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Simultaneous ankle arthroscopy and hindfoot endoscopy for combined anterior and posterior ankle impingement syndrome in professional athletes

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Introduction

This study aimed to evaluate the clinical outcome of simultaneous less-invasive ankle arthroscopy and hindfoot endoscopy for combined anterior ankle impingement syndrome (AAIS) and posterior ankle impingement syndrome (PAIS) in professional athletes.

Materials and methods

Between October 2009 and October 2011, 12 feet of 9 professional athletes (8 men, 1 woman; mean age 25 years; range 19–34 years) with combined AAIS and PAIS underwent simultaneous ankle arthroscopy and hindfoot endoscopy. Radiography, computed tomography, and magnetic resonance imaging were performed in all patients. Ultrasound-guided anesthetic injection was administered for the diagnosis of PAIS. Active plantar and dorsal flexion angles of the ankle before and after surgery, occurrence of complications, and time to return to competitive sports were evaluated.

Results

All feet had osteophytes in the anterior ankle joint. Ostrigonum and a large posterior talar process were found in 8 and 4 feet, respectively. Combined disorders that were noted were lateral ankle instability in 6 feet and an osteochondral lesion of the talus in 4 feet. Median JSSF and VAS scores improved significantly from 63 (range 55–69) points preoperatively to 82 (range 77–100) points postoperatively (p < 0.01), and from 85 (range 70–95) points preoperatively to 8 (range 3–15) points postoperatively (p < 0.01), respectively. Median active plantar and dorsal flexion angles improved significantly from 40° (range, 30°–50°) and 10° (range 5°–20°) preoperatively to 50° (range 40°–55°) and 15° (range 10°–20°) postoperatively, respectively (p < 0.01 and p < 0.05, respectively). One patient complained of numbness in the vicinity of the sural nerve, which resolved spontaneously by the 4th week after surgery. Median time to return to competitive sports was 12 (range 12–15) weeks.

Conclusion

Simultaneous ankle arthroscopy and hindfoot endoscopy for combined AAIS and PAIS enables professional athletes to return to athletic activity.

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References

  1. Morris LH. Report of cases of athlete’s ankle. J Bone Joint Surg Am. 1943;25(1):220.

    Google Scholar 

  2. Tol JL, van Dijk CN. Anterior ankle impingement. Foot Ankle Clin. 2006;11(2):297–310.

    Article  PubMed  Google Scholar 

  3. van Dijk CN, van Bergen CJ. Advancements in ankle arthroscopy. J Am Acad Orthop Surg. 2008;16(11):635–46.

    PubMed  Google Scholar 

  4. Baums MH, Kahl E, Schultz W, Klinger HM. Clinical outcome of the arthroscopic management of sports-related “anterior ankle pain”: a prospective study. Knee Surg Sports Traumatol Arthrosc. 2006;14(5):482–6.

    Article  CAS  PubMed  Google Scholar 

  5. Nihal A, Rose DJ, Trepman E. Arthroscopic treatment of anterior ankle impingement syndrome in dancers. Foot Ankle Int. 2005;26(11):908–12.

    PubMed  Google Scholar 

  6. Takao M, Uchio Y, Naito K, Kono T, Oae K, Ochi M. Arthroscopic treatment for anterior impingement exostosis of the ankle: application of three-dimensional computed tomography. Foot Ankle Int. 2004;25(2):59–62.

    PubMed  Google Scholar 

  7. Tol JL, Verheyen CP, van Dijk CN. Arthroscopic treatment of anterior impingement in the ankle. J Bone Joint Surg Br. 2001;83(1):9–13.

    Article  CAS  PubMed  Google Scholar 

  8. Maquirriain J. Posterior ankle impingement syndrome. J Am Acad Orthop Surg. 2005;13(6):365–71.

    PubMed  Google Scholar 

  9. van Dijk CN. Anterior and posterior ankle impingement. Foot Ankle Clin. 2006;11(3):663–83.

    Article  Google Scholar 

  10. Scholten PE, Sierevelt IN, van Dijk CN. Hindfoot endoscopy for posterior ankle impingement. J Bone Joint Surg Am. 2008;90(12):2665–72.

    Article  CAS  PubMed  Google Scholar 

  11. van Dijk CN, Scholten PE, Krips R. A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy. 2000;16(8):871–6.

    Article  PubMed  Google Scholar 

  12. Henderson I, La Valette D. Ankle impingement: combined anterior and posterior impingement syndrome of the ankle. Foot Ankle Int. 2004;25(9):632–8.

    PubMed  Google Scholar 

  13. Kim HK, Jeon JY, Dong Q, Kim HN, Park YW. Ankle arthroscopy in a hanging position combined with hindfoot endoscopy for the treatment of concurrent anterior and posterior impingement syndrome of the ankle. J Foot Ankle Surg. 2013;52(6):704–9.

    Article  PubMed  Google Scholar 

  14. Wang X, Zhao Z, Liu X, Zhang J, Shen J. Combined posterior and anterior ankle arthroscopy for posterior and anterior ankle impingement syndrome in a switching position. Foot Ankle Int. 2014;35(8):829–33.

    Article  PubMed  Google Scholar 

  15. Karlsson J, Lansinger O. Lateral instability of the ankle joint. Clin Orthop Relat Res. 1992;276:253–61.

    PubMed  Google Scholar 

  16. Takao M, Ochi M, Shu N, Naito K, Matsusaki M, Tobita M, Kawasaki K. Bandage distraction technique for ankle arthroscopy. Foot Ankle Int. 1999;20(6):389–91.

    Article  CAS  PubMed  Google Scholar 

  17. Niki H, Aoki H, Inokuchi S, Ozeki S, Kinoshita M, Kura H, Tanaka Y, Noguchi M, Nomura S, Hatori M, Tatsunami S. Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders I: development of standard rating system. J Orthop Sci. 2005;10(5):457–65.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Niki H, Aoki H, Inokuchi S, Ozeki S, Kinoshita M, Kura H, Tanaka Y, Noguchi M, Nomura S, Hatori M, Tatsunami S. Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders II: interclinician and intraclinician reliability and validity of the newly established standard rating scales and Japanese Orthopaedic Association rating scale. J Orthop Sci. 2005;10(5):466–74.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Scranton PE Jr, McDermott JE. Anterior tibiotalar spurs: a comparison of open versus arthroscopic debridement. Foot Ankle. 1992;13(3):125–9.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  21. Calder JD, Sexton SA, Pearce CJ. Return to training and playing after posterior ankle arthroscopy for posterior impingement in elite professional soccer. Am J Sports Med. 2010;38(1):120–4.

    Article  PubMed  Google Scholar 

  22. Smyth NA, Murawski CD, Levine DS, Kennedy JG. Hindfoot arthroscopic surgery for posterior ankle impingement: a systematic surgical approach and case series. Am J Sports Med. 2013;41(8):1869–76.

    Article  PubMed  Google Scholar 

  23. Cuttica DJ, Smith WB, Hyer CF, Philbin TM, Berlet GC. Osteochondral lesions of the talus: predictors of clinical outcome. Foot Ankle Int. 2011;32(11):1045–51.

    Article  PubMed  Google Scholar 

  24. Choi WJ, Kim BS, Lee JW. Osteochondral lesion of the talus: could age be an indication for arthroscopic treatment? Am J Sports Med. 2012;40(2):419–24.

    Article  PubMed  Google Scholar 

  25. Yoshimura I, Kanazawa K, Takeyama A, Angthong C, Ida T, Hagio T, Hanada H, Naito M. Arthroscopic bone marrow stimulation techniques for osteochondral lesions of the talus: prognostic factors for small lesions. Am J Sports Med. 2013;41(3):528–34.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan

    Wataru Miyamoto, Masato Takao, Kentaro Matsui & Takashi Matsushita

Authors
  1. Wataru Miyamoto
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  2. Masato Takao
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  3. Kentaro Matsui
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  4. Takashi Matsushita
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Corresponding author

Correspondence to Wataru Miyamoto.

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Miyamoto, W., Takao, M., Matsui, K. et al. Simultaneous ankle arthroscopy and hindfoot endoscopy for combined anterior and posterior ankle impingement syndrome in professional athletes. J Orthop Sci 20, 642–648 (2015). https://doi.org/10.1007/s00776-015-0712-x

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  • DOI: https://doi.org/10.1007/s00776-015-0712-x

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