Anterior ankle impingement surgery is an arthroscopic procedure to remove bone spurs and soft tissue from the front of the ankle that cause pain and restriction during ankle dorsiflexion — commonly known as 'footballer's ankle'.
Performed arthroscopically through two small incisions at the front of the ankle. Bone spurs (osteophytes) on the front of the tibia and talus are removed with a burr. Thickened, impinging soft tissue and synovium are debrided. Loose bodies are removed if present. The operation takes 30–45 minutes and is usually a day case.
Surgery is recommended for anterior ankle pain and stiffness during dorsiflexion (bending the ankle up) that has not responded to physiotherapy, injection, and activity modification. It is common in footballers, dancers, and runners.
Physiotherapy (ankle mobilisation and strengthening), corticosteroid injection, activity modification, and heel raises to reduce dorsiflexion demand.
X-rays showing anterior osteophytes. MRI to assess for associated pathology. Day-case procedure.
Relief of anterior ankle pain and improved dorsiflexion in approximately 85–90% of patients. Good outcomes for return to sport.
For two to four weeks.
Osteophytes may regrow over time, particularly if the provocative activity continues.
Superficial peroneal nerve near the anterolateral portal. Usually temporary.
Permanent damage to the superficial peroneal or deep peroneal nerve.
Joint infection.
Inadvertent damage during bone spur removal.
Anterior tibial artery is nearby. Very rare.
General, spinal, or ankle block anaesthesia.
Weight-bearing immediately. Ankle exercises from day one. Return to running at four to six weeks. Return to sport at six to eight weeks. Full recovery two to three months.
Review at two weeks. Further follow-up as needed.
Osteophytes may regrow over time, particularly if the sport or activity that caused them continues. However, many patients enjoy years of relief.
Anterior impingement can occur with or without arthritis. Isolated anterior impingement (footballer's ankle) responds well to arthroscopic debridement. If there is generalised ankle arthritis, the results are less predictable.