| Abstract | Artroskopija u stražnjem dijelu gležnja se tijekom godina prometnula u metodu izbora kojom se na minimalno invazivan način mogu liječiti različite patologije stražnjeg dijela gležnja. Cilj ovog istraživanja je bio utvrditi postotni udjel pojedine dijagnoze zbog koje je indicirana i načinjena artroskopija stražnjeg dijela gležnja kao samostalan zahvat te dobivene rezultate usporediti s rezultatima drugih istraživanja. Nadalje, cilj je bio i utvrditi broj i vrstu prethodno učinjenih operacijskih zahvata, učestalost i vrstu komplikacija nakon načinjenog zahvata te usporediti rezultate s rezultatima drugih istraživanja te utvrditi broj i vrstu ponovno učinjenih operacijskih zahvata na istom gležnju. Pretraživanjem operacijskih protokola Klinike za ortopediju KBC-a Zagreb i Medicinskog fakulteta Sveučilišta u Zagrebu, utvrđeno je da je u razdoblju od 1. siječnja 2011. do 1. siječnja 2020. načinjeno 269 uzastopnih artroskopija stražnjeg dijela gležnja pri čemu je izdvojena skupina od 83 bolesnika kod kojih je artroskopija u stražnjem dijelu gležnja bila načinjena kao samostalan zahvat te koji su nakon zahvata praćeni najmanje 24 mjeseca. Artroskopski zahvat je najčešće bio indiciran poradi sindroma stražnjeg sraza u gležnju i to kod 47 bolesnika (56,6%). Od ostalih indikacija zbog kojih je indiciran operacijski zahvat valja izdvojiti kontrakture subtalarnog zgloba (15 bolesnika), poslijetraumatski osteoartritis subtalarnog zgloba (4 bolesnika), tumorske promjene (3 bolesnika), koštanohrskavična ostećenja talusa (3 bolesnika), osteoid osteom talusa (2 bolesnika), ganglijske ciste (2 bolesnika), zastarjele rupture Ahilove tetive (2 bolesnika), avaskularnu nekrozu talusa (1 bolesnik), lokalizirani oblik pigmentiranog vilonodularnog sinovitisa (1 bolesnik), cistu talusa (1 bolesnik) te talokalkanealnu koaliciju (1 bolesnik). Kod svih bolesnika je operacijski zahvat protekao bez komplikacija. Tijekom poslijeoperacijskog praćenja zabilježene su svega 2 komplikacije (2,4%) prolaznog karaktera dok je sedam bolesnika (8,4%) nakon načinjene operacije ponovno operiralo isti gležanj. Ovo istraživanje govori u prilog tomu da je artroskopija u stražnjem dijelu gležnja najčešće indicirana zbog sindroma stražnjeg sraza u gležnju te da je artroskopija u stražnjem dijelu gležnja sigurna i efikasna metoda liječenja različitih patologija stražnjeg gležnja. |
| Abstract (english) | Over the years, posterior ankle arthroscopy has evolved into a method of choice for minimally invasive treatment of various pathologies of the posterior part of the ankle. The aim of this study was to determine the percentage of each diagnoses for which hindfoot arthroscopy was indicated and performed as a solitary procedure, and to compare the obtained results with the results of other studies. Furthermore, the aim was to determine the number and type of previous surgeries, frequency and type of postoperative complications and to compare the results with the results of other studies and to determine the number and type of reoperations performed on the same ankle. Search of the surgery protocols of the Department of Orthopaedics Surgery, University Hospital Centre Zagreb and University of Zagreb School of Medicine, found that in the period from January 1st, 2011 to January 1st, 2020, 269 consecutive posterior ankle arthroscopies were performed. Within this group, in 83 patients posterior ankle arthroscopy was performed as a solitary procedure and the patients were followed-up for a minimum of 24 months. Arthroscopic surgery was most often indicated due to posterior ankle impingement syndrome in 47 (56.6%) patients. Other indications included subtalar joint contractures (15 patients), post-traumatic osteoarthritis of the subtalar joint (4 patients), tumors (3 patients), osteochondral lesions of the talus (3 patients), osteoid osteoma of the talus (2 patients), ganglionic cysts (2 patients), chronic Achilles’ tendon ruptures (2 patients), avascular necrosis of the talus (1 patient), localized pigmented villonodular synovitis (1 patient), talar cyst (1 patient) and talocalcaneal coalition (1 patient). In all of the 83 arthroscopic surgeries, the perioperative period was uneventful. During postoperative follow-up, only 2 minor complications were recorded (2.4%), while seven patients (8.4%) underwent surgery on the same ankle again after the operation. This research supports the fact that posterior ankle arthroscopy is most often indicated due to the posterior ankle impingement syndrome and that posterior ankle arthroscopy is a safe and effective method of treating various pathologies of the posterior part of the ankle. |
