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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-04-2016 | Ankle

Endoscopic treatment of the posterior ankle impingement syndrome on amateur and professional athletes

Authors: Mauro Cesar Mattos e Dinato, Isabela Ugo Luques, Marcio de Faria Freitas, Miguel Viana Pereira Filho, André Felipe Ninomiya, Rodrigo Gonçalves Pagnano, Maurício Etchebehere

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2016

Abstract

Purpose

To determine whether professional and amateur athletes showed differences in ankle function when treated with endoscopic technique for posterior ankle impingement syndrome, to verify the impact of the presence of associated lesions in clinical evolution and to assess time to return to sport (we hypothesize that time will be the only difference between groups).

Methods

Thirty-two athletes with a diagnosis of posterior impingement syndrome underwent surgery endoscopically. The American Orthopaedics Foot and Ankle Society (AOFAS) scale was used to compare functional results between amateur (15) and professional athletes (17). The satisfaction, time to return to sport, operative time, intraoperative findings and complications were evaluated, and the presence of associated injuries interfering in these results was verified.

Results

The preoperative AOFAS score range for the professional group was 62.9 ± 14 preoperatively and 92.3 ± 7.7 postoperatively, and for the amateur group was 67.9 ± 19.7 and 94 ± 9.3. The satisfaction was excellent or good in 94 % of all cases and fair in 6 %. The average time of surgery was 48.3 + 25 min. Bone involvement was present in 100 % of cases and complications in three cases. Time to return to sports was similar (n.s.) in both groups, and the mean time was 15.6 ± 13.7 and 16.3 ± 9 weeks, respectively.

Conclusion

No significant difference regarding functional results and time to return to sports between professionals and amateur athletes operated was found. Athletes showed mainly good and excellent results and low complication rate. The presence of associated injuries did not significantly influence the results. With these results, the high-level athlete can better programme their surgeries so they can fully recover and perform better in the most important competitions.

Level of evidence

Level III.

Abramowitz Y, Wollstein R, Barzilay Y, London E, Matan Y, Shabat S, Nyska M (2003) Outcome of resection of a symptomatic os trigonum. J Bone Joint Surg Am 85-A(6):1051–1057PubMed

Ahn JH, Kim YC, Kim HY (2013) Arthroscopic versus posterior endoscopic excision of a symptomatic os trigonum: a retrospective cohort study. Am J Sports Med 41(5):1082–1089CrossRefPubMed

Calder JD, Sexton SA, Pearce CJ (2010) Return to training and playing after posterior ankle arthroscopy for posterior impingement in elite professional soccer. Am J Sports Med 38(1):120–124CrossRefPubMed

Galla M, Lobenhoffer P (2011) Technique and results of arthroscopic treatment of posterior ankle impingement. Foot Ankle Surg 17(2):79–84CrossRefPubMed

Guo QW, Hu YL, Jiao C, Ao YF, de Tian X (2010) Open versus endoscopic excision of a symptomatic os trigonum: a comparative study of 41 cases. Arthroscopy 26(3):384–390CrossRefPubMed

Hamilton WG, Geppert MJ, Thompson FM (1996) Pain in the posterior aspect of the ankle in dancers. Differential diagnosis and operative treatment. J Bone Joint Surg Am 78(10):1491–1500PubMed

Hedrick MR, McBryde AM (1994) Posterior ankle impingement. Foot Ankle Int 15(1):2–8CrossRefPubMed

Horibe S, Kita K, Natsu-ume T, Hamada M, Mae T, Shino K (2008) A novel technique of arthroscopic excision of a symptomatic os trigonum. Arthroscopy 24(1):121.e1–121.e4CrossRef

Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15(7):349–353CrossRefPubMed

10.

Marotta JJ, Micheli LJ (1992) Os trigonum impingement in dancers. Am J Sports Med 20(5):533–536CrossRefPubMed

11.

Marumoto JM, Ferkel RD (1997) Arthroscopic excision of the os trigonum: a new technique with preliminary clinical results. Foot Ankle Int 18(12):777–784CrossRefPubMed

12.

Nickisch F, Barg A, Saltzman CL, Beals TC, Bonasia DE, Phisitkul P, Femino JE, Amendola A (2012) Postoperative complications of posterior ankle and hindfoot arthroscopy. J Bone Joint Surg Am 94(5):439–446CrossRefPubMed

13.

Noguchi H, Ishii Y, Takeda M, Hasegawa A, Monden S, Takagishi K (2010) Arthroscopic excision of posterior ankle bony impingement for early return to the field: short-term results. Foot Ankle Int 31(5):398–403CrossRefPubMed

14.

Ogut T, Ayhan E, Irgit K, Sarikaya AI (2011) Endoscopic treatment of posterior ankle pain. Knee Surg Sports Traumatol 19(8):1355–1361CrossRef

15.

Scholten PE, Sierevelt IN, van Dijk CN (2008) Hindfoot endoscopy for posterior ankle impingement. J Bone Joint Surg 90(12):2665–2672CrossRefPubMed

16.

Sitler DF, Amendola A, Bailey CS, Thain LM, Spouge A (2002) Posterior ankle arthroscopy: an anatomic study. J Bone Joint Surg Am 84-A(5):763–769PubMed

17.

Tey M, Monllau JC, Centenera JM, Pelfort X (2007) Benefits of arthroscopic tuberculoplasty in posterior ankle impingement syndrome. Knee Surg Sports Traumatol Arthrosc 15(10):1235–1239CrossRefPubMed

18.

van Dijk CN (2006) Anterior and posterior ankle impingement. Foot Ankle Clin N Am 11:663–683CrossRef

19.

van Dijk CN, Scholten PE, Krips R (2000) A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy 16(8):871–876CrossRefPubMed

20.

Willits K, Sonneveld H, Amendola A, Giffin JR, Griffin S, Fowler PJ (2008) Outcome of posterior ankle arthroscopy for hindfoot impingement. Arthroscopy 24(2):196–202CrossRefPubMed

21.

Yilmaz C, Eskandari MM (2006) Arthroscopic excision of the talar Stieda’s process. Arthroscopy 22(2):225.e1-225.e3CrossRefPubMed

22.

Zwiers R, Wiegerinck JI, Murawski CD, Smyth NA, Kennedy JG, van Dijk CN (2013) Surgical treatment for posterior ankle impingement. Arthroscopy 29(7):1263–1270CrossRefPubMed

Title: Endoscopic treatment of the posterior ankle impingement syndrome on amateur and professional athletes
Authors: Mauro Cesar Mattos e Dinato
Isabela Ugo Luques
Marcio de Faria Freitas
Miguel Viana Pereira Filho
André Felipe Ninomiya
Rodrigo Gonçalves Pagnano
Maurício Etchebehere
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-015-3747-9

At a glance: The STEP trials

Springer Medicine

Endoscopic treatment of the posterior ankle impingement syndrome on amateur and professional athletes

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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