title: Endoscopic repair of posterior ankle impingement syndrome due to os trigonum in soccer players.
abstract: BACKGROUND
  An os trigonum may cause posterior ankle impingement syndrome (PAIS), which may lead to poor sports performance, especially in soccer players. The aim of the present study was to analyze the outcomes of endoscopic repaired posterior ankle impingement (PAI) secondary to os trigonum syndrome within a group of soccer players as well as their return to play time.
  
  
  METHODS
  A retrospective review of 20 soccer players with Tegner activity level 9 was performed. All players were diagnosed of PAIS due to os trigonum. Chief complaint was pain produced with forced plantarflexion when kicking the ball. Conservative treatment was first performed during a 6-week rehabilitation program. When conservative treatment failed, arthroscopic surgical resection of the os trigonum was proposed. Visual analogue scale (VAS) was used to measure pain before and after surgery as well as time until their return to previous sports level.
  
  
  RESULTS
  VAS showed a mean preoperative pain score of 7.5 (SD = 0.9), whereas postoperative VAS at 1 month after surgery decreased to 0.8 (SD = 1.36). Mean symptomatic period was 8.5 months (SD = 4.3), from the beginning of symptoms up to the surgery day. Once patients had undergone surgery, mean time until their return to previous level of sports was 46.9 days (SD = 25.96), reaching the same pre-lesion Tegner level.
  
  
  CONCLUSIONS
  Endoscopic treatment of posterior ankle impingement syndrome due to os trigonum showed excellent results. Hindfoot endoscopy with a posterior approach was an effective treatment and allowed for a prompt return to play in soccer players with a high activity level.
  
  
  METHODS
  Level IV, therapeutic study.
authors.affiliation: Orthopedic Surgery, Fundación García Cugat Hospital Quirón Barcelona, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: López Valerio
authors.affiliation: Orthopedic Surgery, Fundación García Cugat Hospital Quirón Barcelona, Spain Professor Basic Science Department, Universitat Internacional Catalunya, Spain roberto6jas@gmail.com.
authors.forename: Roberto
authors.initials: R
authors.lastname: Seijas
authors.affiliation: Orthopedic Surgery, Fundación García Cugat Hospital Quirón Barcelona, Spain Professor Medicine Department, Universitat Internacional Catalunya, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Alvarez
authors.affiliation: Orthopedic Surgery, Fundación García Cugat Hospital Quirón Barcelona, Spain Professor Basic Science Department, Universitat Internacional Catalunya, Spain Professor Medicine Department, Universitat Internacional Catalunya, Spain Orthopedic Department, Hospital Clínic Barcelona, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Ares
authors.affiliation: Orthopedic Surgery, Fundación García Cugat Hospital Quirón Barcelona, Spain.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Steinbacher
authors.affiliation: Orthopedic Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Sallent
authors.affiliation: Orthopedic Surgery, Fundación García Cugat Hospital Quirón Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Cugat
mesh_terms: D000843:Ankle Joint / Q000601:surgery*; D001182:Arthroscopy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D008297:Male; D010147:Pain Measurement; D020127:Recovery of Function; D012916:Soccer; D013577:Syndrome; D013628:Talus / Q000601:surgery
keywords: Tegner; hindfoot endoscopy; os trigonum; posterior ankle arthroscopy; posterior ankle impingement syndrome; return to play; soccer players