Posterior Ankle Impingement Syndrome

NewsBot · Feb 23, 2022

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes
Baillie, Petaet al
Clinical Journal of Sport Medicine: February 21, 2022 - Volume - Issue -

Objective:
To assess the association between clinical features and magnetic resonance imaging (MRI) findings in posterior ankle impingement syndrome (PAIS) and to compare the prevalence of imaging findings between participants with and without a clinical diagnosis of PAIS.

Design:
Case-control study.

Setting:
Elite ballet and sport.

Participants:
Eighty-two male (54%) and female participants comprising ballet dancers (n = 43), cricket fast bowlers (n = 24), and football (soccer) players (n = 15).

Independent Variables:
Clinical: posterior ankle pain on body chart, passive plantarflexion pain provocation test. Patient-reported outcome measures: Oslo Sports Trauma Research Center Overuse Injury Questionnaire, Foot and Ankle Ability Measure Sports subscale.

Main Outcome Measures:
Imaging findings including posterior ankle bone marrow edema, os trigonum (± bone marrow edema, and increased signal at synchondrosis), Stieda process (± bone marrow edema), talocrural and subtalar joint effusion–synovitis size, flexor hallucis longus tendinopathy, and tenosynovitis identified as present or absent on 3.0-Tesla MRI.

Results:
Imaging findings were not associated with posterior ankle pain or a positive ankle plantarflexion pain provocation test. Imaging findings were not associated with patient-reported outcome measures. Imaging findings did not differ between PAIS-positive and PAIS-negative groups. Os trigonum and Stieda process were prevalent despite clinical status.

Conclusions:
The lack of association between imaging findings and clinical features questions the role of imaging in PAIS. Clinicians should rely primarily on clinical assessment in the diagnosis and management of patients with PAIS.
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NewsBot · Mar 11, 2022

Posterior Ankle Impingement Syndrome in Non-athletic Population: Causes, Treatment Modalities and the Results of Endoscopic Treatment
Bertan Cengiz et al
J Am Podiatr Med Assoc. 2022 Mar 7;1-24

Background: One of the common causes of posterior ankle pain is posterior ankle impingement syndrome (PAIS). Many studies about PAIS have been conducted on special groups such as athletes, dancers, and football players, whereas there has been no previous study of a non-athletic population. This study aimed to evaluate the causes and treatment methods of this syndrome in the non-athletic population and compare it with the athletic population.

Methods: A retrospective review was done and 28 of 46 patients (60.9%) recovered from two-staged conservative therapy. 18 of 46 patients (39.1%) who did not benefit from conservative treatment for three months, hindfoot endoscopy was applied. Patient data, including sex, age, occupation, and sports activity level, were recorded. The Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and Tegner score were recorded. Patient satisfaction was assessed with a 4-point Likert scale. All complications were recorded.

Results: The mean follow-up period was 27.4 months. At the final follow-up examination, the AOFAS hindfoot score had significantly improved from 66.4 to 96.8 (p<0.001). The Tegner activity score improved significantly from 4.6 to 8.8 (p<0.001). The VAS score was 6.4 and increased to 0.9 (p<0.001). Using the 4-point Likert Scale for patient satisfaction, 13 (72.2%) stated that the surgical procedure was excellent, and 4 (27.8%) stated it as good. The mean time to return to work was 4.2 weeks. As complications, only sural nerve dysesthesia was seen in 2 patients(11.1%).

Conclusions: This study can be considered of value as the first study to have evaluated PAIS in the non-athletic population. Conservative treatment showed good results as nearly two-thirds of the patients recovered. Hindfoot endoscopy applied to cases not responding to conservative therapy is a successful treatment with low complication rates.
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NewsBot · Jul 9, 2022

The double posteromedial portals endoscopy for posterior ankle impingement syndrome in athletes
Nicola Maffulli et al
J Orthop Traumatol. 2022 Jul 6;23(1):28

Background: Posterior ankle impingement syndrome (PAIS) may result from flexor hallucis longus tendinopathy, compression of the posterior process of the talus from the presence of an os trigonum, soft-tissue impingement, or a combination of these. Posterior extra-articular endoscopy performed with the patient supine through the double posteromedial portals, with excision of adhesions, excision of the posterior process of the talus or an os trigonum, and decompression of the tendon of the flexor hallucis longus (FHL), can be used in athletes with PAIS.

Methods: Thirty-four athletes with PAIS in whom conservative management had failed underwent posterior ankle endoscopy in the supine position using the double posteromedial portals. The patients were assessed pre- and postoperatively using the American Orthopaedic Foot and Ankle Society hindfoot scale score, the Tegner scale, and the simple visual analogue scale. Time of surgery, return to sports, patient satisfaction, and complications were recorded and analysed. The average length of postoperative follow-up was 26.7 ± 12.6 (range 24 to 72) months.

Results: The mean Tegner activity scale score improved to 9 ± 0.2 postoperatively (p < 0.05), while the mean American Orthopaedic Foot and Ankle Society scale score improved to 96 ± 5.1 (range 87 to 100) postoperatively, with 29 of 34 patients (85.3%) achieving a perfect score of 100 (p < 0.05). The mean time to return to sports was 8.7 ± 0.7 (range 8 to 10) weeks. The complication rate was low, with no superficial wound infections or venous thromboembolism events; only two patients (5.9%) reported pain and tenderness by 3 months after the index procedure.

Conclusion: Posterior ankle endoscopy for the resection of a posterior process of the talus or an os trigonum and decompression of the tendon of FHL is safe and allows excellent outcomes with low morbidity in athletes with PAIS.
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NewsBot · Nov 1, 2022

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes
Peta Baillie et al
Clin J Sport Med. 2022 Nov 1;32(6):600-607

Objective: To assess the association between clinical features and magnetic resonance imaging (MRI) findings in posterior ankle impingement syndrome (PAIS) and to compare the prevalence of imaging findings between participants with and without a clinical diagnosis of PAIS.

Design: Case-control study.

Setting: Elite ballet and sport.

Participants: Eighty-two male (54%) and female participants comprising ballet dancers (n = 43), cricket fast bowlers (n = 24), and football (soccer) players (n = 15).

Independent variables: Clinical: posterior ankle pain on body chart, passive plantarflexion pain provocation test. Patient-reported outcome measures: Oslo Sports Trauma Research Center Overuse Injury Questionnaire, Foot and Ankle Ability Measure Sports subscale.

Main outcome measures: Imaging findings including posterior ankle bone marrow edema, os trigonum (± bone marrow edema, and increased signal at synchondrosis), Stieda process (± bone marrow edema), talocrural and subtalar joint effusion-synovitis size, flexor hallucis longus tendinopathy, and tenosynovitis identified as present or absent on 3.0-Tesla MRI.

Results: Imaging findings were not associated with posterior ankle pain or a positive ankle plantarflexion pain provocation test. Imaging findings were not associated with patient-reported outcome measures. Imaging findings did not differ between PAIS-positive and PAIS-negative groups. Os trigonum and Stieda process were prevalent despite clinical status.

Conclusions: The lack of association between imaging findings and clinical features questions the role of imaging in PAIS. Clinicians should rely primarily on clinical assessment in the diagnosis and management of patients with PAIS.
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Posterior Ankle Impingement Syndrome

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Posterior Ankle Impingement Syndrome

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Acute Tears of the Tibialis Posterior Tendon Following Ankle Sprain

Posterior Medial Ankle Pain

Posterior Tibial Artery anatomy

Stage 1 PTTD Treatment Plan - Posterior Tibial Tendon Dysfunction

Patient With Early Stage PTTD (Posterior Tibial Tendon Dysfunction)

Posterior Tibialis Tendon Dislocation

Anatomical Classification for Tibialis Posterior Tendon Insertion

Share This Page

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