THE ARTHROSCOPIC TREATMENT OF ANTERIOR ANKLE IMPINGEMENT IN ATHLETES

Abstract

SAŽETAK Cilj: Svrha je ovog rada utvrditi uspješnost artroskopskog liječenja sindroma prednjeg sraza gornjega nožnog zgloba. Bolesnici i metode: Ukupan broj od 23 liječena bolesnika klasificiran je na osnovi prisutne artroze na radiološkim preoperacijskim snimkama. Simptomi 5 bolesnika u grupi stupnja O uzrokovani su samo mekotkivnim srazom, u grupi od 13 bolesnika stupnja I. simptomi su uzrokovani mekotkivnim i osteofitnim srazom, a u grupi od 5 bolesnika stupnja II. uza znakove sraza prisutno je i suženje zglobne pukotine. Standardnim operacijskim artroskopskim anteromedijalnim i anterolateralnim ulazima pristupali smo u zglob te provodili sinovijektomiju i abraziju osteofita. Rezultati liječenja obrađeni su praćenjem pet paramatera (bol, oticanje, pokretljivost, šepanje, aktivnost) i vrednovanih Ogilvie- Harrisovim bodovnim sustavom. Vrijeme praćenja bolesnika bilo je dvije godine. Rezultati: U svih pet parametara koji su se pratili, došlo je do statistički značajnog poboljšanja te time i uspješnog liječenja bolesnika. Zaključak: Artroskopsku resekciju nabujalog veziva te osteofita prednjeg ruba tibije i vrata talusa možemo smatrati uspješnim načinom liječenja sindroma prednjeg sraza gornjega nožnog zgloba.SUMMARY AIM: The purpose of our study was to evaluate the results of arthroscopic treatment of anterior ankle impingement. Patients and methods: By using preoperative radiographs, we grouped 23 patients according to the extent of their osteoarthritis. The symptoms of those with grade-0 (5- patients) could be attributed to anterior soft tissue impingement only, in those with grade-I (13 patients) to anterior soft tissue and osteophytic impingement and those with grade-II (5-patients) in narrowing of the joint cavity accompanied by osteophytic impingement. We used anteromedial and anterolateral portals for osteophytic debridment and partial synoviectomy. The results were evaluated recordnig five parameters (pain, swelling, stiffness, limping, activity) in the Ogilvie-Harris score system. Follow up period was 2 years. Results: The success of the patient treatment was confirmed with statistical significant improvement in all five parameters. Conclusion: Arthroscopic excision of soft tissue overgrowths and osteophytes is proved to be a succesive method of tretament of the anterior ankle impingement in athlete

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