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Published in: Journal of Orthopaedic Surgery and Research 1/2016

Open Access 01-12-2016 | Research article

Arthroscopic debridement of the ankle for mild to moderate osteoarthritis: a midterm follow-up study in former professional soccer players

Authors: Leonardo Osti, Angelo Del Buono, Nicola Maffulli

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2016

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Abstract

Background

The aim of this study is to report the clinical and functional outcomes following arthroscopic management of anterior impingement, grade III–IV cartilage lesions, and mild to moderate osteoarthritis of the ankle in former soccer players.

Methods

The study included 15 former male professional soccer players with mild to moderate degenerative changes of the ankle who had undergone arthroscopic debridement and management of secondary injuries of the ankle. Preoperatively and at the last follow-up, at an average of 7.4 years, the American Orthopaedic Foot and Ankle Society (AOFAS) and the Kaikkonen scales and visual analogue scale (VAS) assessment were administered to all patients. Ankle osteoarthritis was assessed from weightbearing anteroposterior and lateral radiographs of both ankles.

Results and discussion

At the last follow-up, the average AOFAS score had increased significantly from 48 (range, 29–69) to 86 (range, 63–94) (P < 0.0001), with good to excellent scores in 11 patients (74 %). The average Kaikkonen preoperative score of 43 (range, 28–70) had significantly improved to 85 (range, 61–95) (P < 0.0001), with good excellent scores in 11 patients (74 %). VAS values were also improved at the last follow-up. At the last appointment, only one (7 %) patient had abandoned altogether any sport, as he did not feel safe with his ankle and he felt too old to continue.

Conclusions

Anterior ankle arthroscopy for management of mild to moderate ankle arthritis is safe, effective, and low cost and allows former athletes to safely return to ordinary daily activities and recreational sport activities.
Literature
1.
go back to reference Conti SF, Wong YS. Complications of total ankle replacement. Clin Orthop Relat Res. 2001;391:105–14.CrossRefPubMed Conti SF, Wong YS. Complications of total ankle replacement. Clin Orthop Relat Res. 2001;391:105–14.CrossRefPubMed
2.
go back to reference Battisti D, Oliva F, Tarantino U, Maffulli N. Pseudoaneurysm of peroneal artery after ankle arthroscopy. Muscles Ligaments Tendons J. 2014;4:269–72.PubMedPubMedCentral Battisti D, Oliva F, Tarantino U, Maffulli N. Pseudoaneurysm of peroneal artery after ankle arthroscopy. Muscles Ligaments Tendons J. 2014;4:269–72.PubMedPubMedCentral
5.
go back to reference Gougoulias N, Khanna A, Maffulli N. How successful are current ankle replacements?: A systematic review of the literature. Clin Orthop Relat Res. 2010;468:199–208.CrossRefPubMedPubMedCentral Gougoulias N, Khanna A, Maffulli N. How successful are current ankle replacements?: A systematic review of the literature. Clin Orthop Relat Res. 2010;468:199–208.CrossRefPubMedPubMedCentral
6.
go back to reference Cheng JC, Ferkel RD. The role of arthroscopy in ankle and subtalar degenerative joint disease. Clin Orthop Relat Res. 1998;349:65–72.CrossRefPubMed Cheng JC, Ferkel RD. The role of arthroscopy in ankle and subtalar degenerative joint disease. Clin Orthop Relat Res. 1998;349:65–72.CrossRefPubMed
7.
go back to reference Amendola A, Petrik J, Webster-Bogaert S. Ankle arthroscopy: outcome in 79 consecutive patients. Arthroscopy. 1996;12:565–73.CrossRefPubMed Amendola A, Petrik J, Webster-Bogaert S. Ankle arthroscopy: outcome in 79 consecutive patients. Arthroscopy. 1996;12:565–73.CrossRefPubMed
8.
go back to reference Phisitkul P, Tennant JN, Amendola A. Is there any value to arthroscopic debridement of ankle osteoarthritis and impingement? Foot Ankle Clin. 2013;18:449–58.CrossRefPubMed Phisitkul P, Tennant JN, Amendola A. Is there any value to arthroscopic debridement of ankle osteoarthritis and impingement? Foot Ankle Clin. 2013;18:449–58.CrossRefPubMed
9.
go back to reference Krips R, van Dijk CN, Halasi PT, Lehtonen H, Corradini C, Moyen B, et al. Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a multicenter study. Foot Ankle Int. 2001;22:415–21.PubMed Krips R, van Dijk CN, Halasi PT, Lehtonen H, Corradini C, Moyen B, et al. Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a multicenter study. Foot Ankle Int. 2001;22:415–21.PubMed
10.
go back to reference Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349–53.CrossRefPubMed Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349–53.CrossRefPubMed
11.
go back to reference Kaikkonen A, Kannus P, Jarvinen M. A performance test protocol and scoring scale for the evaluation of ankle injuries. Am J Sports Med. 1994;22:462–9.CrossRefPubMed Kaikkonen A, Kannus P, Jarvinen M. A performance test protocol and scoring scale for the evaluation of ankle injuries. Am J Sports Med. 1994;22:462–9.CrossRefPubMed
12.
go back to reference Hsu AR, Gross CE, Lee S, Carreira DS. Extended indications for foot and ankle arthroscopy. J Am Acad Orthop Surg. 2014;22:10–9.CrossRefPubMed Hsu AR, Gross CE, Lee S, Carreira DS. Extended indications for foot and ankle arthroscopy. J Am Acad Orthop Surg. 2014;22:10–9.CrossRefPubMed
13.
go back to reference Morales J, García E, Asunción J, Poggio D. Medium-term results of arthroscopic debridement in osteochondral talar lesions. Acta Ortop Mex. 2013;27:319–23.PubMed Morales J, García E, Asunción J, Poggio D. Medium-term results of arthroscopic debridement in osteochondral talar lesions. Acta Ortop Mex. 2013;27:319–23.PubMed
14.
go back to reference Parma A, Buda R, Vannini F, Ruffilli A, Cavallo M, Ferruzzi A, et al. Arthroscopic treatment of ankle anterior bony impingement: the long-term clinical outcome. Foot Ankle Int. 2014;35:148–55.CrossRefPubMed Parma A, Buda R, Vannini F, Ruffilli A, Cavallo M, Ferruzzi A, et al. Arthroscopic treatment of ankle anterior bony impingement: the long-term clinical outcome. Foot Ankle Int. 2014;35:148–55.CrossRefPubMed
15.
go back to reference Murawski CD, Kennedy JG. Operative treatment of osteochondral lesions of the talus. J Bone Joint Surg Am. 2013;95:1045–54.CrossRefPubMed Murawski CD, Kennedy JG. Operative treatment of osteochondral lesions of the talus. J Bone Joint Surg Am. 2013;95:1045–54.CrossRefPubMed
16.
go back to reference van Bergen CJ, Kox LS, Maas M, Sierevelt IN, Kerkhoffs GM, van Dijk CN. Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up. J Bone Joint Surg Am. 2013;95:519–25.CrossRefPubMed van Bergen CJ, Kox LS, Maas M, Sierevelt IN, Kerkhoffs GM, van Dijk CN. Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up. J Bone Joint Surg Am. 2013;95:519–25.CrossRefPubMed
17.
go back to reference Donnenwerth MP, Roukis TS. Outcome of arthroscopic debridement and microfracture as the primary treatment for osteochondral lesions of the talar dome. Arthroscopy. 2012;28:1902–7.CrossRefPubMed Donnenwerth MP, Roukis TS. Outcome of arthroscopic debridement and microfracture as the primary treatment for osteochondral lesions of the talar dome. Arthroscopy. 2012;28:1902–7.CrossRefPubMed
18.
go back to reference Yoshimura I, Kanazawa K, Takeyama A, Angthong C, Ida T, Hagio T, et al. Arthroscopic bone marrow stimulation techniques for osteochondral lesions of the talus: prognostic factors for small lesions. Am J Sports Med. 2013;41:528–34.CrossRefPubMed Yoshimura I, Kanazawa K, Takeyama A, Angthong C, Ida T, Hagio T, et al. Arthroscopic bone marrow stimulation techniques for osteochondral lesions of the talus: prognostic factors for small lesions. Am J Sports Med. 2013;41:528–34.CrossRefPubMed
19.
go back to reference Choi WJ, Choi GW, Kwon HM, Lee JW. Arthroscopic treatment in mild to moderate osteoarthritis of the ankle. Knee Surg Sports Traumatol Arthrosc. 2013;21:1338–44.CrossRefPubMed Choi WJ, Choi GW, Kwon HM, Lee JW. Arthroscopic treatment in mild to moderate osteoarthritis of the ankle. Knee Surg Sports Traumatol Arthrosc. 2013;21:1338–44.CrossRefPubMed
20.
go back to reference Kirkley A, Birmingham TB, Litchfield RB, Giffin JR, Willits KR, Wong CJ, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2008;359:1097–107.CrossRefPubMed Kirkley A, Birmingham TB, Litchfield RB, Giffin JR, Willits KR, Wong CJ, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2008;359:1097–107.CrossRefPubMed
21.
go back to reference Buckwalter JA, Brown TD. Joint injury, repair, and remodeling: roles in post-traumatic osteoarthritis. Clin Orthop Relat Res. 2004;423:7–16.CrossRefPubMed Buckwalter JA, Brown TD. Joint injury, repair, and remodeling: roles in post-traumatic osteoarthritis. Clin Orthop Relat Res. 2004;423:7–16.CrossRefPubMed
22.
go back to reference Cole AA, Kuettner KE. Molecular basis for differences between humanjoints. Cell Mol Life Sci. 2002;59:19–26. Cole AA, Kuettner KE. Molecular basis for differences between humanjoints. Cell Mol Life Sci. 2002;59:19–26.
23.
go back to reference Hassouna H, Kumar S, Bendall S. Arthroscopic ankle debridement: 5-year survival analysis. Acta Orthop Belg. 2007;73:737–40.PubMed Hassouna H, Kumar S, Bendall S. Arthroscopic ankle debridement: 5-year survival analysis. Acta Orthop Belg. 2007;73:737–40.PubMed
24.
go back to reference Giannini S, Buda R, Faldini C, Vannini F, Romagnoli M, Grandi G, et al. The treatment of severe posttraumatic arthritis of the ankle joint. J Bone Joint Surg Am. 2007;89 Suppl 3:15–28.CrossRefPubMed Giannini S, Buda R, Faldini C, Vannini F, Romagnoli M, Grandi G, et al. The treatment of severe posttraumatic arthritis of the ankle joint. J Bone Joint Surg Am. 2007;89 Suppl 3:15–28.CrossRefPubMed
25.
go back to reference Spahn G, Mückley T, Kahl E, Hofmann GO. Factors affecting the outcome of arthroscopy in medial-compartment osteoarthritis of the knee. Arthroscopy. 2006;22:1233–40.CrossRefPubMed Spahn G, Mückley T, Kahl E, Hofmann GO. Factors affecting the outcome of arthroscopy in medial-compartment osteoarthritis of the knee. Arthroscopy. 2006;22:1233–40.CrossRefPubMed
26.
27.
go back to reference Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G, et al. Isolated anterior talofibular ligament Brostrom repair for chronic lateral ankle instability: 9-year follow-up. Am J Sports Med. 2013;41:858–64.CrossRefPubMed Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G, et al. Isolated anterior talofibular ligament Brostrom repair for chronic lateral ankle instability: 9-year follow-up. Am J Sports Med. 2013;41:858–64.CrossRefPubMed
28.
go back to reference Nery C, Raduan F, Del Buono A, Asaumi ID, Cohen M, Maffulli N. Arthroscopic-assisted Brostrom-Gould for chronic ankle instability: a long-term follow-up. Am J Sports Med. 2011;39:2381–8.CrossRefPubMed Nery C, Raduan F, Del Buono A, Asaumi ID, Cohen M, Maffulli N. Arthroscopic-assisted Brostrom-Gould for chronic ankle instability: a long-term follow-up. Am J Sports Med. 2011;39:2381–8.CrossRefPubMed
29.
go back to reference van Eekeren IC, Reilingh ML, van Dijk CN. Rehabilitation and return-to-sports activity after debridement and bone marrow stimulation of osteochondral talar defects. Sports Med. 2012;42:857–70.PubMed van Eekeren IC, Reilingh ML, van Dijk CN. Rehabilitation and return-to-sports activity after debridement and bone marrow stimulation of osteochondral talar defects. Sports Med. 2012;42:857–70.PubMed
30.
go back to reference Frisbie DD, Oxford JT, Southwood L, Trotter GW, Rodkey WG, Steadman JR, et al. Early events in cartilage repair after subchondral bone microfracture. Clin Orthop Relat Res. 2003;407:215–27.CrossRefPubMed Frisbie DD, Oxford JT, Southwood L, Trotter GW, Rodkey WG, Steadman JR, et al. Early events in cartilage repair after subchondral bone microfracture. Clin Orthop Relat Res. 2003;407:215–27.CrossRefPubMed
31.
go back to reference Gill TJ, McCulloch PC, Glasson SS, Blanchet T, Morris EA. Chondral defect repair after the microfracture procedure: a nonhuman primate model. Am J Sports Med. 2005;33:680–5.CrossRefPubMed Gill TJ, McCulloch PC, Glasson SS, Blanchet T, Morris EA. Chondral defect repair after the microfracture procedure: a nonhuman primate model. Am J Sports Med. 2005;33:680–5.CrossRefPubMed
32.
go back to reference Liu C, Shi XG, Liu YJ, Wang ZG, Wei M. Analysis on arthroscopic debridement and visco supplement for the treatment of degenerative osteoarthropathy of ankle. Zhongguo Gu Shang. 2013;26:115–8.PubMed Liu C, Shi XG, Liu YJ, Wang ZG, Wei M. Analysis on arthroscopic debridement and visco supplement for the treatment of degenerative osteoarthropathy of ankle. Zhongguo Gu Shang. 2013;26:115–8.PubMed
33.
go back to reference Mann G, Nyska M, Hetsroni I, Karlsson J. Scoring systems for evaluating ankle function. Foot Ankle Clin. 2006;11:509–19.CrossRefPubMed Mann G, Nyska M, Hetsroni I, Karlsson J. Scoring systems for evaluating ankle function. Foot Ankle Clin. 2006;11:509–19.CrossRefPubMed
Metadata
Title
Arthroscopic debridement of the ankle for mild to moderate osteoarthritis: a midterm follow-up study in former professional soccer players
Authors
Leonardo Osti
Angelo Del Buono
Nicola Maffulli
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2016
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-016-0368-z

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