Clinical Analysis Of Arthroscopic Treatment On Ankle Impingement Syndrome

Objective Summarize the clinical features of the ankle impingementsyndrome，and evaluate the arthroscopic diagnosis and its therapeutic value.Methods From March2008to March2012，24(28ankles) patients Withankle impingement syndrome were treated. There were11(13ankles) malesand13(15ankles) females with a mean age of45yeas(15-76yeas). It includes9cases(37.5%) of left,11cases(45.8%) of right and4cases(16.7%) of bilateral.Pain in patients with the most sensitive parts of the positioning:anteriorolateral16(57.1%),anterior3, anterioromedial5,posterior4.Causes: acute and chronic synovitis in8cases (33.3%), osteoarthritis in7cases (29.2%), traumatic arthritis in7cases (29.2%), exfoliative ofpolychondritis in6patients (25%), rheumatoid arthritis in1patient(4%),joint loose bodies in2cases (8%), gouty arthritis in1patient(4%), wherein insome cases the presence of two or more lesions factors: The traumatic arthritisconsolidated cartilage exfoliation2case, The traumatic arthritis cooperativejoint loose bodies1case, The bone arthritis combined acute and chronicsynovitis3case,The traumatic arthritis combined acute and chronic synovitis2case. The mean duration between the initial and treatment was34months(1month to13yeas). The follow-up of cases were divided to radio frequencygroup and non-radio group.The patients were respectively treated with arthroscopic ankle synovial debridement, exfoliative cartilage debridement,loose body removal surgery, Subchondral bone microfracture surgery. The twogroups of patients were followed up respectively in3and6months aftersurgery. The preoperative and postoperative ankle functions were evaluated bythe AOFAS(the American Orthopaedic Foot and Ankle Society) and VASFAClinical Rating System and meisilin criteria for the ankle-hindfoot.Results The RF group mean AOFAS score increased from71.00+14.63before surgery to89.33+4.27and91.00+4.38at3and6months follow-up,respectively (p <.005). According to the Meislin criteria, the results at the3-month follow-up visit were graded as excellent in3patients, good in2patients, fair in1patients, and poor in0patient. The results at6monthspostoperatively were excellent in3, good in3, and fair in0patients. The NRFgroup mean AOFAS score increased from68.83+18.23before surgery to88.17+11.03and90.28+8.56at3and6months follow-up, respectively (p <.005). According to the Meislin criteria, the results at the3-month follow-up visitwere graded as excellent in7patients, good in7patients, fair in3patients,and poor in1patient. The results at6months postoperatively were excellent in10, good in5, and fair in3patients.No result was regarded as poor. RF groupwith non-RF group, the postoperative AOFAS score showed nostatistically significant. there was no strict grasp the variables between thetwo groups that may affect the comparison result. In the RF group, the preoperative VASFA score compare to postoperative VASFA score of3、6months rank sum test，P<0.05. In the non-RF group, the preoperative VASFAscore compare to postoperative VASFA score of3、6months rank sum test，P<0.05. Compare RF group and non-RF group after3,6months VASFA scorerank sum test, P>0.05. According to foreign literatures, ankle arthroscopicsurgery complication rate was9%to17%, include artery and nerveinjury,which were expressed as numbness of the dominant region and distalskin. Nerve injury accounted for4.4%. In the24surgeries, no nerve injuries,tendon injuries, lower leg compartment syndrome, infection and deep veinthrombosis and other complications were found.Conclusions In the arthroscopic treatment of ankle impingement syndrome,3and6months after surgery when compared with preoperative，the AOFASscore was significantly improved and the VASFA score was significantlydecreased. The total Meislin criterie good rate was79.2%of3months and87.5%of6months after surgery.When RF group compared with the non-RFgroup after3、6months，there was no significant difference in clinical efficacy.The Long-term effect needs further follow-up observation.