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Endoscopic treatment for posterior ankle impingement: high patient satisfaction and low recurrence rate at long-term follow-up
  1. Ruben Zwiers1,2,3,
  2. Thomas P A Baltes1,2,3,
  3. Johannes I Wiegerinck1,2,3,
  4. Gino M M J Kerkhoffs1,2,3,
  5. C Niek van Dijk1,2,3
  1. 1 Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands, Amsterdam, The Netherlands
  2. 2 Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam, The Netherlands
  3. 3 Amsterdam Collaboration on Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
  1. Correspondence to Dr Ruben Zwiers, Academic Medical Center, Department of Orthopedic Surgery, University of Amsterdam, Amsterdam 22660, The Netherlands; r.zwiers{at}


Objectives Good short-term outcomes have been described for endoscopic treatment of posterior ankle impingement. However, long-term outcome is unknown. The aim of this study is to determine the long-term patient satisfaction after endoscopic treatment and evaluate the recurrence rate of posterior ankle impingement. In addition, the aim of this study is to identify factors associated with favourable long-term outcome.

Methods A consecutive series of patients treated endoscopically for posterior ankle impingement between 2000 and 2011 in the Academic Medical Centre in Amsterdam were retrospectively reviewed. Primary outcome was patient satisfaction. Secondary outcome measures were function, pain, recurrence rate and Foot Ankle Outcome Scores. In addition, factors associated with long-term outcome were identified.

Results Two-hundred and three patients with 5–15 years of follow-up were included. Median satisfaction score was 8/10 and for 9/10 for function . Patients had no pain at follow-up. Outcome was similar for different types of impingement and type or level of sport participation. Symptoms recurred in 5% of the patients. In a multivariable analysis, additional flexor hallucis longus (FHL) tendinopathy was associated with lower satisfaction and a higher recurrence rate.

Conclusion Long-term outcome of endoscopic treatment for posterior ankle impingement demonstrated good results, with high patient satisfaction, good functional outcome scores and a low rate of recurrence for all types of posterior ankle impingement. Type and level of sports did not influence outcome. Only the presence of FHL tendinopathy was associated with lower satisfaction and a higher recurrence rate.

Level of evidence Level IV.

  • ankle
  • impingement
  • arthroscopy
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  • Contributors Conception or design of the work; drafting the article: RZ, JIW. Data collection: RZ, TPAB. Data analysis and interpretation: RZ. Critical revision of the article; final approval of the version to be published: All authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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