Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes

Overview

Journal Foot Ankle Orthop

Publisher Sage Publications

Date 2022 Jan 31

PMID 35097403

Authors

Dimitrios Nikolopoulos

George Safos

Konstantinos Moustakas

Neoptolemos Sergides

Petros Safos

Athanasios Siderakis

Dimitrios Kalpaxis

Andreas Moutsios-Rentzos

Affiliations

Soon will be listed here.

Abstract

Background: The os trigonum (OT)-the most common accessory bone of the foot-although usually asymptomatic, may cause posterior ankle impingement syndrome (PAIS), which may be a severely debilitating problem for recreational or competitive athletes. The aim of the present study was to evaluate effectiveness of posterior ankle arthroscopy and to assess the outcome in the treatment of PAIS secondary to OT impingement or OT fractures within a group of young athletes and their return to previous sports level.

Methods: From 2011 to 2018, a retrospective review of 81 recreational athletes of mean age 27.8 years was performed. All patients were diagnosed with PAIS due to OT pathology and were operated on endoscopically with resection of the OT. Pre- and postoperative clinical evaluation were performed at 3 months, 1 year, and 2 years based on visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, and the Foot & Ankle Disability Index (FADI) scores, in a follow-up of at least 2 years.

Results: VAS score was significantly improved from an average of 7.5 (5-9) preoperatively to 1.9 (1-3) at 3 months postoperatively and to 0.6 (0-2) and 0.3 (0 -1) at 1 and 2 years postoperatively. Ankle ROM was significantly improved from an average of 24.8 (10-35) preoperatively to 58.0 (50-65) at 3 months postoperatively and to 64.0 (50-65) at 1 year and 64.7 (60-65) at 2 years postoperatively. AOFAS and FADI scores were significantly improved from 39.4 (18-55) and 49.7 (42.3-62.5) preoperatively to 85.2 (74-89) and 87.3 (81.7-88.5) postoperatively at 3 months to 97.7 (85-100) and 97.9 (93.3-100) postoperatively at 1 year, respectively ( < .001). Only 5 patients dropped to a lower activity level. There were 5 complications (4 transient).

Conclusion: Endoscopic treatment of PAIS due to OT pathology demonstrated excellent results. Posterior ankle arthroscopy was an effective treatment and allowed for a prompt return to a high activity level of their athletic performance.

Level Of Evidence: Level IV, therapeutic study / retrospective case series.

Citing Articles

Beyond the needle: How nonsurgical management transforms foot and ankle ability in male footballers with posterior ankle impingement- a longitudinal study.

Gupta J, Rizvi M, Sharma A, Sami W, Fahad A Al-Kuwari N, Hegazy F Heliyon. 2024; 10(23):e40484.

PMID: 39654717 PMC: 11626724. DOI: 10.1016/j.heliyon.2024.e40484.

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