Anterolateral Ankle Impingement due to Bassett’s Ligament

Category: Arthroscopy; Ankle Introduction/Purpose: The Bassett’s ligament, an accessory band of the anterior inferior tibiofibular ligament (AITFL), is known to be a normal ligamentous structure present in 21-92% of cases. The Bassett’s ligament is also known as a structure that causes anterolateral impingement of the ankle joint after an ankle sprain. However, not much is known about the cause or prognosis of anterolateral impingement by Bassett's ligament. In this study, the symptoms, characteristics, and postoperative results of impingement by Bassett's ligament were reported. Methods: From November 2017 to August 2021, 12 patients who underwent surgical treatment for pain in the anterolateral aspect of the ankle joint, which did not improve with conservative treatment, were enrolled. There were 5 males and 7 females, and the average age was 34.4 years (21-76). The symptoms complained of by the patients and accompanying injuries were analyzed. And the arthroscopic findings and postoperative results were analyzed. Results: All patients had a history of ankle sprain before symptoms. All patients complained of pain and tenderness in the anterolateral aspect of the ankle joint, and the pain improved after injection of lidocaine. And 3 patients (25%) complained of snapping during ankle ROM. Ankle instability was present in 10 patients (83.3%), and OLT was present in 2 patients (16.7%). Arthroscopic findings showed that the Bassett’s ligament impinged with the anterolateral aspect of the talar dome during ROM in all cases. And synovitis was found around the Bassett ligament in all cases, fraying of the Bassett ligament in 5 cases (41.7%), and fraying of the cartilage of the dome of the talus in 4 cases (33.3%). Anterolateral ankle pain disappeared in all patients after surgery. Conclusion: Impingement between the talar dome and the Bassett’s ligament should be considered as one of the causes of anterolateral ankle pain, especially in patients with ankle sprains.