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Foot (Edinb) 2021 Apr 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 2021 Apr 19:2841851211008389. 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 Mar 4. 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 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

Int J Surg Case Rep 2020 21;76:510-516. Epub 2020 Oct 21.

Department of Orthopedics, Institute of Biomedical Science, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima City, Tokushima, 770-8503, Japan. Electronic address:

Introduction: There are some reports of tarsal tunnel syndrome (TTS) entrapment/impingement from bony factors, including exostosis and fragment, but there are no reports on TTS with traumatic osteoarthritis of the ankle that were treated with osteophyte excision for TTS and arthroscopic arthrodesis for osteoarthritis of the ankle.

Presentation Of Case: A 61-year-old woman with left trimalleolar fracture had undergone surgery 3 years earlier and was referred to our hospital for further investigation of persistent left ankle pain and numbness around the left medial malleolus and plantar aspect of the foot. Clinical examination demonstrated plantar hypesthesia and a positive Tinel's sign at the tarsal tunnel. Read More

Cell Tissue Bank 2021 Mar 27;22(1):115-122. Epub 2020 Oct 27.

Department of Hand and Foot Surgery, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021, Jilin, China.

Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the posterior tibial nerve or its terminal branches compressed by its fibro-osseous tunnel beneath the flexor retinaculum on the medial side of the ankle. The current study was a retrospective study of 107 cases of patients with TTS, in which the onset characteristics were summarized, the factors that might affect the surgical treatment effects of TTS were discussed and analyzed. The syndrome diagnoses and treatment experiences of TTS were extracted and analyzed. Read More

JBJS Case Connect 2020 Jul-Sep;10(3):e2000080

1Department of Pediatric Orthopedics and Adult Foot and Ankle Surgery, Orthopedic Hospital Speising, Vienna, Austria.

Case: Two adolescent patients with therapy-refractory ulnocarpal wrist pain because of mild ulnar longitudinal deficiency (ULD; ulna hypoplasia type I according to Bayne) underwent surgical treatment with a Z-shaped ulna lengthening osteotomy and interposition of the iliac crest bone graft. Long-term ULD correction and pain-free motion were maintained in both patients.

Conclusion: Pediatric patients with symptomatic mild ULD are often mistaken for ulnar negative variance with radioulnar impingement and may be successfully treated using this newly described technique. Read More

Gait Posture 2021 Jan 10;83:26-34. Epub 2020 Oct 10.

Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE) | Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

Background: Studies of walking in those with femoroacetabular impingement syndrome have found altered pelvis and hip biomechanics. But a whole body, time-contiuous, assessment of biomechanical parameters has not been reported. Additionally, larger cam morphology has been associated with more pain, faster progression to end-stage osteoarthritis and increased cartilage damage but differences in walking biomechanics between large compared to small cam morphologies have not been assessed. Read More

Gait Posture 2021 Jan 29;83:1-8. Epub 2020 Sep 29.

La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia. Electronic address:

Background: Hip-related pain (HRP) is described as a movement-related disorder. However, little attention is given to the way people with HRP move, especially in populations still participating in sport. Thus, limiting our understanding of movementbased impairments in HRP and their potential relationships with pain/symptoms. Read More

Int Orthop 2021 04 17;45(4):1049-1055. Epub 2020 Sep 17.

Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Zaloška ulica 9, SI-1000, Ljubljana, Slovenia.

Purpose: To compare self-reported joint status, quality of life, level of activity and pain management in patients scheduled for surgical treatment of seven common ankle disorders: osteoarthritis (OA), primary osteochondral lesion of talus (P-OLT), recurrent osteochondral lesion of talus (R-OLT), lateral ankle instability (INST) and anterior (ANT-IMP), posterior (POST-IMP) and combined (COMB-IMP) ankle impingements.

Methods: The cross-sectional study design was implemented. Hospital records of 610 patients that were admitted for surgical intervention on the ankle joint over a seven year period were reviewed. Read More

Clin Sports Med 2020 Oct 13;39(4):911-930. Epub 2020 Aug 13.

Illinois Bone and Joint Institute, LLC, 720 Florsheim Drive, Libertyville, IL 60048, USA.

Posterior ankle pain is a common complaint, and the potential causative pathologic processes are diverse. The constellation of these numerous etiologies has been collectively referred to as posterior ankle impingement syndrome. The pain associated with posterior ankle impingement is caused by bony or soft tissue impingement of the posterior ankle while in terminal plantar flexion. Read More

J Foot Ankle Surg 2020 Nov - Dec;59(6):1197-1200. Epub 2020 Jun 9.

Orthopaedic Surgeon, Orthopaedic Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, China.

This study aimed to evaluate the surgical technique and long-term clinical outcomes of all-inside arthroscopic treatment for flexor hallucis longus (FHL) tendon impingement syndrome. We retrospectively evaluated 34 FHL tendon impingement syndrome patients with complete follow-up data who were admitted from June 2015 to August 2018 and underwent the all-inside arthroscopy technique. The subjects consisted of 20 (58. Read More

BMC Musculoskelet Disord 2020 Aug 18;21(1):556. Epub 2020 Aug 18.

Department of Orthopedics, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, NO. 29, Double Tower Street, Taiyuan, 030012, Shanxi, China.

Background: Combined anterior and posterior ankle impingement has seldom been reported. Cedell fracture, fracture of posteromedial tubercle of talus, is an uncommon and easily missed injury which may elicit posteromedial ankle impingement. The injury mechanisms and management strategies of these two lesions have been reported individually. Read More

Orthop J Sports Med 2020 Jul 22;8(7):2325967120938767. Epub 2020 Jul 22.

Twin Cities Orthopedics, Edina, Minnesota, USA.

Background: Management of ankle pain in dancers can be challenging because of the repetitive stress and complex demands placed on this region. Despite the prevalence of ankle injuries in this population, literature on surgical outcomes and return to dance is limited.

Purpose: To retrospectively evaluate the efficacy and functional outcomes after surgical excision of a symptomatic os trigonum in dancers. Read More

Clin J Sport Med 2020 07;30(4):378-382

Kramer Orthopedics, Newport Beach, CA.

Background: Literature regarding surfing injuries is scarce and most studies report a high number of minor injuries. Recent literature suggests that musculoskeletal injuries are more common than previously reported. In the mid 2000s, competitive surfing has seen an increase in aerial maneuvers, as they have become more highly rewarded by the judging panel, which may be contributing to a change in injury patterns. Read More

Foot Ankle Surg 2021 Apr 15;27(3):296-300. Epub 2020 Jun 15.

Department of Orthopedics, Clinica Del Remei, Barcelona, Spain; Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.

Background: Ankle injuries are one of the most common musculoskeletal disorder. The purpose of this study was to analyze and describe the detailed anatomical arrangement and relationship of posterior ligaments of the ankle, especially de posteroinferior tibiofibular ligament (PITFL) and intermalleolar ligament (IML). Controversy exists in the previous literature regarding their morphology and denomination, as well as the relation with ankle injuries including posterior soft tissue impingement syndrome. Read More

J Foot Ankle Surg 2020 Sep - Oct;59(5):938-941. Epub 2020 May 4.

Orthopedic Surgeon, UniSports Sports Medicine, St Johns, Auckland, New Zealand. Electronic address:

Posterior ankle impingement syndrome is common in sporting populations and encompasses a range of disorders that cause posterior ankle pain during maximal forced plantarflexion. The aim of this study was to evaluate the short- and medium- to long-term outcomes of 2-portal endoscopic surgery for osseous lesions causing posterior ankle impingement syndrome. This was a retrospective case series analysis of all patients who underwent 2-portal endoscopic surgery at a single institution between 2005 and 2016. Read More

Arthrosc Tech 2020 Apr 27;9(4):e559-e563. Epub 2020 Mar 27.

Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China.

Posterior ankle pain is a common foot and ankle problem faced by orthopaedic surgeons. It can have many causes, including posterior ankle joint pathologies (synovitis or osteochondral lesion), ankle impingement (posterior, posterolateral, or posteromedial), flexor hallucis longus pathologies, peroneal tendon problems, posterior tibial tendinopathy, Achilles tendon pathology, posterior subtalar tarsal coalition, or tarsal tunnel syndrome. Most of these pathologies can be managed effectively by an endoscopic approach. Read More

Eur J Orthop Surg Traumatol 2020 Oct 3;30(7):1171-1178. Epub 2020 May 3.

Clinica Ortopedica, Azienda Ospedaliero-Universitaria Parma, Parma, Italy.

Purpose: Chronic anterior ankle pain is a recognized and straightforward characteristic of anterior impingement syndrome. This retrospective study aims to evaluate outcomes, clinical and radiological results in patients affected by anterior ankle impingement, in a context of early osteoarthritis, and treated with mini-open anterior ankle arthrolysis, in the perspective to delay or avoid other demolitive surgical options, such as total ankle replacement and joint fusion.

Methods: In total, 49 patients (50 feet, mean age 45 years) undergone mini-open anterior ankle arthrolysis for anterior impingement, fulfilled inclusion criteria and gave their consent and have been enlisted in the study. Read More

Gait Posture 2020 03 11;77:175-181. Epub 2019 Nov 11.

Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W 10th Avenue, Suite 516, Columbus, OH 43210, United States; Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Suite 3200, Columbus, OH 43202, United States.

Background: Suboptimal patient-reported function and movement impairments often persist after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Individuals with FAIS with preoperative cartilage pathology (ie. chondropathy) demonstrate distinct movement patterns and have worse post-operative outcomes. Read More

J Foot Ankle Surg 2020 Jul - Aug;59(4):826-828. Epub 2020 Jan 22.

Professor, Department of Orthopaedic Surgery, Nara Medical University, Kashiharashi, Nara, Japan.

Fracture of the lateral process of the talus has often been missed or confused with lateral ankle sprain, and this can lead to long-term untreated cases of nonunion, malunion, and subtalar joint osteoarthritis. In a review of the published data, accessory anterolateral talar facet syndrome was not found after treatment of nonunion of the lateral process of the talus fracture. This report presents the case of a 40-year-old male snowboard instructor who suffered from a neglected fracture of the lateral process of the talus and was treated with open reduction using an iliac autogenous bone graft. Read More

Surg Radiol Anat 2020 Jun 6;42(6):691-693. Epub 2020 Jan 6.

Department of Anatomy, School of Life Dentistry at Niigata, Nippon Dental University, Niigata, Japan.

Purpose: The deep component of the posterior inferior tibiofibular ligament (PITFL) was classified by type in this large-scale cadaveric study to provide basic information that will help elucidate the mechanisms underlying ankle joint posterior impingement syndrome.

Methods: This investigation examined 100 legs from 49 Japanese cadavers (mean age at death, 79 ± 11 years; 58 sides from men, 42 from women). In classification, absence of an independent fiber of the deep component of the PITFL were classified as Type I, an independent fiber of the deep component of the PITFL was classified as Type II-a, an independent fiber of the deep component of the PITFL with bundles of fibers connected to the posterior intermalleolar ligament (PIML) was classified as Type II-b, and an independent fiber of the deep component of PITFL with a band shape connected to the PIML was classified as Type III. Read More

World J Orthop 2019 Oct 18;10(10):364-370. Epub 2019 Oct 18.

Department of Orthopaedics, University of California, San Francisco, CA 94143, United States.

Background: Posterior ankle impingement syndrome (PAIS) is a cause of ankle pain due to pinching of bony or soft tissue structures in the hindfoot. The diagnosis is primarily made based on detailed history and accurate clinical examination. The delay in its diagnosis has not yet been described in the pediatric and adolescent population. Read More