Arthroscopic treatment of anterior ankle impingement: A prospective study of 46 patients with 5-year follow-up

摘要

Background: Midterm outcomes after arthroscopic debridement in patients with anterior ankle impingement without osteoarthritisare currently unclear.Purpose: To assess the functional and radiological outcomes after arthroscopic treatment of anterior ankle impingement witha minimum 5-year follow-up in patients without osteoarthritis.Study Design: Case series; Level of evidence, 4.Methods: From September 1999 to March 2006, a consecutive series of eligible patients without ankle osteoarthritis and withanterior ankle impingement, who had persistent ankle pain and activity restrictions despite at least 6 months of nonoperativemanagement, underwent standardized arthroscopic debridement and followed uniform postoperative management. Patientswere assessed preoperatively and at 6 weeks, 6 months, and 12 months and then at 1-year intervals after surgery until a minimumof 5 years follow-up had been achieved, with weightbearing ankle dorsiflexion, Foot Functional Index (FFI), and plain radiographyincluding Scranton and McDermott classification (SMC) grade and tibial osteophyte size.Results: A total of 46 patients (42 male, 4 female) were prospectively assessed, with a mean age at surgery of 29 years (range,16-44 years) and a mean follow-up duration of 5.1 years (range, 5.0-7.5 years). Preoperative ankle radiographs demonstrateda median SMC grade of 2 and a mean tibial osteophyte size of 5.1 mm. At a minimum of 5 years postoperatively, patients demonstratedlimited improvement in ankle dorsiflexion (mean, 24.7°[preoperatively] vs 27.0°[final follow-up]; P = .049); however,they demonstrated substantial improvement in the FFI (mean, 20.5 [preoperatively] vs 2.7 [final follow-up]; P<001). Postoperatively,84% of patients showed a recurrence of radiological osteophytes, with plain radiographs at final follow-up demonstratingno significant difference in the SMC grade (P = .107) or tibial osteophyte size (P = .212) compared with preoperative imaging.There was no significant effect of patient age, sex, body mass index, or SMC grade at the time of surgery on any of the postoperativeoutcome measures.Conclusion: In this prospective outcome study of 46 patients without osteoarthritis managed arthroscopically for anterior ankleimpingement, the functional outcome scores had significantly improved at 5 years postoperatively despite a recurrence of radiographicosteophytes.