Novel Technique for Closed Reduction of an Irreducible Patella Dislocation in a Degenerative Knee.

Patellar dislocations commonly occur in young adults and often reduce spontaneously or with closed reduction in the emergency department. However, traumatic patellar dislocations in older adults pose unique challenges, often complicated by degenerative osteophytes that hinder standard closed reduction methods. When closed reduction proves ineffective, patients may necessitate arthroscopic or open surgical intervention. This case report details the experience of a 60-year-old man with a traumatic patellar dislocation resistant to standard closed reduction methods, attributed to impaction of the patella against a lateral femoral condyle osteophyte. We present a novel technique for addressing irreducible patellar dislocations through closed reduction, which has yet to be documented in existing literature.

Minimally Invasive Cheilectomy for Hallux Rigidus.

Hallux metatarsophalangeal joint cheilectomy is a joint-sparing technique that involves resection of the dorsal metatarsal head osteophytes; this may be achieved through minimally invasive and arthroscopic techniques. General indications for minimally invasive surgery (MIS) cheilectomy are mild-to-moderate hallux rigidus (Grades I-II) with symptomatic dorsal osteophytes causing dorsal impingement and/or shoe wear irritation in those who have failed extensive nonoperative management. The literature confirms equivalent outcomes to open cheilectomy; however, it is somewhat inconsistent regarding superiority. The theoretic benefits of MIS cheilectomy include better cosmesis, reduced wound complications, less soft tissue disruption, and faster recovery.

Dorsal Cheilectomy.

Dorsal cheilectomy refers to a surgical resection of the dorsal osteophyte from the first metatarsal head. It is most often performed in patients with hallux rigidus, who have little to no midrange pain of the first metatarsophalangeal joint. The procedure is simple, quick, and maintains range of motion. Additional advantages of this procedure include low morbidity, quicker postoperative recovery, avoidance of costly implants, and the fact that the procedure does not inhibit future conversion to an arthrodesis. These proposed advantages have led some authors to advocate for the use of a cheilectomy, even in patients with more extensive disease.

Should central osteophytes within the articular cartilage of the lateral compartment be considered when determining the indication of unicompartmental knee arthroplasty for medial osteoarthritis?

Patients with central osteophytes in the lateral compartment may be poor candidates for unicompartmental knee arthroplasty (UKA) for medial knee arthritis given the thin overlying articular cartilage above the central osteophytes that is inadequate for supporting weight-bearing after UKA. Therefore, attempts should be made to detect central osteophytes to confirm suitability for UKA.

[Dysphagia as the main symptom in anterior cervical spine osteophytes (Forestier disease and cervical spondylosis deformans). Case reports and literature review]. / Disfagiya kak osnovnoi simptom pri perednikh osteofitakh sheinogo otdela pozvonochnika (bolezn' Forest'e i tservikal'nyi deformiruyushchii spondilez): obzor literatury i analiz klinicheskikh sluchaev.

Anterior cervical osteophytes are a fairly common X-ray finding in people over 50 years old. Incidence of dysphagia in patients with anterior osteophytes varies from 1% in those aged 40-60 years to 10.6% in patients over 60 years old. The most common causes of anterior cervical hyperosteophytosis causing dysphagia are cervical spondylosis deformans and Forestier disease. We present 2 clinical cases of spondylogenic dysphagia in cervical spondylosis deformans and Forestier disease. The review is devoted to the causes and diagnostic methods for dysphagia caused by anterior cervical osteophytes, as well as surgical options for this pathology. CONCLUSION: Microsurgical resection of anterior osteophytes is an effective method for dysphagia after ineffective therapy for 3 months. Microsurgical osteophytectomy provides stable regression of dysphagia with low recurrence rate.

Vertebral artery stenosis from osteophyte: A systematic review and case series.

BACKGROUND: Rotational vertebral artery syndrome, also referred to as Bow Hunter's syndrome (BHS), manifests when the vertebral artery (VA) is compressed following head rotation. This compression is often caused by an osteophyte and may lead to symptoms of a posterior stroke. This systematic review aims to shed light on the current management strategies for BHS resulting from osteophytes. Additionally, we present two illustrative cases where the VA compression by an osteophyte was effectively resolved by complete resection of the problematic bone spur. METHODS: A literature search was conducted across Embase, PubMed and Medline in September 2023. Keywords related to vertebral artery [MESH], vertebrobasilar insufficiency [MESH] and osteophyte [MESH] were the focus of this review. Risk of bias in retained studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for Qualitative Research. A narrative synthesis of our findings is presented. RESULTS: A total of 30 studies were included in this review. Vertigo was the most reported symptom by patients (n = 16). On imaging, the VA was often compressed at C4-5 (n = 10) and C5-6 (n = 10) with no evident side predominance observed. Anterior cervical discectomy and fusion (ACDF, n = 13) followed by anterior decompression without fusion (n = 8) were the most performed surgical procedures to manage BHS. CONCLUSION: Surgical decompression of the VA is a safe and effective intervention for patients experiencing symptomatic osteophytic compression during head rotation. This procedure restores normal vascular function and reduces the risk of ischemic events. This review highlights the importance of timely diagnosis and intervention in such cases.

The efficacy and safety of ultrasonic bone scalpel for removing retrovertebral osteophytes in anterior cervical discectomy and fusion: A retrospective study.

In this study, we present a novel surgical method that utilizes the ultrasonic bone scalpel (UBS) for the removal of large retrovertebral osteophytes in anterior cervical discectomy and fusion (ACDF) and evaluate its safety and efficacy in comparison to the traditional approach of using high-speed drill (HSD). A total of 56 patients who underwent ACDF for retrovertebral osteophytes were selected. We recorded patients' baseline information, operation time, intraoperative blood loss, complications, JOA and VAS scores, and other relevant data. The mean operation time and the mean intraoperative blood loss in the UBS group were less than those in the HSD group (P < 0.05). Although both groups exhibited considerable improvements in JOA and VAS scores following surgery, there was no statistically significant difference between the two groups (P > 0.05). Additionally, no significant disparities were found in bone graft fusion between the two groups at 6- and 12-months postsurgery. Notably, neither group exhibited complications such as dura tear or spinal cord injury. Our study found that the use of UBS reduced operative time, minimized surgical bleeding, and led to clinical outcomes comparable to HSD in ACDF. This technique offers an effective and safe method of removing large retrovertebral osteophytes.

The Impact of Posterior Intervertebral Osteophytes on Patient-Reported Outcome Measures After L5-S1 Anterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: (1) To develop a reliable grading system to assess the severity of posterior intervertebral osteophytes and (2) to investigate the impact of posterior intervertebral osteophytes on clinical outcomes after L5-S1 decompression and fusion through anterior lumbar interbody fusion (ALIF) and minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). BACKGROUND: There is limited evidence regarding the clinical implications of posterior lumbar vertebral body osteophytes for ALIF and MIS-TLIF surgeries and there are no established grading systems that define the severity of these posterior lumbar intervertebral osteophytes. PATIENTS AND METHODS: A retrospective analysis of patients undergoing L5-S1 ALIF or MIS-TLIF was performed. Preoperative and postoperative patient-reported outcome measures of the Oswestry Disability Index (ODI) and leg Visual Analog Scale (VAS) at 2-week, 6-week, 12-week, and 6-month follow-up time points were assessed. Minimal clinically important difference (MCID) for ODI of 14.9 and VAS leg of 2.8 were utilized. Osteophyte grade was based on the ratio of osteophyte length to foraminal width. "High-grade" osteophytes were defined as a maximal osteophyte length >50% of the total foraminal width. RESULTS: A total of 70 consecutive patients (32 ALIF and 38 MIS-TLIF) were included in the study. There were no significant differences between the two cohorts in patient-reported outcome measures or achievement of MCID for Leg VAS or ODI preoperatively or at any follow-ups. On multivariate analysis, neither the surgical approach nor the presence of high-grade foraminal osteophytes was associated with leg VAS or ODI scores at any follow-up time point. In addition, neither the surgical approach nor the presence of high-grade foraminal osteophytes was associated with the achievement of MCID for leg VAS or ODI at 6 months. CONCLUSION: ALIF and MIS-TLIF are both valid options for treating degenerative spine conditions and lumbar radiculopathy, even in the presence of high-grade osteophytes that significantly occupy the intervertebral foramen. LEVEL OF EVIDENCE: 3.

The anatomy of the extensor tendon insertion in the arthritic distal interphalangeal joint: a cadaveric study.

Dissection of arthritic cadaveric digits revealed an expanded extensor tendon footprint involving the dorsal osteophyte on the terminal phalanx. Osteophyte attachments can be safely released up to the width of a number 15 scalpel blade without risking the integrity of the extensor tendon.

Preoperative Planning Software Does Not Accurately Predict Range of Motion in Reverse Total Shoulder Arthroplasty.

BACKGROUND: The purpose of this study was to determine whether preoperative planning software (PPS) accurately predicts clinical range of motion (ROM) in patients with reverse total shoulder arthroplasty 1 year postoperatively with preoperative and postoperative computed tomography (CT) scans. METHODS: This was a retrospective study of 16 reverse total shoulder arthroplasty patients with preoperative and postoperative (CT) scans obtained at least 1 year postoperatively. Clinical ROM was measured in abduction, external rotation at resting abduction, extension, and flexion at a minimum of 1 year postoperatively. All clinical measurements were obtained before generation of PPS ROM values. Using postoperative CT scans, the achieved implant component positions were quantified and then replicated in PPS on the preoperative CT scans. The preoperative predicted ROM was then recorded, both with and without osteophyte removal. Bland-Altman plots were generated within each motion comparing the differences between clinically measured motion and software-predicted motion. RESULTS: The variation in clinically measured ROM in abduction, external rotation at resting abduction, extension, and flexion were 118 ± 27 (65° to 180°), 33 ± 16 (10° to 75°), 56 ± 8 (50° to 65°), and 137 ± 25 (80° to 160°), respectively. Clinically measured motion differed greatly from PPS-predicted ROM, with mean differences of 33 ± 29 (-32 to 93) for abduction, 44 ± 25 (-38 to 57) for external rotation, 44 ± 25 (-35 to 65) for extension, and 54 ± 50 (-51 to 147) for flexion with no significant correlations between clinically measured and PPS-predicted ROM ( P > 0.05). With humeral or humeral and glenoid osteophyte resection, correlations for only flexion became significant ( P = 0.002 for both). CONCLUSION: The passive glenohumeral impingement-free ROM generated from PPS incompletely predicts clinically measured active humerothoracic ROM, possibly because of the unmeasured factors of soft-tissue tension, muscular strength, humeral torsion, resting scapular posture, and, most importantly, scapulothoracic motion. LEVEL OF EVIDENCE: IV.

The Aggressive Open Anterior Ankle Cheilectomy as Joint Salvage for Anterior Ankle Impingement Syndrome and Arthritis.

Anterior ankle impingement syndrome can frequently present in athletes and post-traumatic patients who have osteophytes contributing to limited dorsiflexion and pain. Surgical treatment options include arthroscopy, open arthrotomy, arthrodesis, and total implant arthroplasty. For many, joint-sparing arthroscopy or arthrotomy yield satisfactory results if significant debridement is performed. If debridement is not aggressive, patients may not obtain the desired improvement. In cases where a larger amount of bone must be removed, or the patient does not have an anatomic appearing talar neck due to osteophytic changes, we have found that an open approach is necessary to achieve good results. To the best of our knowledge, no such technique has been previously published detailing a standard approach to open ankle arthrotomy. Our technique is coined the "Aggressive Open Anterior Ankle Cheilectomy" and involves a systematic 3-step approach. First, the tibial osteophytes are resected with an osteotome; second, the ankle gutters are addressed, and all hypertrophic bones removed; and third, an anatomic talar neck is fashioned. We herein describe our surgical technique and case examples.Level of Evidence: 5.

Weight-Bearing CT with Maximum Ankle Dorsiflexion to Identify Impingement and Tibial Plafond Stress Fracture: A Case Report.

CASE: A 25-year-old male pole vaulter presented with several months of right ankle pain. Radiographs showed an anterior tibial osteophyte with a small intra-articular body suggesting impingement. Weight-bearing computed tomography (CT) revealed an associated tibial plafond stress fracture. Subsequent arthroscopy with osteophyte resection and loose body removal significantly improved symptoms, and he gradually resumed training. CONCLUSION: Stress fractures should always be considered in athletes with ankle pain. A unique aspect of this case was the use of weight-bearing CT in diagnosis and surgical planning. To our knowledge, this is the first described case in which weight-bearing CT was used in this fashion.

Anesthesia Management For A Patient Having Transoral Approach For Anterior Cervical Osteophyte Resection.

Anterior cervical osteophytes (ACOs) are a common condition in the elderly, leading to dysphagia, odynophagia, aspiration, neck pain, dysphonia, and dyspnea. Transoral surgical resection is an approach to managing cervical (C1 and C2) ACOs where the endoscopic endonasal approach is contraindicated. Advantages of the transoral approach include it providing direct access to the cervical spine, limits injury to surrounding neurovascular structures, and eliminates scarring. Anesthesia considerations for transoral surgical resection of ACOs will be covered in the following case report. A review of the literature examines the prevalence of and anesthesia considerations for the transoral approach to anterior cervical osteophyte resection.

Do Clinical Parameters Reflect Local Bone Metabolism in Heterotopic Ossification After Septic or Aseptic THA?

BACKGROUND: Heterotopic ossification (HO) is a common complication after THA. Although current research primarily focuses on treatment and prevention, little is known about the local bone metabolism of HO and clinical contributing factors. QUESTIONS/PURPOSES: We aimed to assess bone remodeling processes in HO using histomorphometry, focusing on the effects of inflammation and prior NSAID treatment. Specifically, we asked: (1) Are HO specimens taken from patients with periprosthetic joint infection (PJI) more likely to exhibit active bone modeling and remodeling than specimens taken at the time of revision from patients without infection? (2) Do clinical or inflammatory serum and synovial parameters reflect the microstructure of and remodeling in both HO entities? (3) Is NSAID treatment before revision surgery associated with altered local bone mineralization or remodeling properties? METHODS: Between June 2021 and May 2022, we screened 395 patients undergoing revision THA at two tertiary centers in Germany. Of those, we considered all patients with radiographic HO as potentially eligible. Based on that, 21% (83 of 395) were eligible; a further 43 were excluded because of an inability to remove the implant intraoperatively (16 patients), insufficient material (11), comorbidities with a major effect on bone metabolism (10), or bone-specific drugs (six), leaving 10% (40) for analysis in this retrospective, comparative study. HO specimens were collected during aseptic (25 patients: 18 male, seven female, mean age 70 ± 11 years, mean BMI 29 ± 4 kg/m 2 ) and septic (15 patients: 11 male, four female, mean age 69 ± 9 years, mean BMI 32 ± 9 kg/m 2 ) revision THA at a mean of 6 ± 7 years after primary implantation and a mean age of 70 ± 9 years at revision. Septic origin (PJI) was diagnosed based on the 2018 International Consensus Meeting criteria, through a preoperative assessment of serum and synovial parameters. To specify the local bone microstructure, ossification, and cellular bone turnover, we analyzed HO specimens using micro-CT and histomorphometry on undecalcified sections. Data were compared with those of controls, taken from femoral neck trabecular bone (10 patients: five female, five male, mean age 75 ± 6 years, mean BMI 28 ± 4 kg/m 2 ) and osteophytes (10 patients: five female, five male, mean age 70 ± 10 years, mean BMI 29 ± 7 kg/m 2 ). The time between primary implantation and revision (time in situ), HO severity based on the Brooker classification, and serum and synovial markers were correlated with HO microstructure and parameters of cellular bone turnover. In a subgroup of specimens of patients with NSAID treatment before revision, osteoid and bone turnover indices were evaluated and compared a matched cohort of specimens from patients without prior NSAID treatment. RESULTS: Patients with aseptic and septic HO presented with a higher bone volume (BV/TV; aseptic: 0.41 ± 0.15, mean difference 0.20 [95% CI 0.07 to 0.32]; septic: 0.43 ± 0.15, mean difference 0.22 [95% CI 0.08 to 0.36]; femoral neck: 0.21 ± 0.04; both p < 0.001), lower bone mineral density (aseptic: 809 ± 66 mg HA/cm 3 , mean difference -91 mg HA/cm 3 [95% CI -144 to -38]; septic: 789 ± 44 mg HA/cm 3 , mean difference -111 mg HA/cm 3 [95% CI -169 to -53]; femoral neck: 899 ± 20 mg HA/cm 3 ; both p < 0.001), and ongoing bone modeling with endochondral ossification and a higher proportion of woven, immature bone (aseptic: 25% ± 17%, mean difference 25% [95% CI 9% to 41%]; septic: 37% ± 23%, mean difference 36% [95% CI 19% to 54%]; femoral neck: 0.4% ± 0.5%; both p < 0.001) compared with femoral neck specimens. Moreover, bone surfaces were characterized by increased osteoblast and osteoclast indices in both aseptic and septic HO, although a higher density of osteocytes was detected exclusively in septic HO (aseptic: 158 ± 56 1/mm 2 versus septic: 272 ± 48 1/mm 2 , mean difference 114 1/mm 2 [95% CI 65 to 162]; p < 0.001). Compared with osteophytes, microstructure and turnover indices were largely similar in HO. The Brooker class was not associated with any local bone metabolism parameters. The time in situ was negatively associated with bone turnover in aseptic HO specimens (osteoblast surface per bone surface: r = -0.46; p = 0.01; osteoclast surface per bone surface: r = -0.56; p = 0.003). Serum or synovial inflammatory markers were not correlated with local bone turnover in septic HO. Specimens of patients with NSAID treatment before revision surgery had a higher osteoid thickness (10.1 ± 2.1 µm versus 5.5 ± 2.6 µm, mean difference -4.7 µm [95% CI -7.4 to -2.0]; p = 0.001), but there was no difference in other osteoid, structural, or cellular parameters. CONCLUSION: Aseptic and septic HO share phenotypic characteristics in terms of the sustained increase in bone metabolism, although differences in osteocyte and adipocyte numbers suggest distinct homeostatic mechanisms. These results suggest persistent bone modeling or remodeling, with osteoblast and osteoclast indices showing a moderate decline with the time in situ in aseptic HO. Future studies should use longitudinal study designs to correlate our findings with clinical outcomes (such as HO growth or recurrence). In addition, the molecular mechanisms of bone cell involvement during HO formation and growth should be further investigated, which may allow specific therapeutic and preventive interventions. CLINICAL RELEVANCE: To our knowledge, our study is the first to systematically investigate histomorphometric bone metabolism parameters in patients with HO after THA, providing a clinical reference for evaluating modeling and remodeling activity. Routine clinical, serum, and synovial markers are not useful for inferring local bone metabolism.

Valgus Stress Radiograph Can Predict Alignment Change of Medial Mobile-Bearing Unicompartmental Knee Arthroplasty.

OBJECTIVE: Finding reliable tools to predict alignment change after medial mobile-bearing unicompartmental knee arthroplasty (UKA) can help surgeons avoid under- or over-correction. This prospective study aimed to investigate whether the parameters related to medial collateral ligament tension on valgus stress radiograph can predict the alignment change of medial mobile-bearing UKA and establish a prediction model. METHODS: This study prospectively included the patients undergoing medial mobile-bearing UKA for knee osteoarthritis from November 2018 and April 2021. Patients took valgus stress radiograph and MRI preoperatively and took full-length weight-bearing anterior-posterior radiograph of the lower extremity preoperatively and postoperatively. The medial joint space width (MJSW) on valgus stress radiograph, area of femoral and tibial osteophyte on MRI, medial extrusion distance (MED) of the meniscus on MRI, and the change in hip-knee-ankle angle (∆HKAA) were measured. Factors influencing ∆HKAA were analyzed by correlation analysis. Univariable and multivariable linear regression analysis was performed to establish a prediction model of ∆HKAA. RESULTS: One hundred and seven knees were included. On average, the preoperative HKAA was 170.84° ± 3.73°, and UKA corrected the alignment to 175.16° ± 3.21° postoperatively (p < 0.001), with ∆HKAA of 4.33° ± 1.93°. Correlation analysis showed that ∆HKAA correlated with MJSW (r = 0.628, p < 0.001), MED (r = 0.262, p < 0.001), and tibial osteophyte area (r = 0.235, p < 0.001). The prediction model for ∆HKAA was obtained by multivariable linear regression: ∆HKAA = -2.003 + 0.947 × MJSW(mm) + 1.838 × total osteophyte area(cm2 ). CONCLUSION: Valgus stress radiographic MJSW and osteophyte area are correlated to the alignment change of medial mobile-bearing UKA. The prediction model for HKAA change is: ∆HKAA = -2.003 + 0.947 × MJSW(mm) + 1.838 × total osteophyte area(cm2 ).

Arthroscopic Treatment of Anterior Ankle Impingement.

Arthroscopic reduction of tibiotalar osteophytes results in good to excellent results in the vast majority of patients. Pain is primarily due to synovial hypertrophy and anterior tibiotalar entrapment associated with the osteophytes. Osteophytes may be due to repetitive trauma such as sports, or associated with subtle or overt ankle instability. A minimally invasive approach results in rapid recovery and less risk than open interventions. In cases where anterior osteophytes have coexisting ankle instability and in many cases ancillary procedures such as ankle stabilization are performed.

Relationship between the morphology of osteophytes and cartilage lesions in anterior ankle impingement in athletes: a cross-sectional study.

BACKGROUND: The present study aimed to describe the frequency and severity of tram-track lesions in anterior ankle impingement in athletes and to evaluate the association between osteophyte morphology and severity of tram-track lesions, the distinctive cartilage lesions associated with tibial osteophytes in anterior ankle impingement syndrome. METHODS: We evaluated 34 athletes who underwent arthroscopic osteophyte resection for anterior ankle impingement between January 2017 and March 2021. RESULTS: We found tram-track lesions in 26 athletes (76.5%). Arthroscopic findings revealed the distribution of the International Cartilage Repair Society grades of tram-track lesions (grade 0, eight; grade 1, seven; grade 2, ten; grade 3, nine; grade 4, zero). These findings indicate that athletes with anterior ankle impingement syndrome may have more severe cartilage lesions than non-athletes. There was a positive correlation between the International Cartilage Repair Society grade and osteophyte size (r = 0.393, p = 0.021). We divided athletes into two groups according to the presence or absence of osteophyte protrusion into the joint space. Osteophyte protrusion was present in 14 athletes (41.2%). All athletes in the protrusion-type group had tram-track lesions; seven (50%) had International Cartilage Repair Society grade 3. The protrusion-type group's International Cartilage Repair Society grade was significantly higher than that of the non-protrusion-type group (p = 0.008). The osteophyte sizes in the two groups were not significantly different (p = 0.341). CONCLUSIONS: Based on these findings, osteophyte protrusion should be assessed when an indication of arthroscopic treatment for anterior ankle impingement syndrome is considered, particularly in athletes.

Posterior Compartment Debridement and Varus Deformity Correction in Total Knee Arthroplasty.

BACKGROUND: Restoration of joint-line position and deformity correction remain important tenets for preserving stability and function after total knee arthroplasty (TKA). We sought to characterize the role of posterior osteophytes in the correction of alignment deformity during TKA. METHODS: We evaluated 57 patients (57 TKAs) who participated in a trial of robotic-arm assisted TKA outcomes. Weight-bearing and fixed preoperative alignment was measured using long-standing radiographs and tools of the robotic-arm tracking system, respectively. Total volume (cm3) of posterior osteophytes was quantified using preoperative planning computed tomography scans. Joint-line position was evaluated using bone resection thicknesses measured using a caliper. RESULTS: The mean (minimum to maximum) initial fixed deformity was 4 degrees (range, 0 to 11) of varus. All patients showed asymmetric posterior osteophytes. Mean total osteophyte volume was 3 cm3 (range, 1 to 9). Total osteophyte volume was positively correlated with severity of fixed deformity (r = 0.48, P = .0001). Removal of osteophytes allowed for the correction of functional alignment to within 3 degrees of neutral in all cases (mean 0 degree), with none requiring release of the superficial medial collateral ligament. Tibial joint-line position was restored to within 3 millimeters in all but 2 cases (mean increase of height, 0.6 [range, -4 to +5]). CONCLUSION: In the end-stage diseased knee, posterior osteophytes typically occupy space in the posterior capsule on the concave side of the deformity. Thorough debridement of posterior osteophytes may help facilitate management of modest varus deformity with decreased need for soft-tissue releases or adjustments to planned bone resection.

CT-Based Calculation Model Assists Precise Treatment for Anterior and Posterior Ankle Bony Impingement.

OBJECTIVE: Ankle arthroscope is the preferred tool for ankle surgeons to treat ankle impingement. However, there is no relevant report on how to improve the accuracy of arthroscopic osteotomy through preoperative planning. The aims of this study were to investigate a novel method to obtain the bone morphology in anterior and posterior ankle bony impingement through computed tomography (CT) calculation model, use this method to guide surgical decision-making, and compare the postoperative efficacy and actual bone cutting volume with conventional surgery. METHODS: This retrospective cohort study includes 32 consecutive cases with anterior and posterior ankle bony impingement by arthroscopy from January 2017 to December 2019. Mimics software was utilized to calculate the bony morphology and measure the volume of the osteophytes by two trained software engineers. The patients were divided into the precise group (n = 15) and the conventional group (n = 17) according to whether obtain and quantify the osteophytes' morphology with CT based calculation model preoperative. All patients were evaluated clinically using visual analog scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, active dorsiflexion and plantarflexion angle before and after surgery at both 3 months and 12 months postoperatively. We obtained the shape and volume of bone cutting through Boolean calculation. Clinical outcomes and radiological data were compared between the two groups. RESULTS: The VAS score, AOFAS score, active dorsiflexion angle and plantarflexion angle were significantly improved in both groups postoperatively. In comparison of the VAS score, AOFAS score, and active dorsiflexion angle, the precise group were higher than the conventional group in the follow-up at 3 and 12 months postoperatively with statistical difference. The difference between the virtual bone cutting volume and the actual bone cutting volume of the anterior edge of distal tibia in the conventional group and precise group were 244.20 ± 147.66 mm3 and 76.53 ± 168.51 mm3 , respectively, there was statistical difference between the two groups (t = -2.927, p = 0.011). CONCLUSION: Using a novel method of obtaining and quantifying the bony morphology with CT-based calculation model for anterior and posterior ankle bony impingement can help guide surgical decision-making preoperatively and assist precise bone cutting during the operation, which can improve the efficacy and evaluate the accuracy of osteotomy postoperatively.