Soft Tissue Impingement: Etiology and Classification, Treatment, Arthroscopic Procedures. Pitfalls, and Tricks

Abstract

Soft tissue ankle impingement lesions have become a clinically interesting topic.

In 1943, Morris described this condition as “athletes’ ankle,” and McMurry (1950) referred to the disorder as “soccer ankle.” Many authors became interested in this pathological issue and viewed it as genuine syndrome: “anterior ankle impingement syndrome.”

This painful condition can be determined by the presence of osteophytes or soft tissue disorder resulting from chronic friction between the joint surfaces or after trauma.

Patients are generally young, often professional athletes, and complain of persistent pain affecting the ankle in the anterior or posterior compartments or both, sometimes associated with a reduced range of motion (ROM). Anterior impingement syndrome may be anterior, anterolateral or anteromedial. Plantarflexion and internal rotation are the most common causes of ligament injuries, resulting in the impingement syndrome.

Posterior ankle impingement is mainly present on forced plantarflexion and may be the result of an acute or chronic injury with a compression of the thick joint capsule or scar tissue between the calcaneus and the posterior tibial rim.

Arthroscopic treatment is an excellent solution for the treatment of anterior or posterior impingement syndrome, given the numerous advantages of this surgical technique. It is important for the surgeon to harvest precise anamnestic data to decide the proper therapeutic indications and treatment.