy in terms of injury to anatomical structures.",
keywords = "Anatomy, Ankle, Arthroscopic education, Cadaveric, Complications, Iatrogenesis",
author = "F. Malagelada and J. Vega and M. Guelfi and G. Kerkhoffs and J. Karlsson and M. Dalmau-Pastor",
year = "2020",
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doi = "10.1007/s00167-019-05373-x",
language = "English",
volume = "28",
pages = "79--85",
journal = "Knee Surgery, Sports Traumatology, Arthroscopy",
issn = "0942-2056",
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Anatomic lectures on structures at risk prior to cadaveric courses reduce injury to the superficial peroneal nerve, the commonest complication in ankle arthroscopy. / Malagelada, F.; Vega, J.; Guelfi, M.; Kerkhoffs, G.; Karlsson, J.; Dalmau-Pastor, M.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 28, No. 1, 01.2020, p. 79-85.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Anatomic lectures on structures at risk prior to cadaveric courses reduce injury to the superficial peroneal nerve, the commonest complication in ankle arthroscopy

AU - Malagelada, F.

AU - Vega, J.

AU - Guelfi, M.

AU - Kerkhoffs, G.

AU - Karlsson, J.

AU - Dalmau-Pastor, M.

PY - 2020/1

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N2 - Purpose: To assess the effectiveness of cadaveric ankle arthroscopy courses in reducing iatrogenic injuries. Methods: A total of 60 novice surgeons enrolled in a basic cadaveric ankle arthroscopy course were divided into two groups. Group A (n = 32) was lectured on portal placement and use of the arthroscope, whereas group B (n = 28) was in addition lectured on specific portal-related complications. Following the performance of anterior ankle arthroscopy and hindfoot endoscopy, the specimens were dissected and carefully assessed for detection of any iatrogenic injuries. Results: The rate of injury to the superficial peroneal nerve (SPN) was reduced from 25 to 3.6%, in group A compared with B (p = 0.033). Injuries to the peroneus tertius or extensor digitorum longus, the flexor hallucis longus and the tibial nerve or the Achilles tendon were also reduced in group B. Overall, the number of uninjured specimens was 50% (n = 30) and higher in group B (57%) than group A (44%). Lesions to the plantaris tendon, the sural nerve or the posterior tibial artery were more common in group B, however, without reaching statistical significance. Overall, 25 (13.9%) anatomic structures were injured in anterior arthroscopy compared to 18 (5%) in hindfoot endoscopy, out of a potential total of 180 and 360, respectively (p = 0.001). Conclusion: Dedicated lectures on portal-related complications have proven useful in reducing the risk of injury to the SPN, the commonest iatrogenic injury encountered in ankle arthroscopy. Hindfoot endoscopy is significantly safer than anterior ankle arthroscopy in terms of injury to anatomical structures.

AB - Purpose: To assess the effectiveness of cadaveric ankle arthroscopy courses in reducing iatrogenic injuries. Methods: A total of 60 novice surgeons enrolled in a basic cadaveric ankle arthroscopy course were divided into two groups. Group A (n = 32) was lectured on portal placement and use of the arthroscope, whereas group B (n = 28) was in addition lectured on specific portal-related complications. Following the performance of anterior ankle arthroscopy and hindfoot endoscopy, the specimens were dissected and carefully assessed for detection of any iatrogenic injuries. Results: The rate of injury to the superficial peroneal nerve (SPN) was reduced from 25 to 3.6%, in group A compared with B (p = 0.033). Injuries to the peroneus tertius or extensor digitorum longus, the flexor hallucis longus and the tibial nerve or the Achilles tendon were also reduced in group B. Overall, the number of uninjured specimens was 50% (n = 30) and higher in group B (57%) than group A (44%). Lesions to the plantaris tendon, the sural nerve or the posterior tibial artery were more common in group B, however, without reaching statistical significance. Overall, 25 (13.9%) anatomic structures were injured in anterior arthroscopy compared to 18 (5%) in hindfoot endoscopy, out of a potential total of 180 and 360, respectively (p = 0.001). Conclusion: Dedicated lectures on portal-related complications have proven useful in reducing the risk of injury to the SPN, the commonest iatrogenic injury encountered in ankle arthroscopy. Hindfoot endoscopy is significantly safer than anterior ankle arthroscopy in terms of injury to anatomical structures.

KW - Anatomy

KW - Ankle

KW - Arthroscopic education

KW - Cadaveric

KW - Complications

KW - Iatrogenesis

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JO - Knee Surgery, Sports Traumatology, Arthroscopy

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