Table 3.

Pearls and Pitfalls of Arthroscopic Ankle Arthrodesis (AAA) with Joystick of the Talus (JOT)

Pearls

Traditional portals are placed on the joint line; despite this, the incisions should be slightly distal to this line to help visualize and debride the articular surfaces.

JOT technique allows performance of AAA in malaligned arthritis, as long as correctable.

The reduction of the deformity must be checked preoperatively, and the patient must be aware of a possible conversion to open surgery.

It is paramount to feel the derotation of the talus within the mortise.

Joining a fibular resection and JOT technique enables the most powerful correction of the preoperative deformity.

Pitfalls

Due to the subtalar joint curvature, a curette must be used to complete debridement.

There is risk of lesion of the posterior tibial neurovascular bundle when placing the 3-mm pin for performing JOT; caution and scopic control are recommended.