Distraction-free ankle arthroscopy for anterolateral impingement

Abstract

The origin of chronic pain after external ankle sprain is better known with arthroscopy's contribution. Chronic hypertrophic synovitis of the anterolateral ankle region is seemingly the cause, resulting in "anterolateral ankle impingement." But is partial synovectomy with fibrosis resection under arthroscopy always possible without any distraction? Are results affected? This retrospective study concerned only patients with soft tissue ankle impingement. All cases with bone and joint diseases were excluded. The final sample of 24 patients had a mean age of 35 years (21-54 years) and presented anterolateral mechanical pain associated with oedema following external ankle sprain. Medical and rehabilitative treatment was undertaken for more than 6 months before arthroscopy. Average time between trauma and arthroscopy was 21 months (5-60 months). Clinical examination revealed no ankle instability or laxity. Debridement with joint lavage was systematically performed under arthroscopy without any distraction. Average patient follow-up was 22 months (12-92 months). All patients had a good Kitaoka score, with 22 patients registering excellent results. There were no septic complications or algodystrophy. Two transient hypoesthesias were observed in the dorsal surface and lateral border of the foot with full postoperative recovery at 6 months. Distraction was never used and simple dorsiflexion was sufficient to perform arthroscopic debridement. In this study, anterolateral ankle impingement diagnosis was primarily clinical. Arthroscopic treatment yielded significant benefits on pain, oedema and resumption of sport activities. Arthroscopic treatment of anterolateral ankle impingements is thus possible with simple dorsiflexion and no distraction, resulting in a possible decrease in complication rates. Level of evidence Retrospective cohort study, Level IV.

Outcomes After Arthroscopic Surgery for Anterior Impingement in the Ankle Joint in the General and Athletic Populations: Does Sex Play a Role?

“…47 Three studies (18.75%) did not report preoperative scores but highlighted improvements. 39,45,46 Complication Rate/Reoperation Of the 1506 patients, 61 (4.01%) cited complications, with mild nerve symptoms as the most common (57.38%; 35/61) (Table 5). There was a 1.06% rate of major complications, with the most common including complex regional pain syndrome (6.56%; 4/61), deep infection (6.56%; 4/61), and reoperation (6.56%; 4/61).…”

Arthroscopic Anterior Ankle Decompression Is Successful in National Football League Players

“…Table 3 lists RTP rates for recreational athletes in published studies. [18][19][20][21][22][23][24][25][26][27] In their recent systematic literature review, Zwiers and colleagues 10 noted that 24% to 96.4% of recreational athletes returned to play after arthroscopic treatment for anterior ankle impingement. The percentage was significantly higher for the professional athletes in our study.…”

Ankle impingement

“…A lateral arthrotomy is often still utilized if a lateral ligamentous procedure is being performed concurrently. However, open approaches have largely been replaced by arthroscopic techniques [ 56 – 80 ].…”