Ankle Arthroscopy without Tourniquet: A Mid-Term Follow-Up.

Ankle arthroscopy is a surgical technique still most commonly performed with a tourniquet. In 2017 we published a randomized controlled trial comparing anterior ankle arthroscopy with and without the tourniquet use. The results showed feasibility of performing the anterior ankle arthroscopy without the tourniquet, as well as comparable functional outcomes at 3- and 6-months follow-up visits, regardless of the tourniquet use. The aim of the current study was to evaluate mid-term functional outcomes after a 5-year period and to document patient satisfaction with the surgery. All 49 available patients from the original study were asked to attend examination at the 60-months follow-up visit. Patients were assessed with the same functional scores, as well as with additional Munich Ankle Questionnaire (MAQ) to assess the postoperative subjective and objective outcome and Abdelatif questionnaire to evaluate patient satisfaction. Any new complications were noted. At the 60-months follow-up visit 39 (79.6%) patients were available for examination. No significant difference was found between the groups regarding the functional outcomes or the MAQ. In comparison with the 3- and 6- months follow-up visits, no further improvement or decline of functional outcomes was present. High patient satisfaction was found in both groups. No new complications were noted during the follow-up period. Similar improvement in both groups reveals that the anterior ankle arthroscopy can be performed without the tourniquet with no negative impact on mid-term functional outcomes. In addition, high patient satisfaction can be expected even after 5 years from surgery, regardless of the tourniquet use.