Clinical Outcomes of Nano Arthroscopy in the Office Setting for the Treatment of Posterior Ankle Impingement

CATEGORY: Ankle; Arthroscopy INTRODUCTION/PURPOSE: The hypothesis of the current study was that IONA in the treatment of posterior ankle impingement would provide the patient with a unique experience of their pathology and facilitate their rapid recovery through an awareness of their own condition and that using IONA would accelerate recovery to sports-specific activities compared to standard arthroscopic procedures. METHODS: This was a retrospective cohort study investigating patients who underwent IONA for posterior ankle impingement between 2019 and 2020. Clinical outcomes were evaluated using the following methods preoperatively and at final follow-up: The Foot and Ankle Outcome Scores (FAOS) and Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference and Pain Intensity domains. A five-point Likert scale regarding patient satisfaction was evaluated at final follow-up. Wilcoxon signed-rank test was performed to compare preoperative and postoperative outcome scores. RESULTS: Ten patients were included in this study, which included 4 males and 6 females with a mean age of 41.9 +- 15.5 years (range, 24-66 years) and a mean body mass index (BMI) of 28.3 +- 6.3 kg/m(2) (range, 17.1 - 39.9). The mean follow-up time was 13.3 +- 2.9 months (range, 11-17 months). The mean PROMIS Pain Intensity T-score significantly decreased from 57.5 +- 8.4 preoperatively to 49.5 +- 5.5 at final follow-up (p<0.001). The mean PROMIS Pain Interference T-score decreased from 69.0 +- 5.8 preoperatively to 63.1 +- 5.8 at final follow-up (p<0.001). There were 7 patients who participated in sports activity prior to the IONA-arthroscopy procedure. Of those, 7 patients (100%) returned to their sports activities. The median time to return to sports was 4.1 weeks (range, 1 to 14 weeks). Lastly, 10 patients (100%) expressed willingness to undergo the same procedure again. CONCLUSION: The current study demonstrates that IONA treatment of posterior ankle impingement results in significant pain reduction, a low complication rate and excellent patient-reported outcomes with high rates of return to work/sport. Additionally, IONA for posterior ankle impingement leads to high patient satisfaction with a significant willingness to undergo the same procedure again.