Jean Louis Rouvillain

Title : Distraction-free ankle arthroscopy for anterolateral impingement

Abstract:

The origin of chronic pain after external ankle sprain is better known with arthroscopy’s contribution. Chronic hypertrophic synovitis of the anterolateral ankle region is seemingly the cause, resulting in "anterolateral ankle impingement". But is partial synovectomy with fibrosis resection under arthroscopy always possible without any distraction? Are results affected?

This retrospective study concerned only patients with soft tissue ankle impingement. All cases with bone and joint diseases were excluded. The final sample of 24 patients had a mean age of 35 years (21-54 years) and presented anterolateral mechanical pain associated with oedema following external ankle sprain. Medical and rehabilitative treatment was undertaken for more than six months before arthroscopy. Average time between trauma and arthroscopy was 21 months (5-60 months). Clinical examination revealed no ankle instability or laxity. Debridement with joint lavage was systematically performed under arthroscopy without any distraction.

Average patient follow-up was 22 months (12-92 months). All patients had a good KITAOKA score, with 22 patients registering excellent results. There were no septic complications or algodystrophy. Two transient hypoesthesias were observed in the dorsal surface and lateral border of the foot with full postoperative recovery at six months. Distraction was never used and simple dorsiflexion was sufficient to perform arthroscopic debridement

In this study, anterolateral ankle impingement diagnosis was primarily clinical. Arthroscopic treatment yielded significant benefits on pain, oedema and resumption of sport activities. Arthroscopic treatment of anterolateral ankle impingements is thus possible with simple dorsiflexion and no distraction, resulting in a possible decrease in complication rates.
Level of evidence: Level IV, Retrospective cohort study
Key words: Ankle, Arthroscopy, Lateral sprain, Chronic lateral ankle pain, Antolateral impingement.

Biography:

Professor Jean Louis Rouvillain, a highly accomplished orthopedic professional, attained qualifications in general surgery in 1981 and orthopedic surgery in 1982. Serving as the Chief of the Orthopedic and Traumatologic Department from 2002 to 2020, he also held the position of Professor in Orthopedic and Traumatology at Antilles Guyane University from 2000 to 2020. Specializing in HIP, Knee, and Foot surgery, his research interests span Biomaterials, Sickle cell disease, Trauma, Sport surgery, and Foot, Hip, and Knee disciplines. He was the President of Ethic committee in Medical Research from 2004 to 2009 and is the Medical Coordinator of the Medical Research and Innovation Department of Martinique from 2013 to 2018. Professor Rouvillain contributed 122 publications and delivered 245 communications in International Congress. He was the past President of AOLF (Association des Orthopédistes de Langue Française) and member of SICOT since 1990, SICOT, EFORT, SOFCOT, and SFA.