ARTHROSCOPIC FOOT AND ANKLE SURGERY: BRAZILIAN SURGEON PROFILE

Observational, cross-sectional study, using a survey sent to all members of the Associação Brasileira de Medicina e Cirurgia do Tornozelo e Pé (ABTPé) in 2017 and 2019.

Results:

In total, 75 surgeons participated in 2017 and 82 in 2019 and most had over 10 years of experience. Of these, 56 participants in 2017 (75%) and 68 in 2019 (82%) used arthroscopy. The number of specialists with no to five years of experience (p = 0.027) and who learned the technique during fellowship (p = 0.007) increased. The use of the 4.0 mm optics and 30° optics (p = 0.040) increased whereas the routine use of traction (p = 0.049) and radiofrequency (p = 0.002) decreased. The main pathology treated with anterior ankle arthroscopy was bone injury. The most frequent complication was neuropraxia.

Conclusion:

Most of the foot and ankle surgeons who use arthroscopy have more than 10 years of experience, performed anterior access, and are concentrated in the Southeast region of the country. The number of younger surgeons who learned the technique during fellowship increased. Level of Evidence III, Cross-Sectional Comparative Study.

Keywords:
Arthroscopy; Ankle Joint; Orthopedics

Question	Alternatives	2017	2019	p-value
Performs arthroscopy	Yes	75%	83%	0.214
Performs arthroscopy	No	25%	17%	0.214
Reason for not performing arthroscopy	I do not believe in the method	9%	15%	0.379
	I believe in the method, but I have no cases that present indications	18%	0%
	I believe in the method, but I did not undergo training to perform it	59%	62%
	I believe in the method, but I have no access to the necessary equipment	14%	23%
Anesthesia^#	Locoregional without sedation	0%	0%	1.000
	Locoregional with sedation	16%	20%	0.435
	Spinal anesthesia	77%	80%	0.435
Tourniquet	Yes	93%	90%	0.548
Tourniquet	No	7%	10%	0.548
Arthroscopic Techniques^#	Anterior ankle arthroscopy	79%	89%	0.059
	Posterior ankle arthroscopy	55%	67%	0.076
	Subtalar arthroscopy	32%	33%	0.369
	First metatarsophalangeal arthroscopy	21%	18%	0.390
	Small joint arthroscopy	3%	10%	0.066
	Tendoscopy	28%	27%	0.505
Number of Arthroscopies per year	Up to 5	10%	20%	0.216
	6 to 10	20%	30%
	11 to 20	29%	24%
	21 to 40	19%	15%
	Over 40	22%	11%
Material used in anterior arthroscopy^#	4 mm optics with 30˚ inclination	55%	70%	0.040*
	2.7 mm or 2.9 mm mini optics	33%	37%	0.398
	70˚ optics	0%	0%	1.000
Material used in posterior arthroscopy^#	4 mm optics with 30˚ inclination	48%	60%	0.094
	2.7 mm or 2.9 mm mini optics	17%	16%	0.486
	70˚ optics	0%	0%	1.000
Material used in subtalar arthroscopy^#	4 mm optics with 30˚ inclination	15%	20%	0.278
	2.7 mm or 2.9 mm mini optics	27%	22%	0.307
	70˚ optics	0%	0%	1.000
Use of radiofrequency	I find it unnecessary	9%	23%	0.002*
	I find it necessary in some cases, but I have no access to the material	14%	16%
	I find it necessary in some cases and I have access to the material	70%	57%
	I use it in all cases	7%	4%
Application of Traction	I do not apply it	33%	40%	0.049*
	I rarely apply it	36%	47%
	I routinely apply it	31%	13%
Traction Type^#	Noninvasive, attached to the surgeon's body	35%	38%	0.404
	Noninvasive, fixed to the table	27%	22%	0.307
	Invasive	0%	1%	0.522
Use of infusion pump	I find it unnecessary, I use gravitational infusion	24%	18%	0.665
	I use it whenever material is available	36%	42%
	I use it in all cases	41%	40%

ATHA EDITORA Rua: Machado Bittencourt, 190, 4º andar - Vila Mariana - São Paulo Capital - CEP 04044-000, Telefone: 55-11-5087-9502 - São Paulo - SP - Brazil
E-mail: actaortopedicabrasileira@uol.com.br

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[1] Correspondence: Mauro Cesar Mattos e Dinato. Rua Mato Grosso, 306, São Paulo, SP, Brazil, 01239040. dinato@vita.org.br