Arthroscopic Treatment of Anterior Ankle Impingement

Authors

  • Ali Abdulkhaleq Ibrahim MBChB/ Candidate of KHCMS.
  • Abdulkadr Muhammed Sleman Alany MBChB/ FIBMS (Ortho)/ Lecturer in college of medicine, Hawler Medical University/ Consultant orthopedic surgeon.

DOI:

https://doi.org/10.56056/amj.2019.104

Keywords:

Anterior ankle impingement syndrome, Arthroscopic, Debridement

Abstract

Background and objectives:Anterior ankle impingement (as a common cause of anterior ankle pain) is becoming re- cently a common diagnosis in peoples who do excessive dorsiflexion of ankle joint in their daily activities. Arthroscopic debridement is nowadays a gold standard procedure for anterior ankle impingement treatment in both osseous and soft tissue type impingements. The objectives of this study are to provide a comprehensive overview of the clinical outcomes of arthroscopic procedures used as a treatment strategy for anterior ankle impingement.

Methods:We per- formed a prospective study on 20 patients diagnosed as cases of anterior ankle impingement on the basis of clinical and radiological examination, the patients complained from either soft tissue or bony impingement. All patients were treated by arthroscopic debridement or burring. Clinical outcome was evaluated according to American orthopedic foot and ankle society score questionnaires, visual analogue scale, and ankle dorsiflexion range achieved. Results: The mean age of the patients was 37.4 year, mean AOFAS ankle hind-foot scale improved from 52.65 preoperatively to 86.95 postoperatively (statistically significant). The mean pain visual analogue scale decreased from 7.9 to 3.1. The mean dorsiflexion angle increased from 7 degrees to 14.5 degrees.

Conclusion: Arthroscopic debridement and excision of impinging soft tissues and burring of impinging bones is the treatment of choice for patients with anterior ankle impingement syndrome of both osseous and soft tissue nature after failure of conservative measures to relieve the symptoms and improve the range of motion.

Downloads

Download data is not yet available.

References

Bekerom MP, Raven EE. The distal fascicle of the anterior inferior tibiofibular ligament as a cause of tibiotalar impingement syndrome: a current concepts review. Knee Surg Sports Traumatol Arthrosc. 2007; 15(4): 465-71.

Hayeri MR, Trudell DJ, Resnick D. Anterior ankle impingement and talar bony outgrowths:osteophyte or enthesophyte? Paleopathologic and cadaveric study with imaging correlation. AJR Am J Roentgenol. 2009; 193(4): W334-8.

Murawski CD, Kennedy JG. Anteromedial impingement in the an- kle joint: Outcomes following arthroscopy. Am J Sports Med 2010; 38: 2017-24.

Vaseenon T, Amendola A. Update on anterior ankle impingement. Curr Rev Musculoskelet Med 2012; 5: 145-50.

Walls RJ, Ross KA, Fraser EJ, et al. Football injuries of the ankle:a review of injury mechanisms, diagnosis and management. World J Orthop. 2016; 7(1): 8-19.

Van Bergen CJ, Gerards RM, Opdam KT, et al. Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities. World J Orthop. 2015; 6(11): 944-53.

Bassett FH 3rd, Gates HS 3rd, Billys BJ, et al . Talar impingement by the anteroinferior tibiofi bular ligament: a cause of chronic pain in the ankle after inversion sprain. J Bone Joint Surg Am. 1990; 72A: 55-9.

Keller K, Nasrilari M, Fuller T, et al. The anterior tibio-talar ligament: one reason for anterior ankle impingement. Knee Surg Sports Traumatol Arthrosc. 2010; 18: 225-32.

Molloy S, Solan S, Bendall SP. Synovial impingement in the ankle. A new physical sign. J Bone Joint Surg Br. 2003; 85(3): 330-3.

Donovan A, Rosenberg ZS. MRI of ankle and lateral hindfoot im- pingement syndromes. AJR Am J Roentgenol. 2010; 195: 595-604.

Ferkel RD, Tyorkin M, Applegate GR, et al. MRI evaluation of anter- olateral soft tissue impingement of the ankle. Foot Ankle Int. 2010; 31: 655-61.

Coull R, Raffiq T, James LE, et al. Open treatment of anterior im- pingement of the ankle. J Bone Joint Surg Br. 2003; 85: 550-3.

Arnold H. Posttraumatic impingement syndrome of the ankle: indi- cation and results of arthroscopic therapy. Foot Ankle Surg. 2011; 17(2): 85-8.

Scranton PE Jr. Comparison of open isolated subtalar arthrodesis with autogenous bone graft versus outpatient arthroscopic subtalar ar- throdesis using injectable bone morphogenic protein-enhanced graft. Foot Ankle Int. 1999; 20: 162-5.

Van Dijk CN. Anterior and posterior ankle impingement. Foot Ankle Clin 2006; 11: 663-83.

Cutsuries A, Saltrick K, Wagner J, et al. Arthroscopic arthroplasty of the ankle joint. Clin Podiatr Med Surg. 1994; 11: 449-67.

Bauer T, Breda R, Hardy P. Anterior ankle bony impingement with joint motion loss: The arthroscopic resection option. Orthop Traumatol Surg Res. 2010; 96: 462-8.

Subhas N, Vinson EN, Cothran RL, et al. MRI appearance of surgi- cally proven abnormal accessory anterior-inferior tibiofibular ligament (Bassett’s ligament). Skeletal Radiol. 2008; 37: 27-33.

Devgan A, Rohilla R, Tanwar M, et al. Comparative analysis of ar- throscopic debridement in osseous versus soft tissue anterior ankle impingement. Journal of clinical orthopaedics and trauma. 2016; 7: 200-6.

Stewart J. Walsh, Bruce C. Twaddle, Michael P. Rosenfeldt, et al. Arthroscopic Treatment of Anterior Ankle Impingement: A Prospective Study of 46 Patients with 5-Year Follow-up Am J Sports Med 2014; 42: 2722-6.

Mohamed Yahia. Arthroscopic treatment of anterolateral ankle soft-tissue impingement in athletes. The Egyptian Orthopaedic Journal. 2018; 53: 26-30.

Reynaert P, Gelen G, Geens G. Arthroscopic treatment of anterior impingement of the ankle. Acta Orthopaedica Belgica. 1994; 60: 384-8.

Downloads

Published

2023-06-13

How to Cite

Ibrahim, A. A., & Sleman Alany, A. M. . (2023). Arthroscopic Treatment of Anterior Ankle Impingement. AMJ (Advanced Medical Journal) , 5(2), 73-78. https://doi.org/10.56056/amj.2019.104

Issue

Section

Articles