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Inflammatory lesions

Rheumatoid arthritis, X-tal synovitis, PVNS and synovial chondromatosis can all affect the ankle.

Rheumatoid arthritis has been reported to have an arthroscopic cure (26). A 95% synovectomy is possible (27), and early synovectomy is better than late (28).

PVNS can be treated arthroscopically in the ankle as elsewhere (29).

Synovial chondromatosis is rare in the ankle, but is treated along standard arthroscopic lines (30).

Other arthritides such as gonarthritis, Crohn’s, gout, chondrocalcinosis are treated with arthroscopic synovectomy (31).

An article in 2004 in the Journal of Paediatric Orthopaedics (32) of 39 ankles shows successful results with arthroscopic synovectomy for haemophilic arthropathy.

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(26) Schoenholz G J, ‘Athroscopic surgery of the shoulder elbow and ankle’ Springfield, IL:Charles C Thomas 1987:59
(27) Aschan W, Moberg E, ‘A long term study of the effect of early synovectomy in rheumatoid arthritis’ Bull Hosp Jt Dis Orthop Inst 1984; 44:106.
(28) Goldie I F, ‘Synovectomy in rheumatoid arthritis: The theoretical aspects and a 14 year follow up in the knee’ Reconstr Surg Traumatol 1981; 18:2
(29) Granowitz S P, D’Antonia J, Mankin H J, ‘The pathogenesis and long term results of PVNS’ Clin Orth 1976; 114:335 Beltran J, Notto AM, Mosure J C, ‘Ankle surface coil MR imaging at 1.5tl’ Radiology 1986; 161:203
(30) Holm C L, ‘Primary synovial chondromatosis of the ankle’ JBJS 1976; 58A:878.
(31) Chen Y, ‘Arthroscopy of the ankle joint’; ‘Arthroscopy of small joints’ New York: Ikaku-shoin, 1985
(32) Dunn Amy L, Busch M T, Wyly J B, Sullivan K M, Abshire T C, ‘Arthroscopic synovectomy for hemophilic joint disease in pediatric population’ Journal of Pediatric Orthopedics 2004; 24:4; 414-26