Combined Anterior and Dual Posterolateral Approaches for Ankle Arthroscopy for Posterior and Anterior Ankle Impingement Syndrome

Category: Arthroscopy Introduction/Purpose: We introduce a novel method of combining the standard anteromedial and anterolateral approaches and dual posterolateral approaches in the arthroscopic treatment of posterior and anterior ankle impingement syndrome and compare the postoperative outcomes with conventional anteromedial/anterolateral and posteromedial/posterolateral Methods: From January 2015 to January 2017, we treated 28 patients with posterior and anterior ankle impingement syndrome by arthroscopy. The patients were divided into the conventional group (n = 13) and the modified group (n = 15) according to the surgical approaches used in the operation. Preoperative and postoperative American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) score, range of ankle motion, and operation time were recorded. The average follow-up was 16 months (range 6-24 months). Results: Posterior and anterior ankle impingement syndrome was confirmed arthroscopically in all patients. After the operation, the range of ankle motion in all patients was restored. There was no significant difference in postoperative AOFAS score, VAS score, dorsiflexion, and plantarflexion between the conventional group and the modified group. Moreover, the operation time was significantly reduced in the modified group compared with the conventional group. There was no recurrence of osteophyte and no complications such as infection, neurovascular injury, or delayed healing of surgical incision in the modified group. Conclusion: Dual posterolateral approaches combined with standard anteromedial and anterolateral approaches was a novel method for arthroscopic treatment of posterior and anterior ankle impingement syndrome. It proved to be safe and effective, and significantly reduced the operation time. Reposition, repeated prep and drape, and limb distraction were avoided.

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Arthroscopic Treatment of Anterior Ankle Impingement Syndrome in Dancers

Foot & Ankle International ◽

10.1177/107110070502601102 ◽

2005 ◽

Vol 26 (11) ◽

pp. 908-912 ◽

Cited By ~ 40

Author(s):

Aneel Nihal ◽

Donald J. Rose ◽

Elly Trepman

Keyword(s):

Soft Tissue ◽

Soft Tissues ◽

Case Series ◽

Scar Tissue ◽

Nonoperative Treatment ◽

Impingement Syndrome ◽

Arthroscopic Treatment ◽

Dance Performance ◽

Ankle Impingement ◽

Anterior Ankle Impingement

Background: The purpose of this study was to evaluate the results of arthroscopic treatment of anterior bony and soft-tissue impingement of the ankle in elite dancers. Methods: The study is a case series retrospectively reviewed. In the period between 1990 and 1999, 11 elite dancers (12 ankles) had ankle arthroscopy after a diagnosis of anterior ankle impingement that markedly interfered with their dancing. Initial nonoperative treatment failed in all subjects. Previous ankle trauma was noted in all subjects. There were seven women and four men (average age 28 years). Tibiotalar exostoses were radiographically noted in six ankles. Standard anteromedial and anterolateral arthroscopic portals and instrumentation were used for resection of bone spurs and debridement of impinging soft tissues. Patients were nonweightbearing for 5 days after surgery and had postoperative physiotherapy. Results: Nine dancers returned to full dance activity at an average of 7 weeks after surgery. One patient did not return to dance performance because of concurrent unrelated orthopaedic problems, but he resumed work as a dance teacher; he developed a recurrent anterior tibial spur that was successfully resected at a second arthroscopy 9 years later. Another dancer developed postoperative scar-tissue impingement and stiffness; she had a repeat arthroscopy 4 months after the initial procedure and subsequently returned to dance performance. All patients eventually had marked postoperative improvement in pain relief and dance performance. Conclusions: Arthroscopic debridement is an effective method for the treatment of bony and soft-tissue anterior ankle impingement syndrome in dancers and has minimal morbidity.

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Double Posteromedial Portals for Excision of a Symptomatic Os Trigonum With Ankle Arthroscopy in Supine Position

10.21203/rs.3.rs-981200/v1 ◽

2021 ◽

Author(s):

Songchuan Su ◽

Qi Hao ◽

Qi Ding

Keyword(s):

Operation Time ◽

Postoperative Recovery ◽

Aofas Score ◽

Os Trigonum ◽

Vas Score ◽

Standard Operation ◽

Standard Procedures ◽

Posterior Ankle Impingement ◽

Novel Method ◽

Better Than

Abstract Background: The existence of abnormal os trigonum often causes posterior ankle impingement syndrome, the commonly used method for excision of symptomatic os trigonum is standard arthroscopic approach when posterior and anterior abnormalities appear in one patient. However, the arthroscopy of posterior and anterior compartement of the ankle joint must be undertaken in one surgical position. In most cases, when adopting the standard arthroscopic approach, the patient has to be firstly positioned supine to perform the anterior procedure, and then re-positioned prone to operate on the posterior compartment. Material and Methods: To simplify this process and shorten operation time, we describe a double posteromedial ankle portals procedure, which provides access to reach both the posterior and anterior compartment without changing position, to exam both symptomatic compartement. Standard operation are conducted by changing position to reach both compartement. Standard operation and double posteromedial ankle portals procedure were conducted to 46 patients (standard approach 23, 2 posteromedial portals 23). Operation time, AOFAS score, KAF score and VAS score were analyzed.Results: It shows operation time reduced from 69.78±5.24 min to 36.61±3.63 min (P<0.05) and postoperative recovery index of novel method including AOFAS score, KAF score and VAS score were better than that in standard way one month after operation, but there was no significance difference after one month. Conclusion: The figures strongly suggest that the double posteromedial portals approach is better than the standard procedures in operation time, short-term postoperative recovery.

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