Arthroscopy combined with hardware removal for chronic pain after ankle fracture.

Purpose: The purpose of this study was to evaluate the effectiveness of arthroscopy combined with hardware removal for chronic pain after satisfactory healing of an ankle fracture. We hypothesized that combining hardware removal with arthroscopy for the intra-articular pathology would improve residual complaints more so than hardware removal alone.

Methods: The outcomes of the 53 young male patients with chronic pain after healed ankle fracture treated with two different therapeutic plans: (1) conservative treatment after hardware removal (group A) and (2) arthroscopic intervention with hardware removal (group B) were prospectively studied. Patients were reviewed preoperatively and 6 and 12 months postoperatively using American Foot and Ankle Society (AOFAS) scale.

Results: Median AOFAS scores improved from 74 (66-80) points to 76 (73-92) points in group A and from 75 (64-80) points to 85 (72-100) points in group B, and this improvement was significantly higher for patients in group B (p = 0.001).

Conclusions: This study supports the notion that when there is a definite diagnosis such as loose body, bony impingement, or anterolateral soft-tissue impingement causing chronic pain after healed ankle fracture, arthroscopic treatment with hardware removal is a better treatment option than hardware removal and conservative treatment.