A PROSPECTIVE-STUDY OF PROGNOSTIC FACTORS CONCERNING THE OUTCOME OF ARTHROSCOPIC SURGERY FOR ANTERIOR ANKLE IMPINGEMENT

Sixty-two consecutive patients with painful limited dorsiflexion of th e ankle not responding to nonoperative treatment participated in a pro spective study, All 42 men and 20 women (average age, 31 years) underw ent arthroscopic surgery, Preoperative radiographs were graded accordi ng to an osteoarthritic and an impingement classification, Standardize d followup took place at 4 months and 1 and 2 years after surgery, Res ults showed that the degree of osteoarthritic changes is a better prog nostic factor for the outcome of arthroscopic surgery for anterior ank le impingement than size and location of the spurs. The hypothesis is that osteophytes without joint space narrowing are not a manifestation of osteoarthritic changes but rather the result of local (micro)traum a. After 2 years, 73% of the patients experienced overall excellent or good results; 90% of those without joint space narrowing had good or excellent results, and 50% of those with joint space narrowing had goo d or excellent results. At the 2-year followup, the group without join t space narrowing showed significantly better scores in pain, swelling , ability to work, and engagement in sports, This study also revealed that patients with less than 2 years of ankle pain before surgery and spurs located anteromedially were more satisfied with the outcome than when longer periods of preoperative pain were involved and when spurs were located anterolaterally.