Arthroscopic treatment of impingement of the ankle reduces pain and enhances function

Abstract

A consecutive series of 105 patients with a median age of 35 (16-62) years who were operated on with arthroscopic resection for impingement of the ankle using standardized technique without distraction is presented. All patients complained of painful dorsiflexion and had failed to respond to conservative treatment. A total of 177 diagnoses were found, soft tissue impingement or synovitis in 89, anterior bony impingement in 44, chondral lesion in 20, loose bodies in 16 and osteoarthritis in eight. At follow-up after 2 years, 65 patients were pain free while 28 patients had experienced reduction of pain. Gait was improved in 30/41 patients and 22 resumed sporting activities. The results were graded excellent in 67, good in 25, fair in six and poor in seven patients. There were four deep infections and one synovial fistula in this series. The deep infections all responded well to arthroscopic synovectomy and intravenous antibiotics. In one patient persistent symptoms were recorded. Ankle arthroscopy yielded good results in the treatment of anterior impingement of the ankle as it effectively reduced pain and enhanced function.

Anterior Ankle Arthroscopy

“…In 1305 ankle arthroscopies, Zengerink and van Dijk 28 reported 7 patients to have developed synovial fistulas at the portal sites. In a consecutive series of 105 patients by Rasmussen and Jensen, 63 1 synovial fistula developed, which responded to arthroscopic synovectomy and intravenous antibiotics. The authors do not speculate on why fistulas developed, but careful closure of the portals with prompt treatment of persistent drainage can assist with the prevention of synovial tract formation.…”

Prevalence and location of bone spurs in anterior ankle impingement: A cadaveric investigation

“…In patients with persistent symptoms despite conservative management, surgical excision of bony spurs and debridement of impinging soft tissue in the anterior ankle is recommended (Talusan, ). Ankle arthroscopy is the current gold standard because there are fewer complications and quicker return to play (Scranton and McDermott, ) than with open treatment (Bauer, ; Rasmussen and Hjorth Jensen, ; Ross, ; Tol et al, ).…”

The synovial fold of the distal tibiofibular joint: A morphometric study

“…Frequently, this is the result of soft tissue impingement in the antero-lateral ankle region between the articular surfaces of the lateral malleolus and the lateral surface of the talus, a clinical entity that has been well documented in the literature (Wolin et al, 1950;Jordan et al, 2000;Molloy et al, 2003;Robinson, 2007;McCarthy et al, 2008). Antero-lateral soft tissue impingement is typically treated by arthroscopic excision and debridement of the impinging soft tissue (Wolin, et al, 1950;Robinson, 2007;McCarthy et al, 2008) and is effec-tive in reducing pain and restoring ankle function in most cases (Rasmussen and Jensen, 2002). However, despite treatment up to 25% of patients continue to suffer chronic ankle pain and dysfunction (Rasmussen and Jensen, 2002).…”