Posterior ankle impingement syndrome in football players: Case series of 26 elite athletes

Abstract

Objective: To describe a clinical treatment algorithm for posterior ankle impingement (PAI) syndrome inprofessional football players.Material and methods: A case series of 26 elite professional football players diagnosed and treated forposterior ankle impingement syndrome were included for the study. All of the athletes received conservative treatment with physical therapy modalities initially. If theŞrst line medical treatment andrehabilitation was ineffective to alleviate the symptoms, ultrasound-guided corticosteroid injection wasproposed and thereafter the patients underwent posterior ankle arthroscopy if the complaints are stillunresolved. The pain scores (AOFAS, VAS), and time to return to play were the main outcome measures.Results: The complaints of 18 (69.2%) players were subsided with non-surgical treatment whereas threeof acute cases andŞve of the chronic cases did not respond to medical treatment and arthroscopicsurgery was performed for eight athletes. Eighteen players returned to training for a mean time of 36.3days (24e42 days) after conservative treatment. The patients who underwent arthroscopic surgeryreturned to training for a mean time of 49.8 days (42e56 days) after the surgery. All athletes returned totheir previous level of competition after treatment without any complications or recurrence in a meanfollow-up 36.5 months (19e77 months).Conclusion: Non-surgical treatment modalities were effective in 2/3 of posterior ankle impingementsyndrome in elite football players. On the other hand, posterior ankle arthroscopy is safe and effectivetreatment option for posterior ankle impingement syndrome if the conservative treatment fails.Level of evidence: Level IV, Therapeutic study