ARTHROSCOPIC TECHNIQUES AT THE ANKLE JOIN T IN RHEUMATOID-ARTHRITIS

Whenever conservative therapy of synovialitis is insufficient, synovec tomy of the ankle joint is indicated. In appropriate cases the arthros copic technique may avoid difficulties that are due to the access to t he ankle joint in open synovectomy or arthrodesis. From 1990-1994 we p erformed 14 ventral arthroscopic synovectomies of the ankle joint with open dorsal synovectomy at the same time. 7 out of 10 patients stated there was a marked decrease in pain and swelling after an average of 3.2 years postoperative. These patients also showed a marked increase in walking distance and ability to climb stairs. During the time of th e follow-up only a slight increase from 1.5 to 1.7 was seen on average in Larsen's radiological staging. The joint space decreased from 3 to 2.5 mm. In cases of relatively isolated manifestation of rheumatoid a rthritis in the ankle joint without severe deviation of axis of the jo int, we performed an arthroscopically assisted arthrodesis of the ankl e joint. 3 out of 4 examined arthrodeses were consolidated 3.6 years p ostoperatively on average. These 3 patients reported a marked increase in walking capacity and were satisfied with the outcome after surgery .