The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases

Christer G Rolf, Caroline Barclay, Masoud Riyami and John George

Ankle sprains are common in sports and can sometimes result in a persistent pain condition. The purpose of this study was to evaluate clinical symptoms, signs, diagnostics and outcomes of surgery for symptomatic chondral injuries of the talo crural joint in athletes, and to evaluate the accuracy of MRI in detecting these injuries.  Over 4 years 61 consecutive athletes with symptomatic chondral lesions to the talocrural joint causing persistent exertion ankle pain were studied.  The main subjective complaint was exertion ankle pain (93%), effusion (75%) and joint line tenderness on palpation (92%) were the most common clinical findings. Arthroscopy identified 75 cartilage lesions. MRI had been performed pre operatively in 39% and 59% of these had been interpreted as normal. Detection rate of cartilage lesions was only 19%, but subchondral oedema was present in 55%. The authors conclude that arthroscopy should be considered early when an athlete presents with exertion ankle pain, effusion and joint line tenderness on palpation after a previous sprain. Also, conventional MRI is not reliable for detecting isolated cartilage lesions, but the presence of subchondral oedema should raise such suspicion.

Journal of Orthopaedic Surgery and Research 2006, 1:4

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