Posterior Ankle Impingement Syndrome in Non-athletic Population: Causes, Treatment Modalities and the Results of Endoscopic Treatment

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  • 1 Acibadem Healthcare Group Kayseri Hospital, Department of Orthopaedics and Traumatology, Kayseri, Turkey.
  • | 2 Koru Sincan Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.


Background: One of the common causes of posterior ankle pain is posterior ankle impingement syndrome (PAIS). Many studies about PAIS have been conducted on special groups such as athletes, dancers, and football players, whereas there has been no previous study of a non-athletic population. This study aimed to evaluate the causes and treatment methods of this syndrome in the non-athletic population and compare it with the athletic population.

Methods: A retrospective review was done and 28 of 46 patients (60.9%) recovered from two-staged conservative therapy. 18 of 46 patients (39.1%) who did not benefit from conservative treatment for three months, hindfoot endoscopy was applied. Patient data, including sex, age, occupation, and sports activity level, were recorded. The Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and Tegner score were recorded. Patient satisfaction was assessed with a 4-point Likert scale. All complications were recorded.

Results: The mean follow-up period was 27.4 months. At the final follow-up examination, the AOFAS hindfoot score had significantly improved from 66.4 to 96.8 (p<0.001). The Tegner activity score improved significantly from 4.6 to 8.8 (p<0.001). The VAS score was 6.4 and increased to 0.9 (p<0.001). Using the 4-point Likert Scale for patient satisfaction, 13 (72.2%) stated that the surgical procedure was excellent, and 4 (27.8%) stated it as good. The mean time to return to work was 4.2 weeks. As complications, only sural nerve dysesthesia was seen in 2 patients(11.1%).

Conclusions: This study can be considered of value as the first study to have evaluated PAIS in the non-athletic population. Conservative treatment showed good results as nearly two-thirds of the patients recovered. Hindfoot endoscopy applied to cases not responding to conservative therapy is a successful treatment with low complication rates.

Corresponding Author: Bertan Cengiz MD, Acibadem Healthcare Group Kayseri Hospital, Department of Orthopaedics and Traumatology, Kayseri, Turkey. (e-mail: