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Extra info for AANA Advanced Arthroscopy. The Foot and Ankle
FIGURE 4-20 Arthroscopic view of the posterior extent of the right subtalar joint. In some joints, the arthroscope can be advanced from the anterolateral portal further into the lateral gutter to the posterolateral recess (Fig. 4-20). As the viewing angle is turned toward the joint, the articular surface of the posterior process of the talus, or the os trigonum if present, can be seen. Turning the viewing angle toward the capsule laterally reveals the posterior talocalcaneal ligament. If the arthroscope cannot be advanced into the posterolateral recess from the anterolateral portal, the arthroscope is switched to the posterior portal to achieve visualization of the structures previously described.
Less aggressive instruments should be used near vulnerable structures or when learning a new procedure. Conceptually, the instruments are constructed similarly, with a rotating blade or burr housed in a sheath that is attached to suction. The surgeon is able to adjust the direction of rotation and the amount of suction. Retrieving Instruments Suction instruments with magnetic tips can be useful for retrieval of broken instruments. Their use may avoid the need for extra portals or an arthrotomy.
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