ARTHROSCOPIC TREATMENT OF ANTEROLATERAL IMPINGEMENT SYNDROME OF THE ANKLE
Metin ÖZALAY1, Sercan AKPINAR1, Murat Ali HERSEKLİ1, Gürkan ÖZKOÇ1, Reha N TANDOĞAN2
1Başkent Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Adana Uygulama ve Araştırma Hastanesi
2Başkent Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Ankara Uygulama ve Araştırma Hastanesi
Keywords: Ankle, Arthroscopy, Antrerolateral impingement syndrome, Chronic ankle pain.
Purpose: Soft-tissue impingement in the lateral gutter of the ankle, also known as anterolateral impingement syndrome (ALIS) is a common cause of lateral ankle pain after recurrent ankle injury. In this study, we evaluated arthroscopic treatment results of ALIS. Materials and
Methods: Fifteen cases (10 men, 5 women) of operative arthroscopic decompression of the ankle were done between 1998 and 2000 for ALIS (1 case bilateral). The average age of the patients was 38 (18-58). Twelve of the patients (%80) had chronic ankle pain after an inversion injury and 3 of the patients (%20) had a previous ankle fracture. The diagnosis was made with using clinical examination. In MRI studies, the synovitis was detected in all patients, but only in four patients (%25) we found diagnostic fibrotic lesions. In 3 patients differential diagnosis were made with using bone scintigraphy.
Results: With the help of Liu scoring system, we evaluated the patients subjectively and objectively. At average 1 year follow-up 13 patients had excellent, 2 had well and 1 had poor results. There were no complications. One patient with associated ankle instability comprised the poor result group and eventually required lateral ankle ligament reconstruction.
Discussion: One of the most common causes of chronic pain after an ankle sprain is soft tissue impingement. ALIS is considered in patients with recurrent ankle sprains and not getting relief from conservative treatment.
Conclusion: Chronic ankle pain due to synovial impingement can be safely and effectively treated by operative ankle arthroscopy.