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Knee Surg Sports Traumatol Arthrosc 2022 Jun 10. Epub 2022 Jun 10.

Football Research Group, Linköping, Sweden.

Purpose: To study the epidemiology and return to play characteristics of anterior and posterior ankle impingement syndromes (AAIS and PAIS) over 18 consecutive seasons in male professional soccer players.

Methods: Between the 2001-2002 and 2018-2019 seasons, 120 European soccer teams were followed prospectively for various seasons. Time loss injuries and player exposures were recorded individually in 6754 unique players. Read More

Arthrosc Sports Med Rehabil 2022 Apr 8;4(2):e629-e638. Epub 2022 Feb 8.

Department of Orthopedic Surgery, NYU Langone Health, New York, New York, U.S.A.

Purpose: To investigate the short-term clinical outcomes and satisfaction for the first set of patients at our institution receiving in-office needle arthroscopy (IONA) for the treatment of posterior ankle impingement syndrome (PAIS).

Methods: A retrospective cohort study was conducted to evaluate patients who underwent IONA for PAIS between January 2019 and January 2021. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and Patient-Reported Outcomes Measurement Information System Pain Interference, and Pain Intensity scores. Read More

Ann Transl Med 2022 Mar;10(6):270

Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: We often attribute the lateral ankle impingement to the valgus calcaneus, while ignoring the varus distal tibia. The diagnostic criteria, severity and treatment of distal tibia varus syndrome (DTVS) have not been reported. This retrospective study sought to propose a diagnosis and classification system for DTVS based on patients' clinical symptoms and imaging findings. Read More

Clin Anat 2022 Apr 6. Epub 2022 Apr 6.

Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.

We aimed to investigate the bone and soft tissue changes accompanying tarsal coalition (TC) and aimed to evaluate their association with the location and type of coalition. Ankle magnetic resonance imagings of 65 patients with TC were included. The relationship between the location and type of coalition and bone marrow edema, subchondral cysts, sinus tarsi syndrome, tarsal tunnel syndrome, posterior impingement syndrome, accessory bone, tibiotalar effusion, talar osteochondritis dissecans, ganglion cysts, and calcaneal spur were evaluated. Read More

North Clin Istanb 2022 8;9(1):23-29. Epub 2022 Feb 8.

Department of Pediatric Radiology, Health Sciences University, Konya City Hospital, Konya, Turkey.

Objective: The os trigonum is a common cause of posterior ankle impingement in children and adults. Its incidence in the medical literature is controversial. The aim of the study is to determine the incidence of os trigonum, medullary imaging features and size in pediatric patients with suspected posterior ankle impingement. Read More

Zhongguo Gu Shang 2022 Mar;35(3):238-42

Foot & Ankle Section, Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.

Objective: To investigate the surgical skills and clinical curative results of arthroscopic treatment of ankle instability combined with anteromedial impingement syndrome.

Methods: From February 2019 to August 2020, 13 patients with ankle instability combined with anteromedial impingement were retrospectively analyzed. There were 10 males and 3 females with age of (40. Read More

J Am Podiatr Med Assoc 2022 Mar 7:1-24. Epub 2022 Mar 7.

*Acibadem Healthcare Group Kayseri Hospital, Department of Orthopaedics and Traumatology, Kayseri, Turkey.

Background: One of the common causes of posterior ankle pain is posterior ankle impingement syndrome (PAIS). Many studies about PAIS have been conducted on special groups such as athletes, dancers, and football players, whereas there has been no previous study of a non-athletic population. This study aimed to evaluate the causes and treatment methods of this syndrome in the non-athletic population and compare it with the athletic population. Read More

NMC Case Rep J 2021 22;8(1):851-855. Epub 2021 Dec 22.

Department of Neurological Surgery, Aichi Medical University, Nagakute, Aichi, Japan.

Double crush syndrome (DCS) is a clinical condition involving impingement of the spinal and peripheral nerves. DCS of the lower limbs has been recognized; however, no detailed reports have been published. Herein, we report a rare case of the coexistence of L5 radiculopathy and peroneal nerve entrapment neuropathy. Read More

Zhonghua Yi Xue Za Zhi 2021 May;101(17):1250-1255

Department of Orthopedics and Sports Medicine, First Affiliated Hospital of Military Medical University of the Army, Chongqing 400038, China.

To analyze the efficacy of arthroscopic posterior ankle debridement through Tang's approach for the treatment of impingement of posterior tubercle of the talus. A retrospective analysis was performed on 64 patients (35 males and 29 females) with posterior tubercle impingement of the talus who underwent surgical treatment from September 2011 to May 2019 in First Affiliated Hospital of Military Medical University of the Army. The disease occurred in left foot in 31 cases and in right foot in 33 cases, with an age ranged from 15 to 65 years ((36±7) years). Read More

J Foot Ankle Surg 2022 Jul-Aug;61(4):e9-e14. Epub 2021 Oct 22.

Department of Orthopaedic Sports Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan.

Posterior ankle impingement syndrome is mainly seen in ballet dancers and frequently associated with specific movements in ballet such as pointe and demi pointe in which the whole-body weight is applied to the maximally plantar flexed ankle. We performed arthroscopic debridement for 2 dedicated ballet dancers on the intervening soft tissue causing posterior ankle impingement syndrome (PAIS). In both cases, T2-weighted magnetic resonance imaging (MRI) revealed low-signal intensity of meniscus-like soft tissue without abnormal osseous findings, connecting from the posterior side of the talus to Kager's fat pad. Read More

Skeletal Radiol 2022 Jun 13;51(6):1115-1125. Epub 2021 Oct 13.

University of Missouri, Hospital Drive, Columbia, MO, 65212, USA.

The purpose of this article is to focus attention on the abnormalities which the radiologist may encounter in patients presenting with lateral ankle or foot pain outside of the context of acute trauma. These include anterolateral impingement, subfibular impingement, subtalar instability and tarsal sinus syndrome, tarsal coalition, sural neuromas, peroneal tendon abnormalities, calcaneocuboid instability and occult cuboid fractures, and painful accessory ossicles. The expected and unexpected findings on radiographs, CT, US, and MRI are discussed. Read More

Arthrosc Sports Med Rehabil 2021 Aug 15;3(4):e1077-e1086. Epub 2021 May 15.

Nara Medical University, School of Medicine, Nara, Japan.

Purpose: To report mid-term clinical results of posterior ankle arthroscopy in the treatment of posterior ankle impingement syndrome (PAIS) and to assess the learning curve and its influence on the results.

Methods: This was a retrospective evaluation of the clinical outcomes of posterior ankle arthroscopy and its learning curve in a series of patients with PAIS. Demographic and clinical data, surgical time, the American Orthopaedic Foot Ankle Society (AOFAS) ankle/hindfoot scores, and time to resumption of sports were recorded. Read More

Am J Sports Med 2021 09 2;49(11):2984-2993. Epub 2021 Aug 2.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Background: Impairments in squat depth have been reported in patients with femoroacetabular impingement syndrome (FAIS). However, little is known about single-leg squat (SLS) performance in these patients, despite this task being commonly used in the rehabilitation and training settings.

Purpose/hypothesis: The aims of this study were (1) to investigate whether patients with FAIS demonstrate differences in SLS performance compared with healthy controls and (2) to determine whether dynamic range of motion (ROM), muscle strength, hip morphologic measures, hip pain, and hip-specific function predict SLS performance in patients with FAIS. Read More

Case Rep Orthop 2021 28;2021:6637081. Epub 2021 Jun 28.

Guy's & St Thomas' Hospital, London, UK.

Posterior ankle impingement syndrome (PAIS) can be caused by osseous pathology from the posterior aspect of the talus. The commonest cause is an os trigonum, an accessory ossicle arising from the tubercle of the posterior talus. We have observed cases where the osseous impingement is due to a chronic fracture nonunion of the tubercle of the posterior talus with unique symptoms, differentiating this clinical syndrome from the more common os trigonum syndrome. Read More

Arthrosc Sports Med Rehabil 2021 Jun 11;3(3):e829-e835. Epub 2021 May 11.

Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai.

Purpose: The purpose of this study was to evaluate the attachment areas of the posterior talofibular ligament (PTFL) on the posterolateral tubercle of the talus and the remaining PTFL attachment areas after consequential bony excision.

Methods: Thirty fresh cadaveric ankles were dissected to study the proximal and distal attachment of the PTFL and separated the PTFL into anterior and posterior bundles. The description of the PTFL footprint and the anatomic landmarks from the surrounding structures were analyzed during consequential posterolateral bony excision. Read More

J ISAKOS 2021 11 30;6(6):329-332. Epub 2021 Jun 30.

2nd Orthopedic Department, General Hospital of Thessaloniki Gennimatas, Thessaloniki, Greece.

Objective: To evaluate the potential differences in American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and Foot Function Index (FFI) at 6-month and 12-month postoperative follow-up of arthroscopic treatment for posterior ankle impingement (PAIS) between os trigonum (OT) and Stieda's process (SP) patients.

Methods: Thirty consecutive patients (32 ankles) treated in our Institution for PAIS with posterior arthroscopy were prospectively enrolled in the study from December 2012 to July 2019. Indications were patients with PAIS with persistent symptoms following conservative management. Read More

J Athl Train 2021 Jun 29. Epub 2021 Jun 29.

Department of Kinesiology and Rehabilitation Science, University of Hawai'i at Mānoa, 1337 Lower Campus Road, Honolulu, HI, 96822, Email:

Context: Symptomatic Femoroacetabular Impingement Syndrome (FAIS) is a painful condition that leads to decreased function. It is currently unknown how walking gait changes over time following surgery for FAIS earlier than one year, or how these changes present in females.

Objective: The purpose was to determine biomechanical gait differences between females with FAIS/labral tears and controls pre-operatively, and three- and six-months post-operatively. Read More

Skeletal Radiol 2021 Dec 19;50(12):2423-2431. Epub 2021 May 19.

La Trobe University Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, 3086, Australia.

Objective: To report the prevalence of MRI features commonly associated with posterior ankle impingement syndrome in elite ballet dancers and athletes and to compare findings between groups.

Materials And Methods: Thirty-eight professional ballet dancers (47.4% women) were age- and sex-matched to 38 elite soccer or cricket fast bowler athletes. Read More

Diagn Interv Radiol 2021 May;27(3):432-439

Lateral hindfoot impingement (LHI) is a subtype of ankle impingement syndrome with classic MRI findings. Biomechanically, LHI is the sequela of lateral transfer of weight bearing from the central talar dome to the lateral talus and fibula. The transfer occurs due to collapse of the medial arch of the foot, most commonly from posterior tibial tendon (PTT) and spring ligament (SL) insufficiency. Read More

Foot (Edinb) 2021 Jun 7;47:101799. Epub 2021 Apr 7.

Texas Children's Hospital, 6701 Fannin St, Houston, TX 77030, USA.

Purpose: The purpose of this study was to identify and characterize various causes of delay in the diagnosis of posterior ankle impingement syndrome (PAIS) in pediatric patients.

Methods: IRB approved prospective study of patients under 18 years who underwent arthroscopic surgery for the diagnosis of posterior ankle impingement after failed conservative treatment at a tertiary children's hospital. Radiographic findings were compared with an age-matched control group. Read More

Orthop J Sports Med 2021 Apr 19;9(4):23259671211001055. Epub 2021 Apr 19.

Institute of Sports Medicine, Beijing Key Laboratory of Sports Injury, Peking University Third Hospital, Beijing, People's Republic of China.

Background: Although endoscopic calcaneoplasty and retrocalcaneal debridement have been extensively applied to treat Haglund syndrome, evidence of the value of the endoscopic procedure remains to be fully established.

Purpose/hypothesis: The purpose of this study was to compare the postoperative outcomes and the amount of osteotomy between open and endoscopic surgery for the treatment of Haglund syndrome. It was hypothesized that endoscopic calcaneoplasty would lead to higher patient satisfaction and lower complication rates compared with open surgical techniques. Read More

Orthop Res Rev 2021 19;13:47-56. Epub 2021 Apr 19.

Department of Orthopaedic Surgery, Chungbuk National University Hospital, Cheongju, South Korea.

A high frequency of associated injuries is seen in patients with chronic lateral ankle instability. Comorbidities include intraarticular pathologies (osteochondral lesion, soft tissue or bony impingement syndrome, loose body, synovitis, etc.), peroneal tendon pathologies, neural injuries, and other extraarticular pathologies. Read More

Acta Radiol 2022 May 19;63(5):652-657. Epub 2021 Apr 19.

La Trobe University Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia.

Background: Posterior ankle impingement syndrome (PAIS) is a common and debilitating condition, commonly affecting people who participate in activities that involve repetitive ankle plantarflexion. The relationship between clinical and imaging findings in PAIS has not been established.

Purpose: To investigate the relationship between clinical and imaging features in PAIS by reviewing the literature comparing symptomatic patients to asymptomatic controls. Read More

J Foot Ankle Surg 2021 Jul-Aug;60(4):706-711. Epub 2021 Mar 4.

Research Statistician, Sports Medicine Division, The Micheli Center for Sports Injury Prevention, Boston Children's Hospital, Walthan, MA.

This case series reports the outcome of posterior ankle decompression and os trigonum or Stieda process resection utilizing an open posterolateral approach in 54 professional, pre-professional, and dedicated recreational dancers. All procedures were performed by a single surgeon at the same facility between 2008 and 2018. The surgical technique is described in detail. Read More

Clin Podiatr Med Surg 2021 Apr 13;38(2):279-290. Epub 2021 Feb 13.

Department of Surgery-Podiatry, Carl T. Hayden Medical Center, 650 East Indian School Road, Phoenix, AZ 85012, USA.

This article offers an overview of os trigonum syndrome, complications, operative techniques, and the authors' preferred protocol. Os trigonum is an ossicle like many other ossicles in the foot and ankle. Individuals who require repetitive plantarflexion of the ankle for activity may develop symptoms of an enlarged os trigonum. Read More

J Dance Med Sci 2021 Mar;25(1):24-29

Orthopaedic Research Center Amsterdam (ORCA), Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam; Academic Center for Evidence Based Sports Medicine (ACES); Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, the Netherlands; FIFA Medical Centre of excellence Ripoll-dePrado-vanDijk SportClinic Madrid, Spain; and FIFA Medical Centre of Excellence Clinica do Dragao Porto, Portugal.

Posterior ankle impingement syndrome (PAIS) involves pain at the posterior as- pect of the ankle, due in dancers largely to repetitive hyperplantarflexion. In daily practice, corticosteroid injection is often used to relieve the pain of PAIS, but little has been recorded with regard to its effectiveness. The primary objective of this study was to determine the ef- fect on pain of corticosteroid injections in professional and elite student ballet dancers with PAIS. Read More

Acta Biomed 2020 12 30;91(14-S):e2020021. Epub 2020 Dec 30.

Department of Orthopaedic Surgery, S. Maria della Misericordia Hospital, Rovereto, Italy.

Ankle arthrodesis has been considered the surgical Gold Standard for advanced ankle arthritis; prosthetic replacement of the tibio-talar joint played a secondary role.The introduction of last generation ankle prostheses lead to better outcome and a lower rate of complication. PSI represents the most recent innovations introduced on the market of ankle arthroplasty:PSI is proposed as a surgical technique capable of making ankle arthroplasty more accurate and more reproducible compared to standard referencing guides Aim of the study is to report early clinical and radiographic outcomes obtained from a single surgeon experience by implanting the same ankle prosthesis using a standard (STD) or a PSI instrumentation Unlike no difference in the average increment of normalized sub score related to function in each group (PSI vs STD), the analysis of normalized pain sub score pointed out a greater average improvement in the PSI group(+75%)compared to the STD group(+62%);this result has been adovacated to the absence of post operative gutter impingement syndrome in the PSI group compared to the STD referencing group. Read More

Foot Ankle Clin 2021 Mar 9;26(1):155-172. Epub 2020 Sep 9.

UFMG - Federal University of Minas Gerais, Brazil. Electronic address:

Ankle impingement refers to a chronic painful mechanical limitation of ankle motion caused by soft tissue or osseous abnormality affecting the anterior or posterior tibiotalar joint. Impingement can be associated with a single traumatic event or repetitive microtrauma. These syndromes are a possible etiology of persistent ankle pain. Read More

Foot Ankle Spec 2021 Jan 12:1938640020985822. Epub 2021 Jan 12.

Singapore General Hospital, Singapore.

The aim of this study was to investigate the outcomes and complications after posterior ankle arthroscopy for the treatment of posterior ankle impingement syndrome, in a local population with a single surgeon series. Two-portal posterior ankle or hindfoot arthroscopy is an alternative option to open surgery in cases of posterior ankle impingement, that showed similar results but with less morbidity and faster recovery. There has been increasing interest in minimally invasive surgical techniques. Read More

Orthop Surg 2021 Feb 11;13(1):53-62. Epub 2021 Jan 11.

Department of Joint Orthopaedics, Yantai Yuhuangding Hospital, Yantai, Shandong Province, China.

Objective: To introduce a 3-portal approach of arthroscopic for anterior ankle impingement syndrome and to compare this method with 2-portal arthroscopy.

Methods: From July 2011 to April 2019, a total of 52 patients (30 females, 22 males) with anterior ankle impingement syndrome underwent surgery with 2-portal approach (anterior medial and anterior lateral approach; N = 26) and modified 3-portal approach (anterior medial, anterior lateral, and an accessory anterior median approach; N = 26) of arthroscopic were recruited retrospectively after we performed a propensity score-matched analysis (PSMA). The mean age at operation time was 44. Read More