Indikacija za artroskopiju stražnjeg dijela gležnja ima puno više od samog stražnjeg sindroma sraza

ankle impingement syndrome. However, other indications of the posterior part of the ankle/hindfoot remain mostly uninvestigated. The aim of this study is to investigate the indications for posterior ankle/hindfoot arthroscopy performed as a solitary procedure and to report the outcomes. A total of 71 patients, who had undergone this procedure in our department over a period of nine years, were analysed. In all cases, the van Dijk et al. technique was followed. The most prevalent indication for posterior/hindfoot arthroscopy remains posterior ankle impingement syndrome in 59.15% of cases. Other indications included ten various posterior ankle/hindfoot pathologies, with the subtalar joint contracture being the most common one (15.49%). During the mean follow-up period of 79 (range, 24 - 127) months, there were 2 minor complications noted, both pertaining to transitory sensory deficits. The total median AOFAS Ankle-Hindfoot score significantly improved from 69 to 98, with the improvement noted regardless of the indication. The satisfaction rate with the procedure was 98.59%. This study has shown that posterior ankle/hindfoot arthroscopy is an efficient and safe orthopaedic tool for the treatment of various posterior ankle and hindfoot articular and periarticular pathologies.Artroskopija stražnjeg dijela gležnja postala je uobičajena operacijska tehnika za liječenje stražnjeg sindroma sraza gležnja. S druge strane, korištenje te tehnike za druge indikacije u području stražnjeg dijela gležnja i dalje se istražuje. Cilj ovog istraživanja bio je analizirati indikacije za artroskopiju stražnjeg dijela gležnja kod bolesnika kod kojih je taj zahvat načinjen kao samostalan zahvat te prikazati rezultate i komplikacije provedenog liječenja. Istraživanje obuhvaća 71 bolesnika kod kojih je tijekom devetogodišnjeg razdoblja načinjen taj zahvat i koji su pristali sudjelovati u njemu. U svim je slučajevima zahvat načinjen prema tehnici koju su opisali van Dijk i sur. Najčešća indikacija za taj zahvat i u našem je istraživanju bila stražnji sindrom sraza gležnja i to u 59,15% slučajeva. Od drugih indikacija najčešća je bila kontraktura subtalarnog zgloba u 15,49%, a sveukupno je bilo 10 različitih indikacija zbog kojih je načinjen taj zahvat. Tijekom praćenja od 79 mjeseci (raspon, 24-127) primijećene su dvije manje komplikacije i to prolazni gubitak osjeta s lateralne strane gležnja i stopala. Ukupni zbroj bodova dobiven AOFAS upitnikom porastao je sa 69 prije zahvata na 98 na pregledu provedenom u svrhu istraživanja uz napomenu da je poboljšanje zabilježeno kod svih indikacija. Gotovo svi su bolesnici (98,59%) bili zadovoljni s načinjenim zahvatom. Rezultati istraživanja ukazuju da je artroskopija stražnjeg dijela gležnja sigurna i učinkovita metoda u liječenju različitih ozljeda i oštećenja u stražnjem dijelu gležnja

External fixation with a locking plate for a tibial frac- ture complicated by osteomyelitis: a case report

External fixation using a locking plate is an uncommon approach, however good clinical outcomes have been reported in the literature so far. It provides certain benefits over conventional external fixators, which hinder everyday activities due to their bulkiness. Aside from being more convenient for the patient, external fixation with locking plate results in less soft tissue trauma, low-profile stable fixation and shortened hospital stay

Localized tenosynovial gigantocellular tumor of the ankle in an adolescent: case report and literature review

Tenosinovijalni gigantocelularni tumor (TGCT) je rijetka benigna monoartikularna bolest koja zahvaća sinovijalnu ovojnicu zgloba, tetive ili burze. Razlikujemo lokalizirani i difuzni oblik bolesti pri čemu je histološka slika kod oba oblika jednaka. Stopa pojavnosti lokaliziranog oblika TGCT-a (LTGCT) iznosi deset slučajeva na milijun ljudi od čega se u oko 5% svih slučajeva pojavljuje u gležnju. Prikazan je rijedak slučaj pojave LTGCT-a u prednjem dijelu gležnja u adolescentice koji se očitovao oteklinom i povremenim bolovima, napose pri sportskim aktivnostima. Na snimci magnetske rezonancije (MR) u prednjem je dijelu gležnja bila vidljiva heterogeno strukturirana, oštro ograničena tumorska tvorba, dok su sve ostale prikazane strukture bile urednih intenziteta signala i primjerene morfologije. Osim bezbolne otekline prednjeg dijela gležnja kliničkim je pregledom utvrđen i deficit dorzalne fleksije stopala. Zahvat je načinjen artroskopski, a tumorska se tvorba zbog svoje veličine nije mogla odstraniti u jednom komadu već se odstranila u dijelovima. Patohistološka analiza je utvrdila da je riječ o TGCT-u. Tijekom razdoblja praćenja od dvije godine bolesnica se nije žalila na tegobe s operiranim gležnjem, a na kontrolnim MR-ima nije zamijećen recidiv. Na TGCT valja pomisliti kao moguću diferencijalnu dijagnozu kod bolesti gležnja, napose kad se bol i oteklina pojave bez ozljede. Artroskopski zahvat je sigurna i učinkovita metoda liječenja LTGCT-a u gležnju ako ju izvodi iskusan operater kojeg prati uhodan tim, no valja istaknuti da se odabir načina kirurškog liječenja treba prilagoditi kako anatomskom položaju tvorbe u zglobu tako i procjeni i preferenciji kirurga.Tenosynovial giant cell tumor (TGCT) is a rare, benign monoarticular disease that affects the synovial lining of joint, tendon or bursa. We distinguish two forms of the disease, localized and diffuse forms, both of which are histologically identical. The incidence rate of the localized form of TGCT (LTGCT) is 10 cases per million people, of which about 5% of all cases occur in the ankle. We present a rare case of LTGCT in the anterior part of the ankle in an adolescent, which was manifested by swelling and occasional pain, especially during sports activities. On the magnetic resonance imaging (MRI) a heterogeneously structured, well encapsulated tumor was visible in the anterior part of the ankle. In addition to the painless swelling in the anterior part of the ankle, the physical examination revealed a deficit of dorsiflexion of the foot. The operation was performed arthroscopically but the tumor could not be removed in a single piece due to its size, so it was removed in multiple pieces. Histopathological analysis confirmed that the tumor was TGCT. During the two-year follow-up period, the patient did not have problems with the operated ankle and no recurrence of the disease was observed on control MRIs. TGCT should be considered as a possible differential diagnosis, especially when pain and swelling of the ankle occur without injury. Arthroscopic surgery is a safe and effective method of treatment if it is performed by an experienced surgeon backed by a welltrained team. The choice of the type of surgical treatment should be determined depending on the anatomical position of the formation in the joint and the surgeon’s assessment and preference

Manifestations of tuberculosis that we rarely think about

Tuberculosis is a multi-system infectious disease caused by Mycobacterium Tuberculosis. Tuberculosis mostly affects lungs but it can spread in the form of extrapulmonary tuberculosis. Around 4.3% of patients experience ischemic stroke and 1.5-3.4% of them experience pulmonary embolism

Posterior ankle impingement syndrome in adolescents

Cilj ovog rada jest ukazati na moguću pojavu stražnjeg sindroma sraza gležnja (SSSG) u populaciji adolescenata te provjeriti tvrdnju da se u toj populaciji njegova dijagnoza postavlja s vremenskom odgodom. Osim toga, željeli smo prikazati i rezultate provedenog kirur- škog liječenja SSSG-a artroskopskim zahvatom u adolescenata te usporediti dobivene rezultate s rezultatima objavljenim u literaturi. U istraživanju je sudjelovalo 16-ero ispitanika koji su u trenutku zahvata imali ≤19 godina i kod kojih je zbog SSSG-a načinjen artro- skopski zahvat samo u stražnjem dijelu gležnja. Sva dostupna medicinska dokumentacija sustavno je pretražena s ciljem utvrđiva- nja razdoblja od pojave prvih simptoma do točne dijagnoze te uzroka nastanka SSSG-a, kao i traženja zabilješki o komplikacijama liječenja. Na pregledu provedenom u sklopu istraživanja procjena funkcijskog stanja gležnja provedena je upitnikom Američkog ortopedskog društva za stopalo i gležanj (AOFAS upitnik), dok je zadovoljstvo ispitanika načinjenim zahvatom ocijenjeno pomoću Abdelatifova upitnika. Prosječna životna dob ispitanika u trenutku zahvata iznosila je 16,8 godina, a medijan trajanja simptoma do postavljanja točne dijagnoze iznosio je 8,5 mjeseci. Zahvat je u svih protekao bez komplikacija, a one nisu uočene ni u poslijeoperacijskom razdoblju. Utvrđeno je značajno poboljšanje rezultata AOFAS upitnika s prosječno 70,9 prije zahvata na 97,0. Svi su ispitanici izrazili izrazito zadovoljstvo načinjenim zahvatom i istaknuli da im se funkcija gležnja popravila nakon načinjenog zahvata. Ovo je istraživanje potvrdilo konstataciju iz literature da se dijagnoza SSSG-a u populaciji adolescenata postavlja s vremenskom odgodom. Osim toga, ovo je istraživanje potvrdilo iznimnu uspješnost liječenja SSSG-a artroskopskom kirurgijom.The goal of the study is to investigate posterior ankle impingement syndrome (PAIS) in the adolescent population and the differ- ences in delay periods for diagnosis. Furthermore, the intention is to present the results for arthroscopic treatment of PAIS in adoles- cents and compare them to the results found in published literature. A total of 16 adolescent patients (≤19 years old) included in the study were operated on solely for PAIS. A search was done on avail- able medical documentation primarily for the causes and length of the PAIS symptoms, and any reported complications. The Amer- ican Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate ankle function, while patient satisfac- tion was measured using the Abdelatif questionnaire. The average age of the patients at the time of the procedure was 16.8 years. The median period from the appearance of the first symptoms until the diagnosis was 8.5 months. No perioperative complications were recorded in the median follow-up period of 75 months. An increase in AOFAS score was noted, ranging from an average of 70.9 preoperatively to 97.0 postoperatively. All of the patients were very satisfied with the results of the procedure, emphasizing postoperative improvement in everyday ankle use. This study confirms the presence of a diagnosis delay for PAIS in the adolescent population, which is in line with the results published in the literature. Additionally, it has been shown that arthroscopic surgery is highly efficient for treating PAIS in the adolescent popu- lation

Posterior ankle arthroscopic surgeries performed between 2011 and 2020 at the Department of Orthopaedic surgery at the University Hospital Center Zagreb

Artroskopija u stražnjem dijelu gležnja se tijekom godina prometnula u metodu izbora kojom se na minimalno invazivan način mogu liječiti različite patologije stražnjeg dijela gležnja. Cilj ovog istraživanja je bio utvrditi postotni udjel pojedine dijagnoze zbog koje je indicirana i načinjena artroskopija stražnjeg dijela gležnja kao samostalan zahvat te dobivene rezultate usporediti s rezultatima drugih istraživanja. Nadalje, cilj je bio i utvrditi broj i vrstu prethodno učinjenih operacijskih zahvata, učestalost i vrstu komplikacija nakon načinjenog zahvata te usporediti rezultate s rezultatima drugih istraživanja te utvrditi broj i vrstu ponovno učinjenih operacijskih zahvata na istom gležnju. Pretraživanjem operacijskih protokola Klinike za ortopediju KBC-a Zagreb i Medicinskog fakulteta Sveučilišta u Zagrebu, utvrđeno je da je u razdoblju od 1. siječnja 2011. do 1. siječnja 2020. načinjeno 269 uzastopnih artroskopija stražnjeg dijela gležnja pri čemu je izdvojena skupina od 83 bolesnika kod kojih je artroskopija u stražnjem dijelu gležnja bila načinjena kao samostalan zahvat te koji su nakon zahvata praćeni najmanje 24 mjeseca. Artroskopski zahvat je najčešće bio indiciran poradi sindroma stražnjeg sraza u gležnju i to kod 47 bolesnika (56,6%). Od ostalih indikacija zbog kojih je indiciran operacijski zahvat valja izdvojiti kontrakture subtalarnog zgloba (15 bolesnika), poslijetraumatski osteoartritis subtalarnog zgloba (4 bolesnika), tumorske promjene (3 bolesnika), koštanohrskavična ostećenja talusa (3 bolesnika), osteoid osteom talusa (2 bolesnika), ganglijske ciste (2 bolesnika), zastarjele rupture Ahilove tetive (2 bolesnika), avaskularnu nekrozu talusa (1 bolesnik), lokalizirani oblik pigmentiranog vilonodularnog sinovitisa (1 bolesnik), cistu talusa (1 bolesnik) te talokalkanealnu koaliciju (1 bolesnik). Kod svih bolesnika je operacijski zahvat protekao bez komplikacija. Tijekom poslijeoperacijskog praćenja zabilježene su svega 2 komplikacije (2,4%) prolaznog karaktera dok je sedam bolesnika (8,4%) nakon načinjene operacije ponovno operiralo isti gležanj. Ovo istraživanje govori u prilog tomu da je artroskopija u stražnjem dijelu gležnja najčešće indicirana zbog sindroma stražnjeg sraza u gležnju te da je artroskopija u stražnjem dijelu gležnja sigurna i efikasna metoda liječenja različitih patologija stražnjeg gležnja.Over the years, posterior ankle arthroscopy has evolved into a method of choice for minimally invasive treatment of various pathologies of the posterior part of the ankle. The aim of this study was to determine the percentage of each diagnoses for which hindfoot arthroscopy was indicated and performed as a solitary procedure, and to compare the obtained results with the results of other studies. Furthermore, the aim was to determine the number and type of previous surgeries, frequency and type of postoperative complications and to compare the results with the results of other studies and to determine the number and type of reoperations performed on the same ankle. Search of the surgery protocols of the Department of Orthopaedics Surgery, University Hospital Centre Zagreb and University of Zagreb School of Medicine, found that in the period from January 1st, 2011 to January 1st, 2020, 269 consecutive posterior ankle arthroscopies were performed. Within this group, in 83 patients posterior ankle arthroscopy was performed as a solitary procedure and the patients were followed-up for a minimum of 24 months. Arthroscopic surgery was most often indicated due to posterior ankle impingement syndrome in 47 (56.6%) patients. Other indications included subtalar joint contractures (15 patients), post-traumatic osteoarthritis of the subtalar joint (4 patients), tumors (3 patients), osteochondral lesions of the talus (3 patients), osteoid osteoma of the talus (2 patients), ganglionic cysts (2 patients), chronic Achilles’ tendon ruptures (2 patients), avascular necrosis of the talus (1 patient), localized pigmented villonodular synovitis (1 patient), talar cyst (1 patient) and talocalcaneal coalition (1 patient). In all of the 83 arthroscopic surgeries, the perioperative period was uneventful. During postoperative follow-up, only 2 minor complications were recorded (2.4%), while seven patients (8.4%) underwent surgery on the same ankle again after the operation. This research supports the fact that posterior ankle arthroscopy is most often indicated due to the posterior ankle impingement syndrome and that posterior ankle arthroscopy is a safe and effective method of treating various pathologies of the posterior part of the ankle

Posterior ankle arthroscopic surgeries performed between 2011 and 2020 at the Department of Orthopaedic surgery at the University Hospital Center Zagreb

Artroskopija u stražnjem dijelu gležnja se tijekom godina prometnula u metodu izbora kojom se na minimalno invazivan način mogu liječiti različite patologije stražnjeg dijela gležnja. Cilj ovog istraživanja je bio utvrditi postotni udjel pojedine dijagnoze zbog koje je indicirana i načinjena artroskopija stražnjeg dijela gležnja kao samostalan zahvat te dobivene rezultate usporediti s rezultatima drugih istraživanja. Nadalje, cilj je bio i utvrditi broj i vrstu prethodno učinjenih operacijskih zahvata, učestalost i vrstu komplikacija nakon načinjenog zahvata te usporediti rezultate s rezultatima drugih istraživanja te utvrditi broj i vrstu ponovno učinjenih operacijskih zahvata na istom gležnju. Pretraživanjem operacijskih protokola Klinike za ortopediju KBC-a Zagreb i Medicinskog fakulteta Sveučilišta u Zagrebu, utvrđeno je da je u razdoblju od 1. siječnja 2011. do 1. siječnja 2020. načinjeno 269 uzastopnih artroskopija stražnjeg dijela gležnja pri čemu je izdvojena skupina od 83 bolesnika kod kojih je artroskopija u stražnjem dijelu gležnja bila načinjena kao samostalan zahvat te koji su nakon zahvata praćeni najmanje 24 mjeseca. Artroskopski zahvat je najčešće bio indiciran poradi sindroma stražnjeg sraza u gležnju i to kod 47 bolesnika (56,6%). Od ostalih indikacija zbog kojih je indiciran operacijski zahvat valja izdvojiti kontrakture subtalarnog zgloba (15 bolesnika), poslijetraumatski osteoartritis subtalarnog zgloba (4 bolesnika), tumorske promjene (3 bolesnika), koštanohrskavična ostećenja talusa (3 bolesnika), osteoid osteom talusa (2 bolesnika), ganglijske ciste (2 bolesnika), zastarjele rupture Ahilove tetive (2 bolesnika), avaskularnu nekrozu talusa (1 bolesnik), lokalizirani oblik pigmentiranog vilonodularnog sinovitisa (1 bolesnik), cistu talusa (1 bolesnik) te talokalkanealnu koaliciju (1 bolesnik). Kod svih bolesnika je operacijski zahvat protekao bez komplikacija. Tijekom poslijeoperacijskog praćenja zabilježene su svega 2 komplikacije (2,4%) prolaznog karaktera dok je sedam bolesnika (8,4%) nakon načinjene operacije ponovno operiralo isti gležanj. Ovo istraživanje govori u prilog tomu da je artroskopija u stražnjem dijelu gležnja najčešće indicirana zbog sindroma stražnjeg sraza u gležnju te da je artroskopija u stražnjem dijelu gležnja sigurna i efikasna metoda liječenja različitih patologija stražnjeg gležnja.Over the years, posterior ankle arthroscopy has evolved into a method of choice for minimally invasive treatment of various pathologies of the posterior part of the ankle. The aim of this study was to determine the percentage of each diagnoses for which hindfoot arthroscopy was indicated and performed as a solitary procedure, and to compare the obtained results with the results of other studies. Furthermore, the aim was to determine the number and type of previous surgeries, frequency and type of postoperative complications and to compare the results with the results of other studies and to determine the number and type of reoperations performed on the same ankle. Search of the surgery protocols of the Department of Orthopaedics Surgery, University Hospital Centre Zagreb and University of Zagreb School of Medicine, found that in the period from January 1st, 2011 to January 1st, 2020, 269 consecutive posterior ankle arthroscopies were performed. Within this group, in 83 patients posterior ankle arthroscopy was performed as a solitary procedure and the patients were followed-up for a minimum of 24 months. Arthroscopic surgery was most often indicated due to posterior ankle impingement syndrome in 47 (56.6%) patients. Other indications included subtalar joint contractures (15 patients), post-traumatic osteoarthritis of the subtalar joint (4 patients), tumors (3 patients), osteochondral lesions of the talus (3 patients), osteoid osteoma of the talus (2 patients), ganglionic cysts (2 patients), chronic Achilles’ tendon ruptures (2 patients), avascular necrosis of the talus (1 patient), localized pigmented villonodular synovitis (1 patient), talar cyst (1 patient) and talocalcaneal coalition (1 patient). In all of the 83 arthroscopic surgeries, the perioperative period was uneventful. During postoperative follow-up, only 2 minor complications were recorded (2.4%), while seven patients (8.4%) underwent surgery on the same ankle again after the operation. This research supports the fact that posterior ankle arthroscopy is most often indicated due to the posterior ankle impingement syndrome and that posterior ankle arthroscopy is a safe and effective method of treating various pathologies of the posterior part of the ankle

POSTERIOR ANKLE IMPINGEMENT SYNDROME: CASE SERIES OF PATIENTS TREATED WITH ARTHROSCOPIC PROCEDURE

Cilj: Stražnji sindrom sraza gležnja (SSSG) se očituje pojavom boli u području stražnjeg dijela gležnja. Danas se kirurško liječenje ovog stanja uobičajeno provodi artroskopskom tehnikom koju su opisali van Dijk i suradnici 2000. godine. Svrha ovog rada jest prikazati rezultate provedenog artroskopskog liječenja SSSG-a tom tehnikom i usporediti dobivene rezultate s rezultatima objavljenima u literaturi. Metode: U razdoblju od 1. siječnja 2011. do 1. siječnja 2020. godine u Klinici za ortopediju KBC-a Zagreb i Medicinskog fakulteta Sveučilišta u Zagrebu operirano je zbog SSSG-a 47 bolesnika. U dostupnoj prijeoperacijskoj medicinskoj dokumentaciji sustavno su prikupljeni demografski podatci tih bolesnika, potom podatci o sportskoj aktivnosti i ozljeđivanju gležnja, načinjenoj radiološkoj obradi, kao i o eventualno prethodno načinjenom kirurškom zahvatu na tom gležnju. Iz operacijskih listi sustavno su, uz opise zahvata, zabilježeni i podatci o vrsti anestezije te je li tijekom zahvata korištena blijeda staza. Podatci o poslijeoperacijskom tijeku prikupljeni su iz evidencije ambulantnih posjeta bolesnika u kojima su sustavno tražene zabilješke o komplikacijama kao i o tome je li bolesnik eventualno ponovno operiran. Procjena funkcionalnog stanja gležnja provedena je upitnikom Američkog ortopedskog društva za stopalo i gležanj (engl. American Orthopaedic Foot & Ankle Society - AOFAS score) prije zahvata te na zadnjem kontrolnom pregledu. Zadovoljstvo bolesnika ispitano je upitnikom prema Abdelatifu. Rezultati: Istraživanjem je obuhvaćeno 42-je ispitanika (25 muškaraca) kojima je prosječna životna dob u trenutku zahvata iznosila 27,2 godine (raspon od 15 do 63). Medijan poslijeoperacijskog praćenja iznosi 80 mjeseci (raspon od 24 do 127). Ozljeda gležnja utvrđena je u 27 ispitanika (64,3 %). U 34 (80,9 %) ispitanika uzrok nastanka SSSG-a bio je koštani sraz. Blijeda je staza uspostavljena za 31 (73,8 %) zahvat. Artroskopski je zahvat u svih ispitanika protekao bez komplikacija, a tijekom poslijeoperacijskog razdoblja zabilježena je samo jedna komplikacija (2,4 %) i to prolazni ispad senzibiliteta na lateralnoj strani stopala u trajanju od 4 tjedna. Prosječni rezultat dobiven upitnikom AOFAS prije zahvata iznosio je 71,9 (raspon od 60 do 86), a na pregledu provedenom u sklopu istraživanja 95,7 (raspon od 78 do 100). Prema upitniku Abdelatifa 39 je ispitanika (92,8 %) bilo izrazito zadovoljno operacijom. Rasprava: Broj usporedivih istraživanja u literaturi je malen, a pregledom literature pronađeno je samo pet istraživanja kod kojih je praćenje bolesnika provođeno barem 60 mjeseci. Valja naglasiti da je kod samo dva od navedenih istraživanja broj analiziranih bolesnika bio veći od 30. U tim je istraživanjima, kao i u našem, procjena funkcionalnog stanja gležnja pokazala poboljšanje. Osim toga, u tim je istraživanjima dokazan izuzetno uspješan povratak sportskim aktivnostima nakon načinjenog zahvata. Stopa komplikacija u našem istraživanju (2,4 %) usporediva je ili manja nego u drugim istraživanjima. Zaključak: Ovo je istraživanje potvrdilo da je operacijsko liječenje SSSG-a, artroskopskom tehnikom koju su opisali van Dijk i sur. 2000. godine, sigurno i efi kasno i nakon duljeg prosječnog praćenja te da omogućuje potpun povratak sportskim aktivnostima.Aims: Posterior ankle pain is a characteristic of the posterior ankle impingement syndrome (PAIS). Currently, this condition is commonly treated arthroscopically following the technique published in 2000 by van Dijk et al. We aimed to investigate our outcomes in treating PAIS using this technique and to compare them to those published in the available literature. Methods: From January 1, 2011 until January 1, 2020, 47 patients were operated on for PAIS at the Department of Orthopedic Surgery, Zagreb University Hospital Center in Zagreb. The available medical records were systematically searched for demographic data, information about sports activities and ankle trauma, radiological studies, as well as previous surgical procedures on the ankle. Operation notes were thoroughly searched for the procedure details, type of anesthesia, and application of a tourniquet. Clinic records were scoured for complications noted or notes on ankle reoperations. The ankle function was assessed before the procedure and on the last check-up using the American Orthopedic Foot & Ankle Society (AOFAS) score. Patient satisfaction was evaluated using the questionnaire published by Abdelatif. Results: This study included 42 patients (25 male), mean age at the time of the procedure 27.2 (range 15 to 63) years. The median follow-up period was 80 (range 24 to 127) months. A history of ankle trauma was confi rmed in 27 (64.3%) cases. In 34 (80.7%) cases, PAIS was the consequence of bony impingement. Tourniquet was used in 31 (73.8%) cases. There were no complications noted during the procedure, with only one postoperative complication (2.4%) presenting as transient lateral foot sensitivity palsy that spontaneously resolved in 4 weeks. The mean preoperative AOFAS score was 71.9 (range 60 to 86), while the mean AOFAS score on the last follow-up was 95.7 (range 78 to 100). Based on Abdelatif questionnaire, 39 (92.8%) patients were very satisfi ed with the procedure. Discussion: The number of comparable studies in the literature is small. Literature review yielded only fi ve studies which had a follow-up period of minimally 60 months. Moreover, only two of those included more than 30 patients. In these two studies, similar to ours, assessment of the functional state of the ankle showed improvement. In addition, the procedure appears to be highly successful in allowing the patients to return to sports activities. Furthermore, thecomplication rate in our study (2.4%) was comparable or lower than in other studies. Conclusion: Our research confi rmed that arthroscopic treatment for PAIS using the van Dijk et al. technique was safe and effi cient even after a longer follow-up period, and it also consistently allowed return to sports activities