AANA Lab Course 908-Foot and Ankle Arthroscopy (APEx)-2019 APEx Series-Foot & Ankle Course Lab Manual

2019 APEx Series-Foot & Ankle Course Lab Manual

Pdf Summary

The 2019 APEx Series Foot/Ankle Course Lab Manual, developed by leading orthopedic and arthroscopic experts under the Arthroscopy Association of North America, offers comprehensive guidance on arthroscopic procedures for foot and ankle conditions. It includes detailed instructions on setup, portal placement, diagnostic arthroscopy, and operative techniques for various pathologies.<br /><br />Anterior ankle arthroscopy, primarily for impingement syndrome, osteochondral lesions, and fractures, emphasizes precise portal placement (anteromedial, anterolateral, posterolateral) and "nick and spread" technique to minimize nerve injury. Subtalar and posterior ankle arthroscopies provide approaches for synovitis, loose bodies, and posterior impingement with positioning tailored for optimal access and safety.<br /><br />Key pathologies covered include anterior ankle impingement—soft tissue and osteophytes causing pain and limited motion—managed via arthroscopic debridement; osteochondral lesions of the talus treated with bone marrow stimulation to promote cartilage repair; and autologous osteochondral transplantation for larger or cystic lesions using grafts from the femoral condyle. Arthroscopic arthrodesis offers a minimally invasive option for end-stage ankle osteoarthritis, achieving high union rates.<br /><br />Additional techniques address subtalar fusion for arthritis and deformities, posterior ankle impingement syndrome, ankle fractures with arthroscopic assessment of ligament and cartilage damage, and Achilles tendon repair using multiple portals and suture techniques. Endoscopic calcaneoplasty effectively treats Haglund’s deformity with lower complication rates than open surgery.<br /><br />Tendoscopy is detailed for Achilles tendinopathy, gastrocnemius contracture, and peroneal tendon pathology with specific portals and procedural steps. First metatarsophalangeal joint arthroscopy allows treatment of hallux rigidus, osteochondral lesions, and loose bodies with careful portal placement and biological augmentation.<br /><br />Postoperative protocols generally encourage early range of motion and progressive weight-bearing. Across procedures, biological adjuvants like PRP and concentrated bone marrow aspirate are increasingly used to enhance healing. Complication rates are low with meticulous technique, although nerve injury, wound issues, and hardware problems can occur. Overall, the manual provides a thorough, stepwise approach to advanced arthroscopic interventions improving patient outcomes in foot and ankle surgery.

Keywords

APEx Series

Foot and Ankle Arthroscopy

Anterior Ankle Arthroscopy

Subtalar Arthroscopy

Posterior Ankle Arthroscopy

Osteochondral Lesions

Arthroscopic Arthrodesis

Achilles Tendon Repair

Endoscopic Calcaneoplasty

Tendoscopy