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THE FUNCTIONALLY UNSTABLE ANKLE AND IMPINGEMENT LESIONS



Abstract

The functionally unstable ankle with giving way or with lack of confidence in the ankle, without major ligamentous laxity, is a common problem in sportsmen and women. The aim of this study was to record the arthroscopic findings in patients with ankle problems, a history of ankle injury, and continuing functional instability.

We reviewed the findings of 90 consecutive ankle arthroscopies in patients suffering from ankle problems interfering with sport. All complained of a combination of pain on sporting activity (38%), a lack of trust in the ankle (30%), or the ankle letting them down when running or turning (22%).

Results showed that isolated lesions identified at arthroscopy were uncommon (7%). 40% had synovitis, often associated with scarring or thickening around the anterior talo-fibular ligament (ATFL). Anterior tibial osteophytes were found in 45% and chondral or osteochondral talar lesions were present in 53%. The majority (80%) also had a lesion in the inferior tibiofibular joint (ITFJ). The ITFJ lesions were often firm, impinging within the ankle joint, and were associated with synovitis. All ankle lesions were arthroscopically resected.

The importance of ATFL impingement lesions, sometimes called meniscoid lesions, has previously been described. We would draw attention to the IFTJ lesions, which were common in our series of unstable ankles, and which we believe are part of the pathology of this condition.

The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom