Posterior Ankle Impingement Syndrome in a Nonathletic Population: Causes, Treatment Modalities, and the Results of Endoscopic Treatment.

Abstract

A common cause of posterior ankle pain is posterior ankle impingement syndrome (PAIS). Many studies about PAIS have been conducted on special groups such as athletes and dancers; there has been no previous study of a nonathletic population. This study aimed to evaluate the causes and treatment methods of PAIS in the nonathletic population and compare it with the athletic population. A retrospective review was performed and 28 of 46 patients (60.9%) recovered from two-staged conservative therapy. In the 18 patients (39.1%) who did not benefit from 3 months of conservative treatment, hindfoot endoscopy was applied. Patient data, including sex, age, occupation, and sports activity level, were recorded. Visual analog scale, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, and Tegner scores were recorded. Patient satisfaction was assessed with a 4-point Likert scale. Complications were recorded. Mean follow-up was 27.4 months. At final follow-up, the AOFAS hindfoot score had significantly improved from 66.4 to 96.8 (P < .001). The Tegner score improved significantly from 4.6 to 8.8 (P < .001). The visual analog scale score was 6.4 and increased to 0.9 (P < .001). Using the 4-point Likert scale for patient satisfaction, 13 (72.2%) stated that the surgical procedure was excellent and five (27.8%) good. Mean time to return to work was 4.2 weeks. Sural nerve dysesthesia was seen in two patients (11.1%). This is the first study to evaluate PAIS in the nonathletic population. Conservative treatment showed good results as nearly two-thirds of the patients recovered. Hindfoot endoscopy in those not responding to conservative therapy is a successful treatment with low complication rates.