EFFECTIVENESS OF ARTHROSCOPY FOR ANKLE IMPINGEMENT SYNDROME_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HANGuansheng ¹ ,  XUBin ¹ , GENGChunhui ² , CHENGXinde ³

1. Department of Orthopaedics, the First Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230022, P. R. China;
2. Department of Orthopaedics, the Second Affiliated Hospital of Bengbu Medical College;
3. Department of Plastic Surgery, the Second Affiliated Hospital of Bengbu Medical College;

Corresponding author：

XUBin, Email: youchen100@126.com

Keywords：

Ankle impingement syndrome; Arthroscopy; Joint function

DOI：

10.7507/1002-1892.20140149

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Objective To explore the effectiveness of arthroscopy for ankle impingement syndrome. Methods Between March 2009 and April 2013, 30 patients with ankle impingement syndrome were treated. Among them, there were 22 males and 8 females with an average age of 28.6 years (range, 16-55 years). Twenty-six patients had a history of obvious ankle sprains. The disease duration was 6-62 months (mean, 21.5 months). All cases had ankle pain, limitation of activity, and positive results of ankle impact test. According to Meislin scoring criteria, 5 cases were rated as good, 8 cases as medium, and 17 cases as poor; the excellent and good rate was 16.7%. American Orthopedic Foot and Ankle Society (AOFAS) score was 43.3±5.1. Visual analogue scale (VAS) score was 6.7±2.3. Preoperative X-ray film showed ankle loose bodies and hyperplasia osteophyte in 6 cases, and lateral malleolus old avulsion fracture in 4 cases. MRI showed soft tissue in the ankle joint in the 17 cases, and articular cartilage injury of tibiotalar joint and bone marrow edema in 7 cases. The location, degree, and organization of the impact were observed under arthroscopy. The joint debridement, removal of loose body and osteophyte, plasty of articular cartilage, and plasma radiofrequency ablation of lateral and medial ligaments were performed. Results All incisions healed primarily. No infection of skin and joint, or neurological and vascular injury was found. All patients were followed up 6-32 months (mean, 19.5 months). According to Meislin scoring criteria at last follow-up, 16 cases were rated as excellent, 11 cases as good, and 3 cases as medium; the excellent and good rate was 90.0%, showing significant difference when compared with preoperative value (Z=6.045, P=0.000). AOFAS score was 89.8±4.3, showing significant difference when compared with preoperative score (t=38.180, P=0.000). VAS score was 2.8±1.6, showing significant difference when compared with preoperative score (t=7.624, P=0.000). Conclusion A clear understanding of impingement characteristics, pertinent joint debridement, and complication treatment are important to treat ankle impingement syndrome by simulating ankle impingement under arthroscopy, which have the advantages of strong pertinence, less injury, and fast recovery.

Citation： HANGuansheng, XUBin, GENGChunhui, CHENGXinde. EFFECTIVENESS OF ARTHROSCOPY FOR ANKLE IMPINGEMENT SYNDROME. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(6): 673-676. doi: 10.7507/1002-1892.20140149 Copy

1.	Brennan SA, Rahim F, Dowling J, et al. Arthroscopic debridement for soft tissue ankle impingement. Ir J Med Sci, 2012, 181(2):253-256.
2.	Wu WT, Chen ZW, Zhou YC. Clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers. Saudi Med J, 2012, 33(10):1087-1092.
3.	程程, 温建民, 林新晓, 等. 关节镜治疗踝关节软组织撞击综合征的临床疗效观察. 中国中医骨伤科杂志, 2012, 20(12):27-28.
4.	Jacobson K, Ng A, Haffner KE. Arthroscopic treatment of anterior ankle impingement. Clinics in Podiatric Medicine and Surgery, 2011, 28(3):491-510.
5.	Bauer T, Pierrard G, Acquitter Y, et al. Arthroscopic treatment of anterior ankle impingement:results of a 70 patient multicenter prospective study. Arthroscopy, 2012, 28(9):e370-382.
6.	Intzirtis P, Tsikouris G, Zampiakis E, et al. Treatment of ankle impingement syndromes in athletes. Br J Sports Med, 2013, 47(10):e3.
7.	Messerli B, Harrast M. Evaluation and treatment of anterolateral ankle impingement syndrome. PM R, 2011, 3(8):776-780.
8.	Freeman MA. Instability of the foot after injuries to the lateral ligament of the ankle. J Bone Joint Surg (Br), 1965, 47(4):669-677.
9.	Dimmick S, Linklater J. Ankle impingement syndrome. Radiol Clin North Am, 2013, 51(3):479-510.
10.	Duncan D, Mologne T, Hildebrand H, et al. The usefulness of magnetic resonance imaging in the diagnosis of anterolateral impingement of the ankle. J Foot Ankle Surg, 2006, 45(5):304-307.
11.	Farooki S, Yao L, Seger LI. Anterolateral impingement of the ankle:effectiveness of MR imaging. Radiology, 1998, 207(2):357-360.
12.	Spiga S, Vinci V, Tack S, et al. Diagnostic imaging of ankle impingement syndromes in athletes. Musculoskelet Surg, 2013, 97(Suppl 2):S145-S153.
13.	Moon JS, Lee K, Lee HS, et al. Cartilage lesions in anterior bony impingement of the ankle. Arthroscopy, 2010, 26(7):984-989.
14.	Russo A, Zappia M, Reginelli A, et al. Ankle impingement:a review of multimodality imaging approach. Musculoskelet Surg, 2013, 97(Suppl 2):S161-S168.
15.	Parma A, Buda R, Vannini F, et al. Arthroscopic treatment of ankle anterior bony impingement:the long-term clinical outcome. Foot Ankle Int, 2014, 35(2):148-155.
16.	Phisitkul P, Tennant JN, Amendola A. Is there any value to arthroscopic debridement of ankle osteoarthritis and impingement? Foot Ankle Clin, 2013, 18(3):449-458.
17.	de Vries JS, Krips R, Blankevoort L, et al. Arthroscopic capsular shrinkage for chronic ankle instability with thermal radiofrequency:prospective multicenter trial. Orthopedics, 2008, 31(7):655.

1. Brennan SA, Rahim F, Dowling J, et al. Arthroscopic debridement for soft tissue ankle impingement. Ir J Med Sci, 2012, 181(2):253-256.
2. Wu WT, Chen ZW, Zhou YC. Clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers. Saudi Med J, 2012, 33(10):1087-1092.
3. 程程, 温建民, 林新晓, 等. 关节镜治疗踝关节软组织撞击综合征的临床疗效观察. 中国中医骨伤科杂志, 2012, 20(12):27-28.
4. Jacobson K, Ng A, Haffner KE. Arthroscopic treatment of anterior ankle impingement. Clinics in Podiatric Medicine and Surgery, 2011, 28(3):491-510.
5. Bauer T, Pierrard G, Acquitter Y, et al. Arthroscopic treatment of anterior ankle impingement:results of a 70 patient multicenter prospective study. Arthroscopy, 2012, 28(9):e370-382.
6. Intzirtis P, Tsikouris G, Zampiakis E, et al. Treatment of ankle impingement syndromes in athletes. Br J Sports Med, 2013, 47(10):e3.
7. Messerli B, Harrast M. Evaluation and treatment of anterolateral ankle impingement syndrome. PM R, 2011, 3(8):776-780.
8. Freeman MA. Instability of the foot after injuries to the lateral ligament of the ankle. J Bone Joint Surg (Br), 1965, 47(4):669-677.
9. Dimmick S, Linklater J. Ankle impingement syndrome. Radiol Clin North Am, 2013, 51(3):479-510.
10. Duncan D, Mologne T, Hildebrand H, et al. The usefulness of magnetic resonance imaging in the diagnosis of anterolateral impingement of the ankle. J Foot Ankle Surg, 2006, 45(5):304-307.
11. Farooki S, Yao L, Seger LI. Anterolateral impingement of the ankle:effectiveness of MR imaging. Radiology, 1998, 207(2):357-360.
12. Spiga S, Vinci V, Tack S, et al. Diagnostic imaging of ankle impingement syndromes in athletes. Musculoskelet Surg, 2013, 97(Suppl 2):S145-S153.
13. Moon JS, Lee K, Lee HS, et al. Cartilage lesions in anterior bony impingement of the ankle. Arthroscopy, 2010, 26(7):984-989.
14. Russo A, Zappia M, Reginelli A, et al. Ankle impingement:a review of multimodality imaging approach. Musculoskelet Surg, 2013, 97(Suppl 2):S161-S168.
15. Parma A, Buda R, Vannini F, et al. Arthroscopic treatment of ankle anterior bony impingement:the long-term clinical outcome. Foot Ankle Int, 2014, 35(2):148-155.
16. Phisitkul P, Tennant JN, Amendola A. Is there any value to arthroscopic debridement of ankle osteoarthritis and impingement? Foot Ankle Clin, 2013, 18(3):449-458.
17. de Vries JS, Krips R, Blankevoort L, et al. Arthroscopic capsular shrinkage for chronic ankle instability with thermal radiofrequency:prospective multicenter trial. Orthopedics, 2008, 31(7):655.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ARTHROSCOPY FOR ANKLE IMPINGEMENT SYNDROME

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