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Hindfoot Endoscopy for the Treatment of Posterior Ankle Impingement Syndrome: A Comparison of Two Methods (a Standard Method versus a Method Using a Protection Cannula)
J Korean Foot Ankle Soc 2018;22:26-31
Published online March 15, 2018;
© 2018 Korean Foot and Ankle Society

Eung-Soo Kim, Chang-Rak Lee*, Young-Jun Kim*, Sang-Myung Roh*, Jae-Keun Park, Heui-Chul Gwak*, Sun-Gyu Jung*

Department of Orthopedic Surgery, Gwangmyeong Saeum Hospital, Gwangmyeong,
*Department of Orthopedic Surgery, Inje University Busan Paik Hospital,
Department of Orthopedic Surgery, Dongrae Bongseng Hospital, Busan, Korea
Correspondence to: Heui-Chul Gwak
Department of Orthopedic Surgery, Inje University Busan Paik Hospital, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea
Tel: 82-51-890-6129, Fax: 82-51-890-6619, E-mail:
Received April 13, 2017; Revised October 23, 2017; Accepted November 20, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: The purpose of this study is to compare the clinical results between two different methods of hindfoot endoscopy to treat posterior ankle impingement syndrome.
Materials and Methods: Between January 2008 and January 2014, 52 patients who underwent hindfoot endoscopy were retrospectively reviewed. Two methods of hindfoot endoscopy were used; Group A was treated according to van Dijk and colleagues’ standard two-portal method, and group B was treated via the modified version of the above, using a protection cannula. For clinical comparison, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, time required to return to activity, and the presence of complications were used.
Results: There was no statistically significant difference in the AOFAS scores at the final follow-up, and there was also no statistically significant difference in the times for the scores to return to the preoperative level. There were no permanent neurovascular injuries and wound problems in either group.
Conclusion: Use of protection cannula may provide additional safety during hindfoot endoscopy. We could not prove whether protection cannula can provide superior safety for possible neurovascular injury. Considering the possible safety and risk of using additional instrument, the use of this method may be optional.
Keywords : Hindfoot, Endoscopy, Os trigonum

March 2018, 22 (1)