Journal article
CAM-type impingement in the ankle
The Iowa orthopaedic journal, Vol.32, pp.1-8
2012
PMCID: PMC3565388
PMID: 23576914
Appears in Diamond Open Access
Abstract
Anterior ankle impingement with and without ankle osteoarthritis (OA) is a common condition. Bony impingement between the distal tibia and talus aggravated by dorsiflexion has been well described. The etiology of these impingement lesions remains controversial. This study describes a cam-type impingement of the ankle, in which the sagittal contour of the talar dome is a non-circular arc, causing pathologic contact with the anterior aspect of the tibial plafond during dorsiflexion, leading to abnormal ankle joint mechanics by limiting dorsiflexion.
A group of 269 consecutive adult patients from the University of Iowa Hospitals and Clinics who were treated for anterior bony impingement syndrome were evaluated as the study population. As a control group, 41 patients without any evidence of impingement or arthrosis were evaluated. Standardized standing lateral ankle radiographs were evaluated to determine the contour of the head/neck relationship in the talus. Two investigators made all the radiographic measurements and intra- and inter-observer reliability were measured.
34% of patients were found to have some anterior extension of the talar dome creating a loss of the normal concavity at the dorsal medial talar neck. A group of 36 patients (13%) were identified as having the most severe cam deformity in order to assess any correlation with coexisting radiographic abnormalities. In these patients, a cavo-varus foot type was more commonly observed. Comparison with a control group showed much lower rates of anterior-medial cam-type deformity of the talus.
Cam type impingement of the ankle is likely a distinct form of bony impingement of the ankle secondary to a morphological talar bony abnormality. Based on the findings of this study, this form of impingement may be related to a cavovarus foot type. In addition, there may be long term implications in the development of ankle OA.
Level III.
Details
- Title: Subtitle
- CAM-type impingement in the ankle
- Creators
- Ned Amendola - University of Iowa Hospitals and Clinics Iowa City, IA 52242, USA. Ned-amendola@uiowa.eduNewhoff DrewTanawat VaseenonJohn FeminoYuki TochigiPhinit Phisitkul
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.32, pp.1-8
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 23576914
- PMCID
- PMC3565388
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 2012
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040328102771
Metrics
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