Skip to main content


Log in

Iatrogenic articular cartilage injuries during ankle arthroscopy

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope



The purpose of this study was to assess the incidence of iatrogenic articular cartilage injuries during ankle arthroscopy and to determine the factors that caused them. The hypothesis of this study was that the incidence of iatrogenic cartilage injuries produced during ankle arthroscopic procedures is high and directly related to the arthroscopic technique.


All consecutive records from ankle arthroscopies performed between 2008 and 2010 were reviewed. Arthroscopic arthrodesis of the ankle was excluded from the study. Iatrogenic articular cartilage injury was defined as any cartilage injury that occurred during the arthroscopic procedure.


The final number of ankle arthroscopic procedures reviewed was 74. There were a total of 23 iatrogenic lesions of the cartilage, for an overall complication rate of 31 %. The two most common injury locations were the anterolateral and central area of the talus. The cartilage lesion was superficial in 78.2 % of injuries (24.3 % of all patients), and deep in 21.8 % of injuries (6.7 % of all patients). Of the 23 injuries found, 65 % of them were sustained during the therapeutic portion of the arthroscopic procedure and the remaining 35 % occurred during the portal creation portion of the procedure.


The incidence of cartilage injury during ankle arthroscopy is high. However, severe damage was found in only 6.7 % of ankle arthroscopies.

Level of evidence

Retrospective case series, Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others


  1. Acevedo JI, Busch MT, Ganey TM, Hutton WC, Odgen JA (2000) Coaxial portals for posterior ankle arthroscopy: an anatomic study with clinical correlation on 29 patients. Arthroscopy 16:836–842

    Article  CAS  PubMed  Google Scholar 

  2. Aydin AT, Ozcanli H, Soyuncu Y, Dabak TK (2006) A new noninvasive controlled intra-articular ankle distraction technique on a cadaver model. Arthroscopy 22:905.e1–905.e3

  3. Barber FA, Click J, Britt BT (1990) Complications of ankle arthroscopy. Foot Ankle 10:263–266

    Article  CAS  PubMed  Google Scholar 

  4. Berndt AL, Harty M (1959) Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am 41:988–1020

    PubMed  Google Scholar 

  5. Bosien WR, Staples OS, Russell SW (1955) Residual disability following ankle sprains. J Bone Joint Surg Am 37:1237–1243

    PubMed  Google Scholar 

  6. Deng DF, Hamilton GA, Lee M, Rush S, Ford LA, Patel S (2012) Complications associated with foot and ankle arthroscopy. J Foot Ankle Surg 51:281–284

    Article  PubMed  Google Scholar 

  7. Ferkel RD, Heath DD, Guhl JF (1996) Neurological complications of ankle arthroscopy. Arthroscopy 12:200–208

    Article  CAS  PubMed  Google Scholar 

  8. Ferkel RD, Small HN, Gittins JE (2001) Complications in foot and ankle arthroscopy. Clin Orthop Relat Res 391:89–104

    Article  PubMed  Google Scholar 

  9. Flick AB, Gould N (1985) Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. Foot Ankle 5:165–185

    Article  CAS  PubMed  Google Scholar 

  10. Golanó P, Vega J, Pérez-Carro L, Götzens V (2006) Ankle anatomy for the arthroscopist. Part I: the portals. Foot Ankle Clin N Am 11:253–273

    Article  Google Scholar 

  11. Raikin SM, Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME (2007) Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int 28:154–161

    Article  PubMed  Google Scholar 

  12. Sugimoto K, Takakura Y, Tohno Y, Kumai T, Kawate K, Kadono K (2005) Cartilage thickness of the talar dome. Arthroscopy 21:401–404

    Article  PubMed  Google Scholar 

  13. Van Dijk CN (1997) Arthroscopy of the ankle. Arthroscopy 13:90–96

    Article  PubMed  Google Scholar 

  14. Van Dijk CN, Tol JL, Verheyen CCPM (1997) A prospective study of prognostic factors concerning the outcome of arthroscopic surgery for anterior ankle impingement. Am J Sports Med 25:737–745

    Article  PubMed  Google Scholar 

  15. Young BH, Flanigan RM, DiGiovanni BF (2011) Complications of ankle arthroscopy utilizing a contemporary noninvasive distraction technique. J Bone Joint Surg Am 93:963–968

    PubMed  Google Scholar 

  16. Zengerink M, van Dijk CN (2012) Ankle complications. Knee Surg Sports Traumatol Arthrosc 20:1420–1431

    Article  PubMed  PubMed Central  Google Scholar 

Download references


The authors would like to thank Julie Agel, from the Department of Orthopaedic Surgery at the University of Minnesota (MN, USA), for her contribution.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Jordi Vega.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vega, J., Golanó, P. & Peña, F. Iatrogenic articular cartilage injuries during ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc 24, 1304–1310 (2016).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: