Richard D. Ferkel, Md
This VJO video was produced for Dr. Ferkel’s Foot and Ankle Arthroscopy, 2nd edition textbook, published by Lippincott Williams & Wilkins.
Dr. Ferkel is currently the director of the sports medicine fellowship program at Southern California Orthopedic Institute. He has published numerous articles and lectures extensively all over the world. In addition, he has invented several surgical devices and has received numerous awards and was selected to be in the book entitled "The Best Doctors in America”. Dr. Ferkel is a qualified medical examiner (QME) for the State of California Industrial Medical Council, Department of Industrial Relations. Dr. Ferkel started the Athletic Training Program at Southern California Orthopedic Institute. In addition, he has been the team physician for Crespi Carmelite, Oaks Christian, and Harvard-Westlake High Schools, and Los Angeles Valley College for many years. He has worked with the U.S. Olympic teams, specifically the U.S. Soccer Team, the Special Olympics, and is a consultant to the NFL, MLB, and NBA.
Sinus tarsi syndrome develops from excessive motions of the subtalar joint that results in subtalar joint synovitis and infiltration of fibrotic tissue into the sinus tarsi space. Historically, the etiology of this condition has not been well understood. Sinus tarsi syndrome is believed to occur following a single traumatic event or a series of ankle sprains that result in significant injuries to the talocrural interosseous and cervical ligaments. With the correct diagnosis, and if conservative treatment fails, arthroscopic debridement intervention is indicated. The posterior portal is made in the usual soft spot lateral to the Achilles tendon on a line drawn perpendicular from the tip of the fibula. The same skin incision can be used for both posterior subtalar and ankle access by varying the location of the capsular puncture. The sinus tarsi is best viewed from the central portal, reserving the anterolateral portal for instrumentation. The interosseous ligament, cervical ligament, retinacular ligaments, and fibrofatty tissue are debrided as necessary in the lateral 1 to 1.5cm of the sinus to avoid injury to the blood supply of the talus. Dr. Ferkel’s patient’s return to full activity within a mean time of 4 months and most all would undergo the procedure again without reservation.Sinus tarsi syndrome develops from excessive motions of the subtalar joint that results in subtalar joint synovitis and infiltration of fibrotic tissue into the sinus tarsi space. Historically, the etiology of this condition has not been well understood. Sinus tarsi syndrome is believed to occur following a single traumatic event or a series of ankle sprains that result in significant injuries to the talocrural interosseous and cervical ligaments. With the correct diagnosis, and if conservative treatment fails, arthroscopic debridement intervention is indicated. The posterior portal is made in the usual soft spot lateral to the Achilles tendon on a line drawn perpendicular from the tip of the fibula. The same skin incision can be used for both posterior subtalar and ankle access by varying the location of the capsular puncture. The sinus tarsi is best viewed from the central portal, reserving the anterolateral portal for instrumentation. The interosseous ligament, cervical ligament, retinacular ligaments, and fibrofatty tissue are debrided as necessary in the lateral 1 to 1.5cm of the sinus to avoid injury to the blood supply of the talus. Dr. Ferkel’s patient’s return to full activity within a mean time of 4 months and most all would undergo the procedure again without reservation.
Specifications
- Total Run Time: 07:22 minutes
- Catalog Number: 1038
- VJO Publication Date: October, 2017