Session Information
Date: Thursday, November 14, 2019
Session Title: Musculoskeletal and Sports Medicine Research Report
Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 8
Disclosures: Richard J. Lawley, MD: Nothing to disclose
Objective: To evaluate the work up and outcomes of athletes with exertional leg pain, specifically the relationship of functional popliteal artery entrapment syndrome (FPAES) and chronic exertional compartment syndrome (CECS), in athletes unable to return to sport or have significant symptomatic improvement after lower leg compartment fasciotomy.
Design: Retrospective case series
Setting: Outpatient clinic – musculoskeletal sports, vascular surgery.
Participants: 36 patients aged 15-67 (average 26.9) diagnosed with FPAES using provocative maneuvers with CT-angiogram with MRI-angiogram. A moderate number (12/36 athletes, 21/58 affected limbs) were referred to vascular surgery for evaluation after having prior fasciotomies for CECS.
Interventions: Partial debulking of anterolateral quadrant of the medial head of the gastrocnemius muscle with or without fasciotomy.
Main Outcome Measures: Return to sport/previous activities.
Results: Mean follow up was 52.3 ± 22.2 months. 78% (28/36) of the patients were able to fully return to their previous athletic competitive levels. All patients were able to resume their athletic sport at a recreational level. Of the patients who had a previous fasciotomy, the distribution of the compartment releases are as follows: anterior in 2 limbs, anterolateral in 5 limbs, posterior in 2 limbs, four compartment in 3 limbs, and 9 were unspecified. The patients participated in a myriad of sports: 14 runners, 9 soccer, 3 unspecified, 2 lacrosse, 2 basketball, 1 triathlete, 1 jumper, 1 diver, 1 water polo, 1 rugby, 1 skier.
Conclusions: Many of the patients that fully returned to sport were unable to return to participate in high levels at their respective sport even after initial fasciotomy for CECS, suggesting that FPAES was unidentified or overlooked. Provocative CT-A and MRI-A protocols can guide the diagnosis as well as location of muscle debulking to alleviate functional entrapment that occurs in these athletes. It is important to make this diagnosis to allow for proper return to sport, decrease time missed.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Lawley RJ, Fredericson M. Identification of Functional Popliteal Artery Entrapment Syndrome in Athletes Who Have Failed Compartment Release [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/identification-of-functional-popliteal-artery-entrapment-syndrome-in-athletes-who-have-failed-compartment-release/. Accessed September 7, 2024.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/identification-of-functional-popliteal-artery-entrapment-syndrome-in-athletes-who-have-failed-compartment-release/