Cadaveric Study Evaluating the Potential for Hindfoot Endoscopy and Flexor Hallucis Longus Tendoscopy Using a 1.9-mm Diameter Needle Arthroscope

Bibliographic Details
Title: Cadaveric Study Evaluating the Potential for Hindfoot Endoscopy and Flexor Hallucis Longus Tendoscopy Using a 1.9-mm Diameter Needle Arthroscope
Authors: Yoshiharu Shimozono MD, PhD, Ryuzo Arai MD, PhD, Yutaka Kuroda MD, PhD, Hiromu Ito MD, PhD, Shuichi Matsuda MD, PhD
Source: Foot & Ankle Orthopaedics, Vol 10 (2025)
Publisher Information: SAGE Publishing, 2025.
Publication Year: 2025
Collection: LCC:Orthopedic surgery
Subject Terms: Orthopedic surgery, RD701-811
More Details: Background: Hindfoot endoscopy is an effective treatment for posterior ankle impingement syndrome (PAIS) and flexor hallucis longus (FHL) tendon disorders. However, FHL tendoscopy, especially from the posteromedial portal, carries a risk of tibial nerve damage. A needle-arthroscopic system with a 1.9-mm-diameter arthroscope, a semirigid frame, and a 0-degree direction of view has been introduced. This study aimed to evaluate the efficacy and safety of this system in visualizing and reaching significant structures in hindfoot endoscopy and FHL tendoscopy through the posteromedial and posterolateral portals using a cadaveric model. Methods: The 1.9-mm-diameter arthroscopic system (NanoScope, Arthrex) was used to perform hindfoot endoscopy in 6 human donor ankles (3 pairs). The arthroscope tube is 9.5 cm long, semirigid, and has an outer diameter of 1.9 mm, a 0-degree direction of view, and a 120-degree field of view. Posteromedial and posterolateral portals were established. Visualization and operative reach were recorded, including the posterolateral talar process, posterior talofibular ligament, intermalleolar ligament, subtalar joint, and FHL tendon. The neurovascular bundle and FHL tendon were examined for kinks or damage. Results: All significant structures were successfully visualized in all specimens. The wide 120-degree field of view facilitated adequate visualization of all structures. In all specimens, the FHL tendon was visualized from the ankle joint to the knot of Henry (zones 1 and 2), and the flexor digitorum longus tendon was observed via both portals. There were no signs of neurovascular damage from either the posterolateral or posteromedial portals. Conclusion: In this cadaver experiment without known pathology, use of a 1.9-mm-diameter needle-arthroscopy with a 0-degree direction of view provided effective visualization of all significant structures in treating PAIS and FHL tendon disorders. It appears that FHL tendoscopy can be performed from the level of the ankle joint to the knot of Henry via both the posterolateral and posteromedial portals.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2473-0114
24730114
Relation: https://doaj.org/toc/2473-0114
DOI: 10.1177/24730114241310237
Access URL: https://doaj.org/article/7e8c2bab7b45438ea6ab879d31a7a436
Accession Number: edsdoj.7e8c2bab7b45438ea6ab879d31a7a436
Database: Directory of Open Access Journals
More Details
ISSN:24730114
DOI:10.1177/24730114241310237
Published in:Foot & Ankle Orthopaedics
Language:English