Safety of Ankle Arthroscopy for the Treatment of Anterolateral Soft-Tissue Impingement

Purpose: To quantify the overall incidence of complications related to arthroscopic treatment of anterolateral soft-tissue ankle impingement. Methods: Electronic databases and relevant peer-reviewed sources, including OvidSP/Medline (http://ovidsp.tx.ovid.com) and Google Scholar, were systematically searched for the terms "anterolateral" AND "ankle" AND "impingement" OR " soft-tissue impingement" AND "arthroscopy." In addition, we manually searched common American and European (including British) orthopaedic and podiatric scientific literature for relevant articles. Studies were eligible for inclusion only if they included the following: a standard 2-portal anterior arthroscopic approach, a minimum mean follow-up of 12 months, and detailed descriptions of all complications encountered. Results: After we considered all the potentially eligible articles, 15 (28.8%) met our inclusion criteria for the study. There were a total of 396 patients (397 ankles), with 16 total complications (4%), 3 (0.8%) of which were major. The weighted mean patient age was 31.2 years, and the weighted mean follow-up was 33.7 months. Conclusions: The results of this systematic review showed an overall incidence of complications of 4%. The complications were categorically divided into major and minor complications, with a very low incidence of major complications (0.8%) and an acceptably low incidence of minor complications (3.3%). On the basis of these findings, arthroscopic treatment of anterolateral ankle soft-tissue impingement is a very safe procedure when indicated.