EVALUATION OF FUNCTION AND QUALITY OF LIFE FOLLOWING POSTERIOR ANKLE ARTHROSCOPY

Abstract

Purpose: Posterior Ankle Arthroscopy (PAA) is a relatively new operative technique for a specific and under-recognized ankle problem, posterior ankle impingement. Prospective data on the old technique, posterior ankle arthrotomy, have shown an unacceptable high complication rate. Literature review on PAA found reports on surgical techniques and anatomical studies only. The purpose of this study was to perform a retrospective study, with short-term follow-up to determine the quality of life, function and clinical results after posterior ankle arthroscopy.

Methods: Twenty-three patients underwent a PAA between 1998 and 2004 at our centre. Fifteen patients (16 PAA) were available for follow-up. They filled out the LEFS-score, the AOFAS clinical rating systems, the SF-12, 3 satisfaction scales and also underwent an examination of their ankle.

Results: The mean follow-up time was 32 months (6–74 months). The mean age at time of surgery was 25 years (19–43 years). After surgery they spent on average two weeks on crutches needing pain medication for 1 week. The mean return to work was 1 month (0–3 months) and return to sport was 5 months (1–24 months). 94% of the patients returned to their preoperative level of sport. Complications included five patients with temporary numbness around their scar and one patient with temporary ankle stiffness. There were no permanent neurovascular injuries. The mean LEFS score at follow-up was 75 (65–80; best = 80). The mean AOFAS score was 91 (77–100: 100 = best). The mean SF-12 score was 51.80 PCS (30.77–60.53); 55,80 MCS (44.26–63.33). All reported they had improved after their surgery and would have the surgery again.

Conclusions: Functional and clinical evaluations after a PAA revealed that all of the patients were very satisfied with the result and showed excellent quality of life. Posterior ankle impingement is an under-recognised clinical entity which now has an effective treatment available. Increased clinical focus on this condition may reveal a higher incidence associated with other diagnosis. We are currently evaluating patients pre and postoperative in a prospective study