Ventral and Dorsal Impingement - Diseases of the Ankle Joint - CENTRE FOR ORTHOPAEDICS, SPORTS MEDICINE AND REHABILITATION - Dr. Erich H. Rembeck

Ventral and Dorsal Impingement

Ventral and dorsal impingement (constriction/ bony growths/ excessive bone formation/ osteochondral fragments)

The anterior and posterior impingement (constriction) of the upper and lower ankle joint is frequently felt by patients as a painful, sharp sensation in the context of extended bending or stretching of the ankle joint. These sensations are frequently the consequence of a constriction of soft tissues and excessive bone formation on the joint after compression or strain injuries. The disease is frequently triggered by reoccurring, small injuries in terms of twisting or roll-over trauma or impact accidents. The clinical picture is typical for footballers due to reoccurring kicks.

For diagnostic evaluation, conventional x-rays frequently suffice. If it is the case that these do not provide adequate information about the origin of the disease, an MRI scan is necessary.

Therapy

The therapy for anterior or posterior constriction of the ankle joint is directed towards the reconstruction of full, pain-free joint movement. In general, this can be achieved by undertaking a minimally invasive intervention (ankle joint endoscopy / arthroscopy). Here, the scar-tissue, excessive bone growths and if necessary, cartilaginous peeling are removed. For posterior constriction symptoms, a hind foot arthroscopy (joint endoscopy) is indicated. The hind foot arthroscopy procedure is one of the newest procedures of ankle joint arthroscopy, and brings many advantages to the experienced surgeon for unclear hind foot pain. Using this method, old adhesions, cartilaginous fragments or bony growths can be detached and minimally invasively removed.

Aftercare

In most cases after an ankle joint endoscopy to remove anterior or posterior constriction symptoms, a two week partial weight-bearing phase should be maintained. During this time, all kinds of physiotherapeutic methods, as well as de-blocking methods can be undertaken.

Ability to work

The recommencement of light office work can occur after approx. one week. At this time the use of under-arm crutches can frequently be dispensed of.

Ability to do sport

Running and jumping sport types should be avoided for four weeks after surgery. Medical machine training can normally be started from the second week. From the fourth week a change to competiton training can occur.