title: Arthroscopic Evaluation of Impingement and Osteochondral Lesions in Chronic Lateral Ankle Instability.
abstract: BACKGROUND
  Anterolateral impingement associated with intra-articular synovitis, scarring, and fibrosis is a less recognized feature in patients with chronic lateral ankle instability. The aim of our study was to ascertain the incidence of intra-articular synovitis, osteochondral lesions (OCLs), impingement lesions (both intra- and extra-articular), and other associated pathologies in patients undergoing modified Broström-Gould ankle ligament reconstruction.
  
  
  METHODS
  We performed a retrospective review of all patients who underwent arthroscopically assisted modified Broström-Gould ankle ligament reconstruction for symptomatic recurrent ankle instability. Patients who had previous ankle surgery or inflammatory arthropathy were excluded. Ankle arthroscopy was performed prior to reconstruction in all patients. Data were obtained from clinical and radiological records including magnetic resonance imaging scans. Arthroscopic findings were recorded in detail intraoperatively. A total of 100 patients (53 females and 47 males) with an average age of 37 years (range, 15-65 years) were reviewed over a 10-year period.
  
  
  RESULTS
  Sixty-three patients (63%) had intra-articular synovitis mostly in the anterior and/or anterolateral compartment, which required arthroscopic debridement. Seventeen patients (17%) were found to have OCLs, and 12 (12%) patients had anterior bony impingement lesions.
  
  
  CONCLUSIONS
  This study found a high incidence of anterior/anterolateral synovitis in patients with chronic lateral ankle instability. However, there was a relatively low incidence of anterior bony impingement lesions or OCLs in our series.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Arrowe Park Hospital, Upton, UK saurabhsodak@gmail.com.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Odak
authors.affiliation: Kings's College London, London, UK.
authors.forename: Raju
authors.initials: R
authors.lastname: Ahluwalia
authors.affiliation: Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Deepak G
authors.initials: DG
authors.lastname: Shivarathre
authors.affiliation: Arrowe Park Hospital, Upton, UK.
authors.forename: Atif
authors.initials: A
authors.lastname: Mahmood
authors.affiliation: Arrowe Park Hospital, Upton, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Blucher
authors.affiliation: Arrowe Park Hospital, Upton, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Hennessy
authors.affiliation: Arrowe Park Hospital, Upton, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Platt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000473:pathology / Q000601:surgery*; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology; D002908:Chronic Disease; D003646:Debridement; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000473:pathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D012189:Retrospective Studies; D013585:Synovitis / Q000473:pathology / Q000601:surgery; D055815:Young Adult
keywords: Broström; ankle arthroscopy; chronic lateral ankle instability; impingement; osteochondral lesions