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Clinical Outcomes of Nano Arthroscopy in the Office Setting for the Treatment of Posterior Ankle Impingement

2021 Congress Paper Abstracts

Clinical Outcomes of Nano Arthroscopy in the Office Setting for the Treatment of Posterior Ankle Impingement

Nathaniel P Mercer, MS, UNITED STATES John F Dankert, MD, PhD, UNITED STATES Alan P. Samsonov, BS, UNITED STATES Tobias Stornebrink, MD, NETHERLANDS Gino M. M. J. Kerkhoffs, MD, PhD, Prof., NETHERLANDS John G. Kennedy, MD, FRCS, UNITED STATES

NYU Langone Health, New York, NY, UNITED STATES


2021 Congress   Abstract Presentation   5 minutes   Not yet rated

 

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Sports Medicine

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Summary: This study demonstrates that in-office needle arthroscopy (IONA) treatment of posterior ankle impingement results in significant pain reduction, a low complication rate and excellent patient reported outcomes with high rates of return to work/sport.


The hypothesis was that IONA in the treatment of posterior ankle impingement would provide the patient with a unique experience of their pathology and facilitate their rapid recovery through an awareness of their own condition, and that using IONA would accelerate recovery to sports-specific activities compared to the literature using standard arthroscopic procedures.

Methods

This was a retrospective cohort study investigating patients who underwent IONA for posterior ankle impingement between 2019 and 2020. Clinical outcomes were evaluated using the following methods preoperatively and at final follow-up: The Foot and Ankle Outcome Scores (FAOS) and Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference and Pain Intensity domains. A five-point Likert scale regarding patient satisfaction was evaluated at final follow-up. Wilcoxon signed-rank test was performed to compare preoperative and postoperative outcome scores.

Results

Ten patients were included in this study, which included 4 males and 6 females with a mean age of 41.9 ± 15.5 years (range, 24-66 years) and mean body mass index (BMI) of 28.3 ± 6.3 kg/m2 (range, 17.1 – 39.9). The mean follow-up time was 13.3 ± 2.9 months (range, 11-17 months). The mean postoperative FAOS-reported symptoms, pain, daily activities, sports activities, and quality of life were 80.3 ± 12.6, 78.2 ± 13.9, 77.93 ± 11.4, 76.0 ± 13.6 and 71.1 ± 12.1 at final follow-up respectively. The mean PROMIS Pain Intensity T-score significantly decreased from 57.5 ± 8.4 preoperatively to 49.5 ± 5.5 at final follow-up (p<0.001). The mean PROMIS Pain Interference T-score decreased from 69.0 ± 5.8 preoperatively to 63.1 ± 5.8 at final follow-up (p<0.001). There were 7 patients who participated in sports activity prior to IONA-arthroscopy procedure. Of those, 7 patients (100%) returned to their sports activities. The median time to return to sports was 4.1 weeks (range, 1 to 14 weeks). The median time to return to work was 3.4 days ± 5.3. Patients reported an overall positive experience with a mean rating scale of 9.5 ± 1.5 (range, 5 to 10). Nine patients (90%) reported the highest rating (10/10) for overall positive experience and felt that seeing their procedure in real time aided in their understanding of their underlying pathology. Lastly, 10 patients (100%) expressed willingness to undergo the same procedure again.

Conclusion

The current study demonstrates that IONA treatment of posterior ankle impingement results in significant pain reduction, a low complication rate and excellent patient reported outcomes with high rates of return to work/sport. Additionally, IONA for posterior ankle impingement leads to high patient satisfaction with a significant willingness to undergo the same procedure again.


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