Successful Treatment of Anterior Knee Impingement Syndrome in Taekwondo Athletes / 대한정형외과학회잡지

Fat pad hypertrophy, degeneration and scar tissue at the anterior knee in Taekwondo athletes can occur due to repetitive training such as kicking. This scar tissue can cause pain at the anterior compartment of the knee joint by impingement during knee flexion and extension. We obtained good results for treating anterior impingement syndrome by performing arthroscopic resection, and we also report on the relevant medical literature.

Anterior Impingement Syndrome of the Ankle / 대한족부족관절학회지

Impingement syndrome of the ankle is defined as painful mechanical limitation of full ankle movement secondary to osseous and/or soft tissue abnormality. These conditions occur more commonly in active people and athletes probably because recurrent subclinical injury is an important factor in development of the syndrome. Impingement syndromes of the ankle are categorized according to their anatomical site around the ankle joint. Anterolateral, anterior and posterior impingement has been extensively described in the orthopaedic literature. The purpose of this article is to review the clinical feature and management of anterior impingement syndrome of the ankle.

Fracture of a Polyethylene Tibial Post in a Scorpio Posterior-Stabilized Knee Prosthesis

We report the case of a polyethylene tibial post fracture in a 72-year-old woman 14 months after a Scorpio posterior-stabilized (PS) total knee arthroplasty. The polyethylene wear was found around the fracture site of the post, especially over the anterior aspect of the post base. The failure mechanism of the post fracture in the present case was anterior impingement with excessive wear over the base of the anterior aspect of the tibial post, which became a stress-riser of post and cam articulation. This is the first report of a polyethylene tibial post fracture of a Scorpio PS prosthesis.

Open Ostectomy of Anterior Impingement Syndrome: Comparison of Athletes and Nonathletes / 대한정형외과학회잡지

PURPOSE: To analyse the clinical results of open treatment of anterior impingement syndrome of the ankle and to determine if being athletics or nonathletics affects the result. MATERIALS AND METHODS: This study included 54 consecutive patients who had undergone surgery with an open modality. All had been diagnosed with anterior impingement syndrome and received conservative therapy for more than at least 3 months prior to surgery. Among them, 22 patients were high-level athletes. The patients were evaluated with a physical examination and simple radiograph. A bone scan or MRI were added if necessary. The patients were categorized into four groups according to the McDermott's grading system based on the lateral radiograph. Patients with McDermott's grade 4 change and with osteochondral lesions were excluded. The results of the Ogilvie-Harris score, a visual analogue scale of the patient satisfaction and the time to return to full activity were assessed. RESULTS: The mean follow-up was 32 months, 82% of patients had good or excellent results. In general, the Ogilvie Harris score improved postoperatively. However, there was no significant difference between groups. There was no statistical significance between the athletics and non-athletics in terms of the improvement in the Ogilvie-Harris score. 91% of patients were satisfied in the final follow-up (more than 80% in the visual analogue scale). The mean time to return to full activity was 10.5 weeks with the athletes and 8.8 weeks with the nonathletes. CONCLUSION: Open surgical treatment for anterior impingement syndrome may be an effective modality regardless of the patient being an athlete or non-athlete.

Open Treatment of Anterior Impingement Syndrome of the Ankle in Elite Level Soccer Players / 대한족부족관절학회지

PURPOSE: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. MATERIALS AND METHODS: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. RESULTS: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. CONCLUSION: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

Anterior impingement of the Ankle Treated by Arthroscopic Removal of bony Spur / 대한정형외과학회잡지

From September 1992 to April 1994, we reviewed 7 patients after arthroscopic surgery for anterior impingement in the ankle, who complained ankle pain and limitation of motion. All patients were mem and main symptoms were severe pain at full dorsiflexion of ankle and limitation of motion. Bony spur was located on the anterior aspect of tibia, and it was possible to resect the tibial bony spur arthroscopically without distraction devices. Mean operation time was 55 minutes. Pain, swelling and limitation of motion were much improved. There was no postoperative complication. Arthroscopic resection of the anterior tibial bony spur is an effective treatment for anterior impingement in the ankle.