Anterior Impingement / Arthroscopy

Anterior ankle impingement is a common cause of chronic ankle pain and restricted movement, especially in athletes and physically active individuals.

Often resulting from repeated microtrauma, previous ankle sprains, or bony overgrowth, anterior impingement occurs when soft tissue or bone blocks normal movement at the front of the ankle joint. When conservative treatments fail, ankle arthroscopy offers a minimally invasive and highly effective surgical solution.

At Perth Orthopaedic & Sports Medicine Centre, Dr Daniel Meyerkort provides expert diagnosis and treatment for anterior ankle impingement using the latest arthroscopic techniques. This article will explore the condition in detail, covering non-surgical and surgical management, the benefits and risks of arthroscopy, and how patients can expect to recover.

Understanding Anterior Ankle Impingement

Anterior ankle impingement is the painful entrapment of tissue at the front (anterior) of the ankle joint. It can be caused by:

  • Repetitive dorsiflexion (e.g. in sports like football, ballet, running)

  • Recurrent ankle sprains

  • Osteophyte formation (bony spurs)

  • Synovial or capsular thickening

  • Previous trauma or fractures

Common symptoms include:

  • Pain at the front of the ankle, especially when bending the ankle upwards

  • Stiffness or loss of range of motion

  • Swelling after activity

  • Catching or locking sensations in the joint

Diagnosis typically involves a thorough physical examination, imaging with X-ray or MRI, and assessment of functional movement.

Non-Surgical Management of Anterior Ankle Impingement

In early or mild cases of anterior impingement, non-surgical treatment can be effective. Options include:

1. Activity Modification

Avoiding aggravating activities like running on uneven surfaces or deep squatting can reduce symptoms.

2. Physiotherapy

A targeted rehabilitation program helps restore range of motion, improve ankle stability, and reduce impingement from soft tissue tightness. Dr Meyerkort often collaborates with experienced sports physiotherapists in Perth and regional areas.

3. Anti-Inflammatory Medication

NSAIDs can reduce inflammation and provide temporary relief.

4. Corticosteroid Injection

Ultrasound-guided injections may help reduce inflammation in cases where pain is severe or limiting function.

While these measures can relieve symptoms, they may not address the underlying bony impingement. Persistent or worsening pain often necessitates surgical treatment.

Surgical Management: Ankle Arthroscopy

Ankle arthroscopy is a minimally invasive procedure where small incisions are made to insert a camera and specialised instruments into the ankle joint. It allows Dr Meyerkort to visualise and treat the impingement with precision, preserving surrounding structures.

Indications for Arthroscopy:

  • Failure of non-operative treatment after 3-6 months

  • Persistent pain and functional limitation

  • Evidence of osteophytes or synovitis on imaging

  • Mechanical symptoms like catching or locking

The Procedure:

Performed as a day surgery at Hollywood Private Hospital, ankle arthroscopy involves:

  1. Small incisions (portals) at the front of the ankle

  2. Insertion of an arthroscope for direct visualisation

  3. Removal of bony spurs (osteophytes)

  4. Debridement of inflamed synovium or scar tissue

  5. Minimal disruption to ligaments or tendons

This keyhole approach offers faster recovery, less post-operative pain, and lower risk of complications compared to traditional open surgery.

Benefits of Ankle Arthroscopy

There are many advantages to arthroscopic management of anterior ankle impingement:

  • Minimally Invasive: Small incisions reduce trauma to surrounding tissues

  • Faster Recovery: Most patients resume normal activity within 6-12 weeks

  • Accurate Diagnosis and Treatment: Direct visualisation of the joint allows precise removal of impinging tissue or bone

  • Low Infection Risk: Compared to open surgery, infection and wound complications are rare

  • High Success Rate: Most patients experience significant symptom relief and improved mobility

Patients under the care of Dr Daniel Meyerkort benefit from comprehensive surgical planning, advanced arthroscopic techniques, and a personalised rehabilitation plan post-surgery.

Risks & Complications of Ankle Arthroscopy

While ankle arthroscopy is generally safe, as with any procedure, there are potential risks:

  • Infection

  • Bleeding or bruising

  • Nerve irritation or damage (causing temporary numbness)

  • Blood clots (DVT)

  • Persistent stiffness or swelling

  • Incomplete relief of symptoms if there is significant cartilage damage

Dr Meyerkort takes every precaution to minimise these risks, including pre-operative screening, sterile technique, and close post-operative follow-up.

Recovery and Rehabilitation

After surgery, patients typically wear a compression bandage and are advised to rest, elevate, and ice the ankle for the first few days. Weight-bearing is allowed as tolerated, and physiotherapy begins soon after to restore strength and motion.

A general recovery timeline is as follows:

  • Week 1–2: Reduced swelling, gentle range of motion exercises

  • Week 2–4: Begin walking normally, progress strength and balance training

  • Week 6–12: Return to sport or high-level activity

Return to sport varies depending on the extent of the surgery and the patient’s goals, but many athletes are back to training within 2–3 months.

Why Choose Dr Daniel Meyerkort at Perth Orthopaedic & Sports Medicine?

Dr Daniel Meyerkort is an experienced fellowship-trained orthopaedic surgeon with a special interest in sports ankle & knee. Based at Perth Orthopaedic & Sports Medicine Centre, he offers:

  • Expert assessment and diagnosis of complex ankle conditions

  • Access to advanced imaging and surgical facilities at Hollywood Hospital

  • Minimally invasive arthroscopic techniques tailored to the individual

  • Coordinated care with leading physiotherapists throughout WA

  • Telehealth consultations for regional patients across the state

Whether you're an elite athlete, weekend warrior, or experiencing ongoing ankle pain from a past injury, Dr Meyerkort provides world-class care with a personalised approach.

Anterior ankle impingement can significantly affect mobility and quality of life, especially in active individuals. While non-surgical treatments play an important role in early management, ankle arthroscopy provides a definitive solution when symptoms persist. With minimally invasive techniques, rapid recovery, and high success rates, patients under the care of Dr Daniel Meyerkort at Perth Orthopaedic & Sports Medicine Centre can expect expert management and outstanding outcomes.

West Perth & Hollywood Hospital Locations

If you are experiencing persistent ankle pain or suspect anterior ankle impingement, contact Perth Orthopaedic & Sports Medicine Centre to book a consultation with Dr Daniel Meyerkort. In-person and Telehealth appointments are available.