PDF(Sci-hub)
Abstract：
BACKGROUND: Open surgical excision of the os trigonum has been the traditional treatment for posterior ankle impingement syndrome (PAIS). However, the endoscopic excision has recently become quite popular. Purpose/Hypothesis: The purpose of our study was to compare the results of endoscopic versus open excision of a symptomatic os trigonum for the treatment of PAIS in an athletic population. It was hypothesized that the endoscopic technique would be superior to the open technique regarding functional outcomes, pain, and time to return to training and the previous sports level.
METHODS: Randomized controlled trial; Level of evidence, 2.
METHODS: From 2008 to 2011, 52 athletes underwent a symptomatic os trigonum excision; 26 athletes had an open procedure (group A) and 26 had an endoscopic procedure (group B). The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and the Visual Analog Score-Foot and Ankle (VAS-FA) were obtained, and the time to return to training and to previous sports level was recorded.
RESULTS: Patients in group B appeared to have significant improvement of AOFAS hindfoot score compared with those in group A ( P < .05), whereas no statistical significance was found for the postoperative VAS-FA scores between the 2 groups. The mean ± SD time to return to training was 9.58 ± 3.98 weeks for group A and 4.58 ± 1.47 weeks for group B ( P < .001). The time to return to previous sports level was 11.54 ± 3.89 weeks for group A and 7.12 ± 2.25 weeks for group B ( P < .001). The overall complication rate was 23% for group A (6 cases) and 3.8% for group B (1 case).
CONCLUSIONS: Both the open procedure and the endoscopic approach yielded acceptable outcomes in terms of function and pain. However, complication rates were remarkably lower with endoscopic treatment, and the time to return to full activities was much shorter. Endoscopic excision of the os trigonum is a safe and effective treatment option for athletes who require early return to their previous sports level.
METHODS: Randomized controlled trial; Level of evidence, 2.
METHODS: From 2008 to 2011, 52 athletes underwent a symptomatic os trigonum excision; 26 athletes had an open procedure (group A) and 26 had an endoscopic procedure (group B). The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and the Visual Analog Score-Foot and Ankle (VAS-FA) were obtained, and the time to return to training and to previous sports level was recorded.
RESULTS: Patients in group B appeared to have significant improvement of AOFAS hindfoot score compared with those in group A ( P < .05), whereas no statistical significance was found for the postoperative VAS-FA scores between the 2 groups. The mean ± SD time to return to training was 9.58 ± 3.98 weeks for group A and 4.58 ± 1.47 weeks for group B ( P < .001). The time to return to previous sports level was 11.54 ± 3.89 weeks for group A and 7.12 ± 2.25 weeks for group B ( P < .001). The overall complication rate was 23% for group A (6 cases) and 3.8% for group B (1 case).
CONCLUSIONS: Both the open procedure and the endoscopic approach yielded acceptable outcomes in terms of function and pain. However, complication rates were remarkably lower with endoscopic treatment, and the time to return to full activities was much shorter. Endoscopic excision of the os trigonum is a safe and effective treatment option for athletes who require early return to their previous sports level.
摘要：
背景：开放手术切除三角骨一直是后踝关节撞击综合征（PAIS）的传统治疗方法。然而,内窥镜切除最近变得相当流行。目的/假设：我们研究的目的是比较内窥镜和开放切除有症状的三角骨治疗运动人群PAIS的结果。据推测，在功能结局方面，内窥镜技术将优于开放技术，疼痛,和时间回到训练和以前的运动水平。
方法：随机对照试验；证据水平，2.
方法：从2008年到2011年，52名运动员接受了有症状的三角骨切除术；26名运动员接受了开放手术（A组），26名运动员接受了内窥镜手术（B组）。获得了美国骨科足踝协会（AOFAS）后足评分和足踝视觉模拟评分（VAS-FA），并记录了恢复训练和以前运动水平的时间。
结果：与A组相比，B组患者的AOFAS后足评分明显改善（P<0.05），而两组间术后VAS-FA评分无统计学意义.恢复训练的平均±SD时间A组为9.58±3.98周，B组为4.58±1.47周（P<.001）。A组恢复运动水平的时间为11.54±3.89周，B组为7.12±2.25周（P<0.001）。A组（6例）总并发症发生率为23％，B组（1例）为3.8％。
结论：开放手术和内镜方法在功能和疼痛方面均取得了可接受的结果。然而,内镜治疗的并发症发生率明显降低，恢复全面活动的时间要短得多。对于需要尽早恢复到以前运动水平的运动员，内窥镜切除三角是一种安全有效的治疗选择。
方法：随机对照试验；证据水平，2.
方法：从2008年到2011年，52名运动员接受了有症状的三角骨切除术；26名运动员接受了开放手术（A组），26名运动员接受了内窥镜手术（B组）。获得了美国骨科足踝协会（AOFAS）后足评分和足踝视觉模拟评分（VAS-FA），并记录了恢复训练和以前运动水平的时间。
结果：与A组相比，B组患者的AOFAS后足评分明显改善（P<0.05），而两组间术后VAS-FA评分无统计学意义.恢复训练的平均±SD时间A组为9.58±3.98周，B组为4.58±1.47周（P<.001）。A组恢复运动水平的时间为11.54±3.89周，B组为7.12±2.25周（P<0.001）。A组（6例）总并发症发生率为23％，B组（1例）为3.8％。
结论：开放手术和内镜方法在功能和疼痛方面均取得了可接受的结果。然而,内镜治疗的并发症发生率明显降低，恢复全面活动的时间要短得多。对于需要尽早恢复到以前运动水平的运动员，内窥镜切除三角是一种安全有效的治疗选择。
