Endoscopy for the treatment of posterior ankle impact syndrome: Learning curve

Background: This study aimed to demonstrate our learning curve of endoscopy for the treatment of Posterior Ankle Impact Syndrome (PAIS), assessing the operative time and evolution of the outcomes.

Methods: We conducted a retrospective review of 39 patients submitted to endoscopic treatment by a single surgeon over a period of ten years. We divided the study population into four blocks of ten consecutive patients and compared the mean operative time and outcomes between the four blocks. For the learning curve model, we performed linear regression analysis and logarithmic transformation.

Results: We found a decrease in the surgery duration over time (P = .0273). All patients had an improvement in the AOFAS Scale (P < .0001), regardless of the group (P = .07). The learning rate was estimated at 83%, indicating a 17% reduction of the operative time as the cumulative cases doubled.

Conclusions: This study showed a decrease in the operative time of the posterior ankle endoscopy over the years, with an estimated learning rate of 83%. The outcomes and incidence of complications showed no relationship with operative time and the number of cases operated.

Level of evidence: Level IV, case series.