Current concepts review: Arthroscopic treatment of anterior ankle impingement.
Anterior ankle impingement is a common cause of chronic ankle pain, particularly in athletic populations. Morris and McMurray provided the earliest descriptions of anterior impingement, coining the condition as "athlete's ankle" or "footballer's ankle". The pathology has since been a topic of considerable investigation and has been re-termed "anterior ankle impingement syndrome". Treatment with open surgery has provided good results historically, but at the price of significant complications. Advancements in ankle arthroscopy have decreased the risk of complication drastically and evidence in the literature indicates that anterior arthroscopy is an effective approach to treating osseous and soft tissue impingement. Effective clinical diagnosis and diagnostic imaging are critical for pre-surgical planning. Preoperative detection of anterior osteophytes has been correlated with outcomes. Factors such as joint space narrowing and large osteophytes may also influence outcomes. Therefore, a comprehensive understanding of diagnosis and surgical technique can influence patient outcomes, and patient expectations can be managed around prognostic indicators such as the presence of osteoarthritis. The purpose of this review is to discuss the etiology, clinical presentation, diagnosis, surgical technique, and postoperative rehabilitation of anteromedial and anterolateral anterior ankle impingement syndrome and to evaluate the evidence-based outcomes of arthroscopic management.
Hospital for Special Surgery, Department of Orthopaedic Surgery, 523 E 72nd Street, East River Professional Building, Ste 507, New York, NY 10021, United States.
Keir A
KA
Ross
Hospital for Special Surgery, Department of Orthopaedic Surgery, 523 E 72nd Street, East River Professional Building, Ste 507, New York, NY 10021, United States; University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
Christopher D
CD
Murawski
Hospital for Special Surgery, Department of Orthopaedic Surgery, 523 E 72nd Street, East River Professional Building, Ste 507, New York, NY 10021, United States.
Niall A
NA
Smyth
Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22700, Amsterdam 1100 DE, The Netherlands.
Ruben
R
Zwiers
Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22700, Amsterdam 1100 DE, The Netherlands.
Johannes I
JI
Wiegerinck
Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22700, Amsterdam 1100 DE, The Netherlands.
Christiaan J A
CJ
van Bergen
Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, PO Box 22700, Amsterdam 1100 DE, The Netherlands.
Cornelis Niek van
CN
Dijk
Hospital for Special Surgery, Department of Orthopaedic Surgery, 523 E 72nd Street, East River Professional Building, Ste 507, New York, NY 10021, United States. Electronic address: KennedyJ@HSS.EDU.
John G
JG
Kennedy
D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000843:Ankle Joint; D001182:Arthroscopy; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013577:Syndrome
Ankle; Anterior ankle impingement syndrome; Arthroscopy; Impingement