[Arthroscopic treatment of anterior synovitis of the upper ankle joint in the athlete].

UNLABELLED

In a retrospective study we analyzed the results of arthroscopic treatment of anterior synovitis of the ankle in 35 athletes. 5 athletes suffered additionally from anterior osteophytes and 3 presented with an anterolateral plica. Average age was 25 years (SD: 8.3) and follow-up interval was 32.4 months (SD: 19.4). 8 patients suffered from additional hyperlaxity of the ankle joint. At time of follow-up the patients were examined clinically as well as radiologically. The results were scored according to an ankle score containing the criteria pain, function, athletic activity, walking aids, range of motion, and swelling. During surgery a partial synovectomy was performed as well as removal of anterior osteophytes or anterolateral plica if necessary. The overall score increased non-significantly from 66.2 preoperatively to 78.7 postoperatively (p > 0.05). Comparing the different criteria the score parameter pain significantly increased after arthroscopy. All other parameters (function, athletic activity, walking aids, range of motion, swelling) showed only slight changes in this patient group. Athletes with hypermobile joint showed worse results compared to the others. Even after surgery we documented severe restriction in athletic activity. Only 9 patients performed their activities on their previous level, 19 reduced their activity level and 7 discontinued their athletic activity. In 6 cases we found iatrogenic temporary neurologic damage.

CLINICAL RELEVANCE

Due to the uncertain clinical outcome and the documented high risk of neurovascular complications, patient selection for arthroscopic partial synovectomy in the athletic population should be performed extremely carefully. Prior to surgery, all other conservative options including changes of running shows as well as modifications in exercise program and athletic activity should be considered.