Arthroscopic Resection of the Anterolateral Impingement of the Ankle in Patients with Chronic Functional Instability

Henrique Mansur Gonçalves^*1,2, Isnar Moreira de Castro Junior², Max Rogério Freitas Ramos³, Cesar Barbosa Gonçalves⁴, Yonder Archanjo Ching San Junior⁵ & Flavio Carvalho Cruz⁵

¹M.D., MSc., School of Medicine of Federal University of the State of Rio de Janeiro, Rio de Janeiro - RJ, Brazil; Brasília Air Force Hospital, Brasília - DF, Brazil
²M.D., Foot and Ankle Department, National Institute of Traumatology and Orthopedic, Rio de Janeiro - RJ, Brazil
³PhD., Department of General and Specialized Surgery, Federal University of the State of Rio de Janeiro, Rio de Janeiro - RJ, Brazil
⁴M.D. Foot and Ankle Department, Navy Hospital Marcílio Dias, Rio de Janeiro - RJ, Brazil
⁵M.D., MSc., School of Medicine of Federal University of the State of Rio de Janeiro, Rio de Janeiro - RJ, Brazil

Henrique Mansur Gonçalves, M.D., MSc., School of Medicine of Federal University of the State of Rio de Janeiro, Rio de Janeiro - RJ, Brazil; Brasília Air Force Hospital, Brasília - DF, Brazil.

Keywords: Ankle Sprain; Functional Instability; Anterolateral Impingement; Arthroscopy

Abstract

Introduction
Ankle sprains are very common injuries, especially in athletes. Most of the time, conservative treatment provides complete recovery of symptoms. However, approximately 3,0% may lead to anterolateral impingement, a common cause of chronic joint pain and functional ankle instability.
Methods
Twenty-six patients, of which 76,9% were women, underwent arthroscopy debridement of the anterolateral impingement. The mean age was 38,5 ± 10,7 years. Mean time between injury and surgery was 33,1 months, with a mean follow-up of 31.2 months (between June 2008 and February 2015).
Results
The mean of postoperative AOFAS score was 84.5 points and the median of pain scale was equal to 2. A quantity of 92,3% of the patients stated they were satisfied with the surgery performed and 84,6% of the patients had improvement of the functional instability. There was no statistically significant difference between the postoperative AOFAS score and classification of pain of patients with time between injury and surgery less than 24 months and greater than or equal to 24 months (p-value = 0.169, Mann-Whitney Test, and p-value Fisher’s exact test = 1,000, respectively). There was no statistically significant difference between the postoperative AOFAS score and classification of pain of patients with postoperative time less than 24 months and patients with postoperative time greater than or equal to 24 months (p-value = 0.085 Mann-Whitney Test, and p-value = 0,063, Fisher’s Exact Test, respectively).
Conclusion
Chronic pain and functional ankle instability can be treated simply by arthroscopic debridement of the anterolateral impingement. Good outcomes of the surgery, low pain scores and high AOFAS scores are independent of patient’s gender, injury side, time between injury and surgery and postoperative time.

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).