What is Anterior Ankle Impingement?
Anterior impingement of the ankle is a common cause of ankle pain. There are two main types of impingement, boney or soft tissue. Bone impingement can result from an ankle fracture, secondary to instability, or from repetitive loading in a position of ankle dorsiflexion (noted especially in athletes). Soft tissue impingement can occur without a previous injury, or more commonly in the setting of previous ankle sprains and fractures. Patients oftentimes feel impingment with higher level activities such as sports and especially in a position of dorsiflexion, that is, when the patient brings the knee above and in front of the foot, such as when squatting or jumping. Ankle impingement causes pain across the front of the ankle joint typically. A difference in ankle range of motion when compared to the other side is oftentimes reported.
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Non-operative Treatments for Anterior Ankle Impingement
The non-operative treatment includes injections, NSAIDS, and activity modification. If ankle instability, typically experienced by the patient as repetitive ankle sprains, is contributing to the problem, an ankle brace may be helpful to prevent the excessive and abnormal movement about the ankle.
Surgical Treatment for Anterior Ankle Impingement
Surgical treatment is best performed with arthroscopy, and includes removal of bone and soft tissues causing impingement. During the procedure, the ankle can be tested to simulate normal motion and to ensure the extent of decompression. The success rate with arthroscopic treatment is high, and other injuries within the joint can be diagnosed and treated at the same time. Dr Carreira has published a review of the treatments of ankle impingement in JBJS Reviews, a prestigious journal in orthopedics that is read about orthopedic surgeons internationally.