title: Arthroscopic Treatment for Anterior Ankle Impingement: A Systematic Review of the Current Literature.
abstract: OBJECTIVE
  To provide a comprehensive overview of the clinical outcomes of arthroscopic procedures used as a treatment strategy for anterior ankle impingement.
  
  
  METHODS
  A systematic literature search of the Medline, Embase (Classic), and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases was performed. Studies that met the following inclusion criteria were reviewed: studies reporting outcomes of arthroscopic treatment for anterior ankle impingement; studies reporting on more than 20 patients; a study population with a minimum age of 18 years; and studies in the English, Dutch, German, Italian, or Spanish language. Two reviewers independently performed data extraction. Extracted data consisted of population characteristics, in addition to both primary and secondary outcome measures. The Downs and Black scale was used to assess the methodologic quality of randomized and nonrandomized studies included in this review.
  
  
  RESULTS
  Twenty articles were included in this systematic review. Overall, good results were found for arthroscopic treatment in patients with anterior ankle impingement. In the studies that reported patient satisfaction rates, high percentages of good to excellent satisfaction were described (74% to 100%). The percentages of patients who would undergo the same procedure again under the same circumstances were also high (94.3% to 97.5%). Complication rates were low (4.6%), particularly with respect to major complications (1.1%). The high heterogeneity of the included studies made it impossible to compare the results of the studies, including between anterolateral impingement and anteromedial impingement.
  
  
  CONCLUSIONS
  Arthroscopic treatment for anterior ankle impingement appears to provide good outcomes with respect to patient satisfaction and low complication rates. However, on the basis of the findings of this study, no conclusion can be made in terms of the effect of the type of impingement or additional pathology on clinical outcome.
  
  
  METHODS
  Level IV, systematic review of Level II and IV studies.
authors: Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Ruben
authors: R
authors: Zwiers
authors: Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Johannes I
authors: JI
authors: Wiegerinck
authors: Hospital for Special Surgery, New York, New York, U.S.A.
authors: Christopher D
authors: CD
authors: Murawski
authors: Hospital for Special Surgery, New York, New York, U.S.A.
authors: Ethan J
authors: EJ
authors: Fraser
authors: Hospital for Special Surgery, New York, New York, U.S.A.. Electronic address: kennedyj@hss.edu.
authors: John G
authors: JG
authors: Kennedy
authors: Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: C Niek
authors: CN
authors: van Dijk
mesh_terms: D000843:Ankle Joint / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000601:surgery*; D017060:Patient Satisfaction; D016896:Treatment Outcome