Ankle Impingement

Ankle impingement is pain and stiffness of the ankle usually without instability. This usually occurs when the ankle ligament heals with abundant scar tissue or synovitis (inflammation of the joint capsule). It is important to obtain a MRI to rule out other causes of pain and stiffness inside the ankle joint such as a talar osteochondral lesions. If the patient does not respond to physical therapy for impingement, then a cortisone injection can be considered to "break up" the scar tissue. Multiple cortisone injections are usually not recommended since they can cause long-term cartilage damage. If the effect of the cortisone injection is only temporary, then ankle arthroscopic removal or debridement of the scar tissue can be considered. This is done arthroscopically. The surgery is an outpatient(ambulatory) procedure performed under general anesthesia or regional block with sedation. The patient is discharged with crutches, but can place weight on the ankle when they feel comfortable. Physical therapy begins around two weeks after the sutures are removed. The patient advances their activities as they respond to strengthening with physical therapy.