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Analysis of ankle pathologies related to symptomatic medial impingement of the ankle in non-athletes
Arthrosc Orthop Sports Med 2024;11:57-63
Published online November 1, 2024;  https://doi.org/10.14517/aosm24009
© 2024 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Jun Young Choi, Jin Soo Suh, Do Yeon Kim

Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea
Correspondence to: Jun Young Choi, https://orcid.org/0000-0002-3864-9521
Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea. Tel: +82-31-910-7968, Fax: +82-31-910-7967, E-mail: osddr8151@paik.ac.kr
Received August 21, 2024; Revised October 2, 2024; Accepted October 4, 2024.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Despite reports on the occurrence and treatment of medial impingement of the ankle (MIA) in athletes, the causes and accompanying pathology in non-athletes remain unknown. This study aimed to identify the pathologies associated with symptomatic MIA in non-athletes.
Methods: Between 2015 and 2024, this observational study enrolled 354 nonathletic outpatients who presented MIA on radiographs, regardless of typical MIA symptoms. The enrolled patients were grouped according to MIA-related symptoms, and several parameters were compared regarding ankle sprain history, standing and stress ankle radiographs, and hindfoot alignment radiographs. Patients with symptomatic MIA were evaluated by magnetic resonance imaging (MRI) for more detailed information regarding pathology.
Results: Of the 354 participants, 38 were symptomatic (10.7%). Compared with the asymptomatic group, the symptomatic group was significantly older and had higher rates of recent ankle sprains in the preceding three months (all, P < 0.001). Radiographically, a medial osteochondral lesion of the talus (OLT) was significantly more common than other lesions, and the incidence of anterior and varus instabilities was more significant in the symptomatic group (all, P < 0.001). In the symptomatic group, MRI revealed that the medial OLT was observed in 81.6% of the patients, and anterior talofibular ligament abnormality was identified in 100%.
Conclusion: This study revealed only a small portion of patients with MIA who presented with the related symptoms, and they do so under certain conditions. Older male patients with a recent history of an ankle sprain revealed susceptibility to MIA symptoms. Based on our results, thorough examinations for ankle instability and medial OLT should be actively considered during the initial assessment.
Keywords : Ankle; Anteromedial impingement; Medial impingement; Instability; Osteochondral lesion
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November 2024, 11 (2)
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