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

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 effect...

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Autores principales: Nikolopoulos, Dimitrios, Safos, George, Moustakas, Konstantinos, Sergides, Neoptolemos, Safos, Petros, Siderakis, Athanasios, Kalpaxis, Dimitrios, Moutsios-Rentzos, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697201/
https://www.ncbi.nlm.nih.gov/pubmed/35097403
http://dx.doi.org/10.1177/2473011420945330
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author Nikolopoulos, Dimitrios
Safos, George
Moustakas, Konstantinos
Sergides, Neoptolemos
Safos, Petros
Siderakis, Athanasios
Kalpaxis, Dimitrios
Moutsios-Rentzos, Andreas
author_facet Nikolopoulos, Dimitrios
Safos, George
Moustakas, Konstantinos
Sergides, Neoptolemos
Safos, Petros
Siderakis, Athanasios
Kalpaxis, Dimitrios
Moutsios-Rentzos, Andreas
author_sort Nikolopoulos, Dimitrios
collection PubMed
description 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 (P < .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.
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spelling pubmed-86972012022-01-28 Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes Nikolopoulos, Dimitrios Safos, George Moustakas, Konstantinos Sergides, Neoptolemos Safos, Petros Siderakis, Athanasios Kalpaxis, Dimitrios Moutsios-Rentzos, Andreas Foot Ankle Orthop Article 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 (P < .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. SAGE Publications 2020-09-23 /pmc/articles/PMC8697201/ /pubmed/35097403 http://dx.doi.org/10.1177/2473011420945330 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Nikolopoulos, Dimitrios
Safos, George
Moustakas, Konstantinos
Sergides, Neoptolemos
Safos, Petros
Siderakis, Athanasios
Kalpaxis, Dimitrios
Moutsios-Rentzos, Andreas
Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
title Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
title_full Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
title_fullStr Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
title_full_unstemmed Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
title_short Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
title_sort endoscopic treatment of posterior ankle impingement secondary to os trigonum in recreational athletes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697201/
https://www.ncbi.nlm.nih.gov/pubmed/35097403
http://dx.doi.org/10.1177/2473011420945330
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