title: Outcome of Arthroscopic Treatment of Posterior Impingement of the Ankle.
abstract: BACKGROUND
  Open and arthroscopic techniques have been utilized in the treatment of posterior impingement of the ankle and hindfoot. Because posterior impingement occurs more frequently in patients who repetitively plantarflex the ankle, this population may especially benefit from a procedure that reduces pain and results in maximal range of motion (ROM). The purpose of this study was to assess the outcome of hindfoot endoscopy in patients with posterior ankle impingement through a higher level of function outcome measures and physical examination parameters, focused on analysis of ROM.
  
  
  METHODS
  Twenty patients were followed prospectively at a minimum 1-year follow-up (mean 38.2 months). Nineteen of 20 patients were competitive athletes. Patients completed a minimum of 3 months of nonoperative treatment. Diagnoses included os trigonum, tibial exostosis, talar exostosis, loose body or fracture nonunion, and ganglion cyst removal. Patients underwent arthroscopic treatment utilizing a posterior approach; all relevant pathology was addressed.
  
  
  RESULTS
  At the most recent follow-up, visual analog scale pain and American Orthopaedic Foot & Ankle Society hindfoot scores showed significant improvement (P < .01) pre- to postoperatively; Tegner score remained unchanged (P = .888). Three patients were professional athletes; all returned to their previous level of professional activity. ROM variables between affected and unaffected sides reached statistical similarity at the most recent follow-up. Only ankle plantarflexion reached statistical significance when compared pre- to postoperatively. Fifteen percent of patients reported postoperative neuritis.
  
  
  CONCLUSIONS
  Posterior ankle arthroscopy allowed for maintenance or restoration of anatomic ROM of the ankle and hindfoot, ability to return to at least previous level of activity, and improvement in objective assessment of pain relief and higher level of function parameters. Complications associated with this procedure were minimal.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Broward Health Sports Medicine and Orthopedics, Fort Lauderdale, FL, USA dcarreira@gmail.com.
authors.forename: Dominic S
authors.initials: DS
authors.lastname: Carreira
authors.affiliation: Illinois Bone & Joint Institute, University of Illinois, Chicago, IL, USA.
authors.forename: Anand Mahesh
authors.initials: AM
authors.lastname: Vora
authors.affiliation: Broward Health Sports Medicine and Orthopedics, Fort Lauderdale, FL, USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Hearne
authors.affiliation: Broward Health Sports Medicine and Orthopedics, Fort Lauderdale, FL, USA.
authors.forename: John
authors.initials: J
authors.lastname: Kozy
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001182:Arthroscopy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular; D000068958:Return to Sport; D064232:Visual Analog Scale; D055815:Young Adult
keywords: minimally invasive; os trigonum; posterior impingement; subtalar arthroscopy; trigonal process