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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 4, 550-553.
doi: 10.1302/0301-620X.85B4.13871  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Open treatment of anterior impingement of the ankle

R. Coull, FRCS (Trauma & Orth), Specialist Registrar1; T. Raffiq, FRCS I, Senior House Officer1; L. E. James, MRCS, Clinical Research Fellow2; and M. M. Stephens, MSc BioEng, FRCS I, Consultant Orthopaedic Surgeon1

1 Cappagh National Orthopaedic Hospital, Finglas, Dublin II, Republic of Ireland.
2 University College Hospital, Grafton Way, London WC1E 3BG, UK.

Correspondence should be sent to Mr M. M. Stephens at Suite 8, Mater Private Hospital, Eccles Street, Dublin 7, Republic of Ireland.

We assessed the long-term outcome of open debridement for the treatment of anterior impingement of the ankle in 27 patients. By using preoperative radiographs to group patients according to both the McDermott and the van Dijk scoring system, we assessed the accuracy of these classifications in predicting outcome. The Ogilvie-Harris scoring system, a visual analogue scale of patient satisfaction, the time to return to full activities, and the ability to return to sports determined the clinical outcome. Follow-up radiographs were used to assess the recurrence of osteophytes. We also assessed the incidence of talar osteochondral lesions at surgery.

At a mean follow-up of 7.3 years, 23 of 25 patients (92%) without joint-space narrowing had a good or excellent result. Improvement in the Ogilvie-Harris score was seen in all patients. In athletes, 19 of 24 (79%) were able to return to sports at the same level. Two patients with preoperative joint-space narrowing had a poor result.

Osteophytes usually recurred and most patients did not feel that the range of dorsiflexion returned to normal, but symptomatic relief allowed most to return to high-level sport.

Our results for non-arthritic joints suggest that this is a safe and successful procedure.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General