L’arthrose de la cheville chez le footballeur – Quel rôle joue la syndesmose ?

Abstract

Les lésions de la syndesmose tibio-fibulaire joueraient un rôle clé dans le développement de l’arthrose chez les footballeurs. En raison des torsions et chocs répétés, ces traumatismes entraîneraient une instabilité chronique de la cheville, modifiant la répartition des charges sur l’articulation et favorisant l’usure prématurée du cartilage. Le diagnostic précoce semble essentiel pour limiter les complications, reposant sur des tests cliniques spécifiques et une imagerie par IRM. Selon la gravité des lésions, le traitement pourrait être conservateur avec immobilisation et rééducation, ou chirurgical incluant la fixation de la syndesmose et la reconstruction ligamentaire. Une prise en charge adaptée permettrait ainsi de réduire le risque d’arthrose précoce. La prévention semble également un élément clé, impliquant le renforcement musculaire, des stratégies de jeu adaptées et une meilleure gestion des blessures. Ces mesures contribueraient à limiter l’impact des lésions syndesmotiques sur la santé articulaire des footballeurs.

Osteoarthritis of the ankle is less common than that of the hip or knee, but it can have a significant impact on mobility and quality of life, particularly in high-impact sports such as soccer. Unlike primary osteoarthritis in other joints, ankle osteoarthritis is predominantly post-traumatic, often resulting from fractures or ligament damage. Soccer players are particularly at risk, due to repetitive strain, frequent ankle sprains and the physical nature of the game. Among these injuries, syndesmosis lesions are of particular concern because of their crucial role in ankle stability. Disruption of syndesmosis can lead to biomechanical changes, increased joint stress and, ultimately, cartilage degradation. Despite the high incidence of ankle injuries in soccer, there is a lack of dedicated studies exploring the direct link between syndesmotic instability and the development of ankle osteoarthritis in this sporting population. Current research highlights the biomechanical consequences of syndesmosis lesions, including abnormal load distribution and joint incongruence, which could accelerate degenerative processes. However, further investigations are needed to establish causal relationships, identify risk factors and develop targeted prevention and treatment strategies. This literature review synthesizes current knowledge on syndesmosis lesions, their impact on ankle biomechanics and their potential role in the development of osteoarthritis in soccer players. Given the long-term consequences of post-traumatic osteoarthritis and its impact on sporting careers and life after retirement, future research is essential to better understand this issue, optimize rehabilitation protocols and improve the long-term joint health of footballers.