title: Posterior ankle impingement syndrome in football players: Case series of 26 elite athletes.
abstract: OBJECTIVE
  To describe a clinical treatment algorithm for posterior ankle impingement (PAI) syndrome in professional football players.
  
  
  METHODS
  A case series of 26 elite professional football players diagnosed and treated for posterior ankle impingement syndrome were included for the study. All of the athletes received conservative treatment with physical therapy modalities initially. If the first line medical treatment and rehabilitation was ineffective to alleviate the symptoms, ultrasound-guided corticosteroid injection was proposed and thereafter the patients underwent posterior ankle arthroscopy if the complaints are still unresolved. The pain scores (AOFAS, VAS), and time to return to play were the main outcome measures.
  
  
  RESULTS
  The complaints of 18 (69.2%) players were subsided with non-surgical treatment whereas three of acute cases and five of the chronic cases did not respond to medical treatment and arthroscopic surgery was performed for eight athletes. Eighteen players returned to training for a mean time of 36.3 days (24-42 days) after conservative treatment. The patients who underwent arthroscopic surgery returned to training for a mean time of 49.8 days (42-56 days) after the surgery. All athletes returned to their previous level of competition after treatment without any complications or recurrence in a mean follow-up 36.5 months (19-77 months).
  
  
  CONCLUSIONS
  Non-surgical treatment modalities were effective in 2/3 of posterior ankle impingement syndrome in elite football players. On the other hand, posterior ankle arthroscopy is safe and effective treatment option for posterior ankle impingement syndrome if the conservative treatment fails.
  
  
  METHODS
  Level IV, Therapeutic study.
authors.affiliation: Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Gençlerbirliği Sports Club, Department of Sports Medicine, Ankara, Turkey.
authors.forename: Savaş
authors.initials: S
authors.lastname: Kudaş
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Sports Medicine, Ankara, Turkey. Electronic address: gurhan.donmez@hacettepe.edu.tr.
authors.forename: Gürhan
authors.initials: G
authors.lastname: Dönmez
authors.affiliation: Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
authors.forename: Çetin
authors.initials: Ç
authors.lastname: Işık
authors.affiliation: Ankara University Faculty of Medicine, Department of Sports Medicine, Ankara, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Çelebi
authors.affiliation: Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Department of Radiolog, Ankara, Turkey.
authors.forename: Nurdan
authors.initials: N
authors.lastname: Çay
authors.affiliation: Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Bozkurt
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000628:therapy*; D001182:Arthroscopy / Q000379:methods*; D056352:Athletes; D006801:Humans; D007592:Joint Diseases / Q000628:therapy*; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D012916:Soccer / Q000293:injuries*; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
keywords: Ankle; Arthroscopy; Football; Pain; Posterior ankle impingement; Talus