Safety and Clinical Efficacy of Double Posterolateral Coaxial Portals for Endoscopic Management of Posterior Ankle Impingement Syndrome

Abstract Double Posterolateral Coaxial Portals has been designed by us for Endoscopic Management of Posterior Ankle Impingement. This study’s purpose was analyzed the safety and clinical efficacy of this new designed portals. Six fresh foot samples were randomly selected. The distances of two posterolateral portals to sural nerve in the neutral, dorsiflexion and plantar flexion positions were measured to evaluate the safety. The clinical efficacy of the operative approach for endoscopic management of posterior ankle impingement syndrome was prospectively analyzed, and its effectiveness and complications were evaluated. In 6 samples, the mean distances of the first and second portals to sural nerve were 2.26 ± 0.22 cm and 1.59 ± 0.12 cm in the neutral position,2.21 ± 0.21 cm and 1.55 ± 0.12 cm in the dorsiflexion 30°position, and 2.46 ± 0.29 cm and 1.73 ± 0.19 cm in the plantar flexion 30°position; thus, two portals had a big safety distance to sural nerve. Totally 38 patients received the endoscopic treatment of posterior ankle impingement syndrome with double posterolateral coaxial portals from January 2012 to December 2017. Such operative approach provided a full field of subtalar joint and posterior ankle during operation. The mean follow-up time was 28.2 (range, 24–72) months, the satisfaction rate was 94.7%; none of patients experienced complications; VAS score was decreased to 0.50 at the last visit from 5.82 before operation(P < .001), while AOFAS score was increased to 92.34 from 71.68, and the differences were both statistically significant (P < .001); the excellent/good rate was 97.3℅. In treating posterior ankle impingement syndrome, double posterolateral coaxial portals have such advantages of good safety, miniature nerve injury, a good field of posterior ankle and subtalar joint, good clinical efficacy, and few complications, thus they are an operative approach which is reliable, effective, safe and worthy of being popularized.