Research article summary (published 29 Sep 2009):

Hindfoot endoscopy for posterior ankle impingement. Surgical technique.

Full Abstract

BACKGROUND: The surgical treatment of posterior ankle impingement is associated with a high rate of complications and a substantial time to recover. An endoscopic approach to the posterior ankle (hindfoot endoscopy) may lack these disadvantages. We hypothesized that hindfoot endoscopy causes less morbidity and facilitates a quick recovery compared with open surgery. METHODS: Fifty-five consecutive patients with posterior ankle impingement were treated with an endoscopic removal of bone fragments and/or scar tissue. The symptoms were caused by trauma (65%) or overuse (35%). All patients were enrolled in a prospective protocol. At baseline, the age, sex, work and sports activities, American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores, and preinjury Tegner scores were determined for all patients. At the time of follow-up, AOFAS hindfoot scores and Tegner scores were assessed and the time to return to work and sports activities was determined. Complications were recorded. Patients scored the overall result as poor, fair, good, or excellent by means of a 4-point Likert scale. RESULTS: The median duration of follow-up was thirty-six months, and no patient was lost to follow-up. The median AOFAS hindfoot score increased from 75 points preoperatively to 90 points at the time of final follow-up. The median time to return to work and sports activities was two and eight weeks, respectively. At the time of follow-up, patients in the overuse group were more satisfied than those in the posttraumatic group, and the AOFAS hindfoot scores were higher in patients in the overuse group (median, 100 points) compared with patients in the posttraumatic group (median, 90 points). A complication occurred in one patient who had a temporary loss of sensation of the posteromedial aspect of the heel. CONCLUSIONS: The outcome after endoscopic treatment of posterior ankle impingement compares favorably with the results of open surgery reported in the literature. Hindfoot endoscopy appears to cause less morbidity than open ankle surgery and facilitates a quick recovery. Patients treated for posterior ankle impingement caused by overuse have better results than those treated following trauma.

Author information

Author/s: van Dijk, C N (CN); de Leeuw, P A J (PA); Scholten, P E (PE);

Affiliation: Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands. c.n.vandijk(-atsign-)amc.uva.nl

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: The Journal of bone and joint surgery. American volume (J Bone Joint Surg Am), published in United States. (Language: eng)

Reference: 2009-Oct; vol 91 Suppl 2 (issue ) : pp 287-98

Dates: Created 2009/10/06; Completed 2009/11/02;

PMID: 19805591, status: MEDLINE (last retrieval date: 11/2/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Ambulatory Surgical Procedures - methods Ankle Injuries - pathology; surgery Arthroscopes Arthroscopy - methods Decompression, Surgical - methods Follow-Up Studies Humans Injury Severity Score Male

Male Orthopedic Procedures - methods Pain Measurement Prospective Studies Range of Motion, Articular - physiology Recovery of Function Risk Assessment Surgical Procedures, Minimally Invasive - methods Treatment Outcome

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