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Bojanić I, Plečko M, Mataić A, Dimnjaković D. Anterior and Posterior Arthroscopic Treatment of Primary Synovial Chondromatosis of the Ankle. Foot Ankle Int 2021; 42:440-447. [PMID: 33203258 DOI: 10.1177/1071100720970961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Primary synovial chondromatosis (PSC) is a progressive disorder of unknown etiology resulting in formation of multiple loose bodies. If left untreated, it may lead to degenerative changes or malignant transformation to chondrosarcoma. METHODS Seventeen patients who underwent combined posterior and anterior ankle arthroscopy within the same operative session and had histologically confirmed PSC were included in this retrospective study. American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate ankle function preoperatively and at a final follow-up. A 3-question survey was used to evaluate patient's satisfaction at the final follow-up. RESULTS In 14 patients, loose bodies were found in both compartments of the ankle, in 2 only in the anterior compartment, and in 1 only in the posterior compartment. All patients had evident signs of synovial inflammation in both compartments. The AOFAS Ankle-Hindfoot score increased from the preoperative median score of 65 (range, 29-90) to 95 (range, 65-100) at the final follow-up. Fourteen patients reported they were extremely satisfied with the outcome, 1 was moderately satisfied, and 2 were dissatisfied. No cases of recurrence of synovitis or loose body formation were noted, nor any signs of malignant transformation during the follow-up period. CONCLUSION We believe the risk of recurrence of PSC, which is in close relation to malignant transformation, can be minimized by performing a complete synovectomy of the ankle. Our experience and review of literature makes us believe that ankle PSC should be regarded as a whole joint disorder. Performing a combined posterior and anterior arthroscopic procedure within the same operative session should always be considered in patients with ankle PSC. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
- Ivan Bojanić
- Department of Orthopedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.,Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Mihovil Plečko
- Department of Orthopedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ana Mataić
- Clinical Department of Pathology and Cytology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Damjan Dimnjaković
- Department of Orthopedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
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Qin DA, Jin ZZ, Song JF. Combined anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in a 58-year-old female: a case report. BMC Musculoskelet Disord 2020; 21:556. [PMID: 32811509 PMCID: PMC7433144 DOI: 10.1186/s12891-020-03584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Combined anterior and posterior ankle impingement has seldom been reported. Cedell fracture, fracture of posteromedial tubercle of talus, is an uncommon and easily missed injury which may elicit posteromedial ankle impingement. The injury mechanisms and management strategies of these two lesions have been reported individually. But the concurrent lesion of both of them has not been reported. CASE PRESENTATION We reported a 58-year-old female with combined anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in whom open osteophytes debridement, fracture internal fixation and posterior talotibial ligament reconstruction were performed. The AOFAS hindfoot score was 90 at 1 year follow-up. To our knowledge, this was the first reported case with anterior, posterior and posteromedial impingement which was treated operatively with an excellent short-term outcome. CONCLUSIONS To fully recognize this occult lesion and avoid missing is imperative for reducing the morbidities. We suggest CT and MRI as excellent imaging modalities that can help the timely diagnosis and appropriate treatment for this combined impingement with circumferential lesions.
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Affiliation(s)
- De-An Qin
- Department of Orthopedics, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, NO. 29, Double Tower Street, Taiyuan, 030012, Shanxi, China.
| | - Zhi-Zhen Jin
- Department of Orthopedics, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, NO. 29, Double Tower Street, Taiyuan, 030012, Shanxi, China
| | - Jie-Fu Song
- Department of Orthopedics, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, NO. 29, Double Tower Street, Taiyuan, 030012, Shanxi, China
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Zhang H, Zhai L, Pan Z, Yu H, Zhu J, Tang K. [Effectiveness of Tang's arthroscopy approach for anterior and posterior ankle impingement syndrome]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2019; 33:1340-1344. [PMID: 31650745 PMCID: PMC8337454 DOI: 10.7507/1002-1892.201904129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 09/17/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the effectiveness of Tang's arthroscopy approach in treatment of anterior and posterior ankle impingement syndrome. METHODS Between August 2010 and September 2017, 92 patients with anterior and posterior ankle impingement syndrome were retrospectively analyzed. There were 58 patients were treated with Tang's arthroscopy approach under floating decubitus (group A) and 34 patients were treated with standard anterior and posterior approaches (group B). There was no significant difference in gender, age, body mass index, side, disease duration, preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score, and preoperative visual analogue scale (VAS) score between the two groups ( P>0.05).The operation time, AOFAS score, VAS score, and Roles-Maudsley score were recorded to evaluated the pain and function of the ankle, and patient subjective satisfaction. The X-ray film and MRI at 12 months were used to observe the ankle impingement. RESULTS Median operation time of group A was 50.5 minutes [95%CI (49.3, 54.6)], which was significantly shorter than that of group B [88.5 minutes, 95%CI (76.5, 92.8)] (Z=-4.685, P=0.000). All incisions in group A healed by first intention; while the incisions of 2 cases in group B delayed healed after debridement. The follow-up time of group A was (54.7±18.8) months, while that of group B was (55.4±17.9) months, and there was no significant difference between the two groups ( t=-0.178, P=0.859). The lateral X-ray films at 12 months showed that the talus process was removed incompletely in 2 cases (3.4%) of group A and 1 case (2.9%) of group B. There was no significant difference in the incidence between the two groups (χ 2=0.014, P=0.699). At last follow-up, the AOFAS scores were 83.1±6.6 in group A and 85.2±6.4 in group B; the VAS scores were 1.3±1.1 in group A and 1.6±1.0 in group B. The AOFAS and VAS scores at last follow-up were superior to preoperative ones ( P<0.05), but there was no significant difference between the two groups ( P>0.05). The median subjective satisfaction score of group A was 2.0 [95%(1.4, 1.7)], which was better than that of group B [2.0, 95%(1.6, 2.2)] ( Z=-2.480, P=0.013). CONCLUSION Arthroscopic treatment of anterior and posterior ankle impingement syndrome through Tang's approach can shorten the operation time, simplify the procedures, and obtain good effectiveness and patient satisfaction.
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Affiliation(s)
- Hongxin Zhang
- Department of Orthopedics Surgery, the 89th Hospital of Chinese PLA, Weifang Shangdong, 261021, P.R.China;Department of Orthopedics/Sports Medicine Center, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing, 400038, P.R.China
| | - Longdi Zhai
- Department of Orthopedics Surgery, the 89th Hospital of Chinese PLA, Weifang Shangdong, 261021, P.R.China
| | - Zhaoxun Pan
- Department of Orthopedics Surgery, the 89th Hospital of Chinese PLA, Weifang Shangdong, 261021, P.R.China
| | - Hongchang Yu
- Department of Orthopedics Surgery, the 89th Hospital of Chinese PLA, Weifang Shangdong, 261021, P.R.China
| | - Jinhang Zhu
- Department of Orthopedics Surgery, the 89th Hospital of Chinese PLA, Weifang Shangdong, 261021, P.R.China
| | - Kanglai Tang
- Department of Orthopedics/Sports Medicine Center, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing, 400038,
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Van Dijk CN, Vuurberg G, Batista J, d’Hooghe P. Posterior ankle arthroscopy: current state of the art. J ISAKOS 2017. [DOI: 10.1136/jisakos-2016-000082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Painful stress reaction in the posterior subtalar joint after resection of os trigonum or posterior talar process. INTERNATIONAL ORTHOPAEDICS 2017; 41:1585-1592. [DOI: 10.1007/s00264-017-3489-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 04/18/2017] [Indexed: 12/18/2022]
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Miyamoto W, Miki S, Kawano H, Takao M. Surgical outcome of posterior ankle impingement syndrome with concomitant ankle disorders treated simultaneously in patient engaged in athletic activity. J Orthop Sci 2017; 22:463-467. [PMID: 28087215 DOI: 10.1016/j.jos.2016.12.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 12/02/2016] [Accepted: 12/15/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is unclear whether simultaneous surgery for posterior ankle impingement syndrome (PAIS) and concomitant ankle disorders, such as anterior ankle impingement syndrome (AAIS), lateral ankle instability (LAI), and osteochondral lesion of the talus (OLT), allows for early return to athletic activity. METHODS Ninety-seven patients who engaged in athletic activity (mean age 27 [range 18-43] years) and were treated by a hindfoot endoscopic approach for PAIS alone or simultaneously for PAIS and concomitant ankle disorders were included in this study. The patients were divided into four groups: PAIS alone (group A, n = 61), PAIS with AAIS (group B, n = 8), PAIS with LAI with or without AAIS (group C, n = 20), and PAIS with OLT with or without AAIS/LAI (group D, n = 8). In all patients, the concomitant ankle disorder was treated simultaneously by arthroscopic debridement for AAIS, bone marrow stimulation or autologous cancellous bone transplantation for OLT, and anterior talofibular ligament repair or reconstruction for LAI. American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores before and 2 years after surgery and times from surgery to resuming training and athletic activity were compared between the groups. RESULTS Mean AOFAS score improved significantly after surgery in all groups (groups A and C, P < .0001; groups B and D: P < .05). The time taken to return to training was significantly longer in group D than in groups A, B, and C (all P < .01) as was the time taken to return to athletic activity in groups C and D when compared with group A (P < .01); however, there were no significant differences in this regard between groups B and C. CONCLUSION Concomitant surgery for AAIS and LAI with PAIS did not delay the postoperative start of training, however, concomitant surgery for LAI and OLT delayed the return to athletic activity when compared with PAIS surgery alone. STUDY DESIGN Clinical Retrospective Comparative Study.
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Affiliation(s)
- Wataru Miyamoto
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan.
| | - Shinya Miki
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan
| | - Masato Takao
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan
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Lui TH. Decompression of Posterior Ankle Impingement With Concomitant Anterior Ankle Pathology by Posterior Ankle Arthroscopy in the Supine Position. Arthrosc Tech 2016; 5:e1191-e1196. [PMID: 28224076 PMCID: PMC5310188 DOI: 10.1016/j.eats.2016.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 07/12/2016] [Indexed: 02/03/2023] Open
Abstract
Posterior ankle endoscopy is a safe and effective approach for treatment of posterior ankle impingement. This is usually performed with the patient in prone position. The purpose of this technical note is to describe an arthroscopic approach of decompression of posterior ankle impingement with the patient in supine position. This is indicated if there is posterior ankle impingement together with other ankle pathology requiring anterior ankle arthroscopy. This approach allows treatment of both anterior ankle and posterior ankle pathology with the patient in the supine position. Concomitant anterior ankle arthroscopy can be performed with the usual orientation without the need of change of patient's position.
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Affiliation(s)
- Tun Hing Lui
- Address correspondence to Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S., Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China.Department of Orthopaedics and TraumatologyNorth District Hospital9 Po Kin RoadSheung Shui, NTHong Kong SARChina
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Das steife Sprunggelenk. ARTHROSKOPIE 2016. [DOI: 10.1007/s00142-016-0080-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lui TH, Chan LK. The safety of the posterior ankle arthroscopy in management of posterior ankle impingement: A cadaveric study. Foot (Edinb) 2016; 27:4-9. [PMID: 26802814 DOI: 10.1016/j.foot.2015.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Arthroscopic management of the posterior ankle impingement with the patient in supine position has the advantage of dealing with anterior ankle pathology at the same time without the need to change position of the patient. This study aims at evaluation of the safety of portal establishment and instrumentation of this technique. METHODS Sixteen fresh-frozen cadaver specimens were used. The relationships of the posteromedial and posterolateral portals to the adjacent tendons and nerves and the relationship of the coaxial portal tract with the posterior ankle capsule and the flexor hallucis longus tendon were studied. RESULT Angle θ1 between the intermalleolar line and the posterior ankle coaxial portal tract averaged 1° (-10° to 22°). Angle θ2 between the intermalleolar line and the metal rod where the neurovascular bundle started to move averaged 19° (10° to 30°). Angle θ3 between the intermalleolar line and the metal rod where it reached the lateral border of the Achilles tendon was larger than angle θ2 in all specimens. The angle of safety (θs) averaged 18° (-1° to 26°). CONCLUSIONS Injury to the tendon, nerves or vessels is possible during establishment of the portals and resection of the os trigonum.
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Affiliation(s)
- T H Lui
- Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China.
| | - L K Chan
- Institute of Medical and Health Sciences Education and Department of Anatomy, The University of Hong Kong, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China.
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Song B, Li C, Chen Z, Yang R, Hou J, Tan W, Li W. Combined Anterior and Dual Posterolateral Approaches for Ankle Arthroscopy for Posterior and Anterior Ankle Impingement Syndrome. Foot Ankle Int 2016; 37:605-10. [PMID: 26892889 DOI: 10.1177/1071100716632042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND 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 approaches. METHODS From January 2013 to January 2015, 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. CONCLUSIONS 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. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
- Bin Song
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Changchuan Li
- Department of Orthopaedics, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Zhong Chen
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Rui Yang
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Jingyi Hou
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Weiquan Tan
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Weiping Li
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
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Evidence-based indications for hindfoot endoscopy. Knee Surg Sports Traumatol Arthrosc 2016; 24:1386-95. [PMID: 26744282 DOI: 10.1007/s00167-015-3965-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/23/2015] [Indexed: 01/25/2023]
Abstract
PURPOSE The 2-portal hindfoot endoscopic technique with the patient in prone position, first introduced by van Dijk et al. (Arthroscopy 16:871-876, 2000), is currently the most used by foot and ankle surgeons to address endoscopically pathologies located in the hindfoot. This article aims to review the literature to provide a comprehensive description of the level of evidence available to support the use of the 2-portal hindfoot endoscopy technique for the current generally accepted indications. METHODS A comprehensive review was performed by use of the PubMed database to isolate literature that described therapeutic studies investigating the results of different hindfoot endoscopy treatment techniques. All articles were reviewed and assigned a classification (I-V) of level of evidence. An analysis of the literature reviewed was used to assign a grade of recommendation for each current generally accepted indication for hindfoot endoscopy. A subscale was used to further describe the evidence base for indications receiving a grade of recommendation indicating poor-quality evidence. RESULTS On the basis on the available evidence, posterior ankle impingement syndrome, subtalar arthritis and retrocalcaneal bursitis have the strongest recommendation in favour of treatment (grade Cf). CONCLUSION Although a low level of evidence of the included studies, the review showed that adequate literature to support the use of the 2-portal endoscopic techniques for most currently accepted indications exists. Future "higher quality" evidence could strengthen current recommendations and further help surgeons in evidence-based practice. LEVEL OF EVIDENCE Level V, Review of Level III, IV and V studies.
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Abstract
Posterior and anterior arthroscopy of the ankle and hindfoot may have to be undertaken at the same surgical sitting. Standard arthroscopic practice does not allow to approach both compartments without changing the position of the patient. In the supine position, most intra-articular structures of posterior portion of the ankle joint can be accessed from anterior portals with judicious traction, but visualization of posterior extra-articular compartment and hindfoot are not possible. To avoid repositioning of the patient, we have developed a procedure that allows access to the posterior compartment of the ankle with the patient supine. We describe a 2 posteromedial ankle portals procedure, which allows to reach both the posterior side of the ankle joint and the hindfoot extra-articular compartments keeping the patient supine throughout the procedure. After treatment of anterior compartment disorders using standard anterior portals, 2 posteromedial entry portals permit to visualize and treat pathologies of the posterior ankle and of the hindfoot, without prolonging surgery.
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Miyamoto W, Takao M, Matsui K, Matsushita T. Simultaneous ankle arthroscopy and hindfoot endoscopy for combined anterior and posterior ankle impingement syndrome in professional athletes. J Orthop Sci 2015; 20:642-8. [PMID: 25797332 DOI: 10.1007/s00776-015-0712-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 03/01/2015] [Indexed: 12/01/2022]
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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Affiliation(s)
- Wataru Miyamoto
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan,
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Combined arthroscopic management of concurrent posterior and anterior ankle pathologies. Knee Surg Sports Traumatol Arthrosc 2014; 22:2837-42. [PMID: 24718735 DOI: 10.1007/s00167-014-2980-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 03/30/2014] [Indexed: 01/27/2023]
Abstract
PURPOSE To determine the technical feasibility and preliminary clinical efficacy of performing simultaneous arthroscopic management in cases with combined posterior and anterior ankle pathologies utilizing previously described standard arthroscopic procedures within a single surgical sitting. METHODS Nineteen consecutive patients with combined anterior and posterior ankle pathologies were included in the current study, after at least 6 months of failed conservative managements. Combined standard posterior and anterior ankle arthroscopy was performed in all patients within the same surgical session; first with the patient in the prone position, then with the patient turned onto the supine position to perform the anterior procedure. RESULTS All patients were available for the follow-up; the median follow-up period was 33 months (range 22-61 months). No persistent neurological deficits or infections were recorded. The American Orthopedic Foot and Ankle Society Ankle and Hind foot Scale score significantly improved from 70.2 ± 15.2 points preoperatively to reach 93.0 ± 5.4 points at 1 year post-operatively (p < 0.001). Sixteen patients (84.2 %) returned to their previous activity levels. CONCLUSIONS Combined arthroscopic management of concurrent posterior and anterior ankle pathologies within the same surgical session is initially clinically encouraging; it allows for an earlier return to activities of daily living without a significantly added morbidity. LEVEL OF EVIDENCE Case series, Level IV.
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Lui TH. Arthroscopic Treatment of Posterior Ankle Impingement in the Supine Position Using Coaxial Posterior Portals. Foot Ankle Int 2014; 35:834-837. [PMID: 24798913 DOI: 10.1177/1071100714534218] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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