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Dallman J, Wolf MR, Campbell T, Herda T, White J, Tarakemeh A, Vopat BG. Current Definitions of Failure in Lateral Ankle Instability Surgery: A Systematic Review. Am J Sports Med 2023:3635465231153165. [PMID: 36917833 DOI: 10.1177/03635465231153165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND "Failure" is a term that is frequently used to describe an unfavorable outcome for patients who undergo surgical treatment for lateral ankle instability (LAI). A standard definition of failure for the surgical treatment of ankle instability has not been established by clinicians and researchers. PURPOSE To identify the definitions of ankle instability treatment failure that are currently in the literature and to work toward the standardization of the definition. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS A systematic search of MEDLINE, SPORTDiscus, CINAHL, Embase, and Web of Science was conducted to identify clinical studies that included patients who underwent surgical treatment for LAI and included information about surgical failure. Studies with level of evidence 1 to 4 were included in this review. Animal studies, biomechanical studies, cadaveric studies, review articles, and expert opinions were excluded. The included studies were then reviewed for definitions of failure of any surgical procedure that was performed to correct LAI. RESULTS Of the 1200 studies found, 3.5% (42/1200) published between 1984 and 2021 met the inclusion criteria and were analyzed. After reviewing the data, we found numerous definitions were reported in the literature for LAI surgical failure. The most common was recurrent instability (40% [17/42]), followed by rerupture (19% [8/42]). For the original surgical procedure, the anatomic Broström-Gould technique was used most frequently (57% [24/42]). The failure rate of the Broström-Gould technique ranged from 1.1% to 45.2% depending on the definition of failure. CONCLUSION There were multiple definitions of failure for the surgical treatment of LAI, which is one of the reasons why the rate of failure can vary greatly. The literature would benefit greatly from the standardization of the definition of ankle instability treatment failure. This definition should include specific, objective physical examination findings that eliminate the ambiguity surrounding failure.
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Affiliation(s)
| | - Megan R Wolf
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.,Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA
| | - Tanner Campbell
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Trent Herda
- Neuromechanics Laboratory, Department of Health, Sport & Exercise Sciences, University of Kansas, Lawrence, Kansas, USA
| | - Jacob White
- Dykes Library, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Armin Tarakemeh
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Bryan G Vopat
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
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Sánchez CA, Briceño I, Robledo J. Resultados de uma técnica modificada de reconstrução assistida por artroscopia para instabilidade lateral do tornozelo. Rev Bras Ortop 2022; 57:577-583. [PMID: 35966426 PMCID: PMC9365499 DOI: 10.1055/s-0041-1741446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/20/2021] [Indexed: 12/01/2022] Open
Abstract
Objective
The present study assesses the results of a minimally invasive surgical technique for acute and chronic ankle instability management.
Methods
The present case series study retrospectively evaluated 40 patients undergoing arthroscopic-assisted percutaneous ankle ligament reconstruction from 2013 to 2019.
Results
The present study included 17 males and 23 females with an average age of 38.3 years old. Postintervention follow-up using American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores identified improvement of > 30 points in function and pain control. The most frequently occurring associated injuries were osteochondral (35%). No patient required reintervention or had infection during follow-up.
Conclusion
The technique in the present study is easy and achieves satisfactory results for function and pain control.
Level of Evidence
IV.
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Affiliation(s)
- Carlos A. Sánchez
- Departamento de Ortopedia e Traumatologia, Pontificia Universidad Javeriana, Bogotá, D.C., Colômbia
| | - Ignacio Briceño
- Departamento de Ortopedia e Traumatologia, Pontificia Universidad Javeriana, Bogotá, D.C., Colômbia
| | - Jaime Robledo
- Departamento de Ortopedia e Traumatologia, Hospital Universitario San Ignacio, Bogotá, D.C., Colômbia
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Butarbutar J, Irvan I, Lim MA, Pranata R. Do We Need Extensor Retinacular Enhancement on Broström Lateral Ankle Repair? A Systematic Review and Meta-analysis. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aims
This meta-analysis compared inferior extensor retinaculum (IER) enhancement in Broström-Gould procedure and anatomical Broström repair. We aim to evaluate functional ankle score (American Orthopaedic Foot & Ankle Society (AOFAS) score, Karlsson score), talar tilt, talar anterior translation, and complications between both groups.
Methods
A comprehensive systematic literature search was carried out using Wiley Library, Scopus, Pubmed, ScienceDirect, and EuropePMC databases from inception up until 19 December 2020. While the intervention was IER enhancement, the control was those without IER enhancement. The primary outcome was the functional ankle score (AOFAS and Karlsson score). The secondary outcomes were talar tilt, talar anterior translation, and other complications.
Results
There was a total of 298 patients from 7 studies included in this systematic review and meta-analysis. IER enhancement was associated with lower AOFAS (mean difference -1.115 [-2.197, -0.033], p=0.043; I2: 0%) during follow-up. Lower Karlsson score was observed in the IER enhancement group (mean difference -2.004 [-3.442, -0.567], p=0.006; I2: 3.71%) during follow-up. Talar tilt (mean difference -0.145 degree [-0.436, 0.146], p=0.329; I2: 0%) and anterior displacement (mean difference -0.109 mm [-0.096, 0.314], p=0.299; I2: 0%) in the two groups were similar on follow-up. The complications were similar in both groups (OR 0.87 [0.40, 1.89], p=0.719; I2: 0%). Meta-regression analysis indicates that the association between IER and AOFAS was not affected by age (p=0.927) and male gender (p=0.930).
Conclusion
This meta-analysis showed that ATFL repair with non-IER enhancement was non-inferior compared to those with IER enhancement.
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Hanhan S, Goren K, Rivkin A, Saba F, Nevo H, Dar N, Shilo D, Liebergall M, Shoseyov O, Deutsch D, Blumenfeld A, Haze A. Regeneration of grade 3 ankle sprain, using the recombinant human amelogenin protein (rHAM + ) in a rat model. J Orthop Res 2021; 39:1540-1547. [PMID: 32410235 DOI: 10.1002/jor.24718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/03/2020] [Accepted: 05/08/2020] [Indexed: 02/04/2023]
Abstract
Lateral ligament tears, also known as high-grade ankle sprains, are common, debilitating, and usually heal slowly. Ten to thirty percent of patients continue to suffer from chronic pain and ankle instability even after 3 to 9 months. Previously, we showed that the recombinant human amelogenin (rHAM+ ) induced regeneration of fully transected rat medial collateral ligament, a common proof-of-concept model. Our aim was to evaluate whether rHAM+ can regenerate torn ankle calcaneofibular ligament (CFL), an important component of the lateral ankle stabilizers. Right CFLs of Sabra rats were transected and treated with 0, 0.5, or 1 µg/µL rHAM+ dissolved in propylene glycol alginate (PGA). Results were compared with the normal group, without surgery. Healing was evaluated 12 weeks after treatment by mechanical testing (ratio between the right and left, untransected ligaments of the same rat), and histology including immunohistochemical staining of collagen I and S100. The mechanical properties, structure, and composition of transected ligaments treated with 0.5 μg/μL rHAM+ (experimental) were similar to untransected ligaments. PGA (control) treated ligaments were much weaker, lax, and unorganized compared with untransected ligaments. Treatment with 1 μg/μL rHAM+ was not as efficient as 0.5 μg/μL rHAM+ . Normal arrangement of collagen I fibers and of proprioceptive nerve endings, parallel to the direction of the force, was detected in ligaments treated with 0.5 μg/μL rHAM+ , and scattered arrangement, resembling scar tissue, in control ligaments. In conclusion, we showed that rHAM+ induced significant mechanical and structural regeneration of torn rat CFLs, which might be translated into treatment for grades 2 and 3 ankle sprain injuries.
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Affiliation(s)
- Salem Hanhan
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Koby Goren
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Amit Rivkin
- Faculty of Agriculture, Food and Environment, Institute of Plant Sciences and Genetics in Agriculture, Hebrew University, Rehovot, Israel
| | - Faris Saba
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Hani Nevo
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Naama Dar
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Dekel Shilo
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Meir Liebergall
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Oded Shoseyov
- Faculty of Agriculture, Food and Environment, Institute of Plant Sciences and Genetics in Agriculture, Hebrew University, Rehovot, Israel
| | - Dan Deutsch
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Anat Blumenfeld
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Amir Haze
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Zhang YW, Rui YF. A systematic review of the "Logsplitter" injury: how much do we know? Injury 2021; 52:358-365. [PMID: 33234265 DOI: 10.1016/j.injury.2020.11.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/11/2020] [Accepted: 11/15/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND As an emerging proposed type of ankle joint injury, the concept of logsplitter injury is a unified overview of the high-energy ankle fracture and dislocation accompanied by distal tibiofibular syndesmosis separation and displacement. Since the concept of logsplitter injury is still relatively novel, there is no uniform standard for its clinical classification, diagnosis and treatment currently. Thus, we reviewed previous literatures here to provide certain references for its better clinical diagnosis and treatment in future. METHODS The available literatures from January 1985 to June 2020 in five medical databases were searched and analyzed. The original articles that evaluated the outcomes of patients treated surgically for the logsplitter injury were included. The detailed data were then extracted from each research, including the researchers, type of study, level of evidence, type of center research, groups, number of patients, gender, age, causes of injury, time from injury to surgery, operative time, intraoperative blood loss, length of follow-up, postoperative complications and clinical outcomes. The overall search procedures were performed by the two independent reviewers. RESULTS Seven pieces of researches (199 patients) were eligible for inclusion. All researches were either retrospective or prospective study, and all but one was single center study. Falling from height ranked first in the causes of injury (52.8%), and followed by the traffic accidents (29.6%). Clinical outcomes were all measured using the American Orthopaedic Foot and Ankle Society (AOFAS) score, and the mean AOFAS score at the final follow-up was 77.9 points. CONCLUSIONS None of the definitive consensuses exists on how logsplitter injury should be diagnosed and surgically managed. In light of the novel concept, short presentation time and numerous postoperative complications, the logsplitter injury has not been well understood by most surgeons currently, and its overall situation still needs to be supported by a larger sample size of multicenter research in the future.
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Affiliation(s)
- Yuan-Wei Zhang
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China.; School of Medicine, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China.; Orthopaedic Trauma Institute, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China.; Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China
| | - Yun-Feng Rui
- Department of Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China.; School of Medicine, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China.; Orthopaedic Trauma Institute, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China.; Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, No. 87 Ding Jia Qiao, Nanjing, Jiangsu, 210009, PR China.
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Gonera B, Kurtys K, Paulsen F, Polguj M, LaPrade RF, Grzelecki D, Karauda P, Olewnik Ł. The plantaris muscle - Anatomical curiosity or a structure with important clinical value? - A comprehensive review of the current literature. Ann Anat 2021; 235:151681. [PMID: 33561523 DOI: 10.1016/j.aanat.2021.151681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/15/2020] [Accepted: 12/23/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Although the plantaris muscle is vestigial in humans, it is far too important to remain omitted. The aim of this study is to provide a comprehensive review of the existing literature focused on plantaris muscle clinical value, grafting usefulness and its morphological variations. Hopefully this study will be of great use for every medical practitioner due to its clarity and conciseness despite such broaden scope of this article. MATERIAL AND METHODS The article is written based on 100 studies published since 1868 until 2020. During careful selection process 12 papers were dismissed due to their insufficient sample size, wrong methods used or results that were previously discovered. RESULTS Many aspects concerning the plantaris muscle are already well examined, summarized and described. However this study has shown how much we still do not know and which fields require further investigations. CONCLUSION The anatomical variations of plantaris muscle morphology may cause mid-portion Achilles tendinopathy, tennis leg syndrome or increase the risk of failure while harvesting the tendons.
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Affiliation(s)
- Bartosz Gonera
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland.
| | - Konrad Kurtys
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany; Sechenov University, Department of Topographic Anatomy and Operative Surgery, Moscow, Russia
| | - Michał Polguj
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | | | - Dariusz Grzelecki
- Centre of Postgraduate Medical Education, Department of Orthopedics and Rheumoorthopedics, Otwock, Poland
| | - Piotr Karauda
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
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Evolution in Surgical Management of Ankle Instability in Athletes. J Am Acad Orthop Surg 2021; 29:e5-e13. [PMID: 33306560 DOI: 10.5435/jaaos-d-20-00176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/10/2020] [Indexed: 02/01/2023] Open
Abstract
Recent concepts are changing the management of ankle instability. These include concurrent medial and lateral instabilities, use of ankle arthroscopy, use of suture anchors, all-arthroscopic stabilization, synthetic augmentation, and early postoperative rehabilitation. Medial sided injuries occur in up to 72% of the lateral ankle sprains, and concomitant repair may provide greater stability. Suture anchors are equally as strong as transosseous tunnels, and the technique is simple, reproducible, and may decrease complications, but anchors do increase costs. Synthetic augmentation demonstrates greater strength than Broström alone in cadaver-based biomechanical testing. Although clinical studies of synthetic augmentation have demonstrated equivocal stability and pain compared with Broström alone, synthetic augmentation may expedite rehabilitation. All-arthroscopic ankle stabilization is gaining popularity with increasing publications. Early findings demonstrate comparable biomechanical and clinical data compared with open techniques. Early postoperative weight-bearing within 2 weeks seems to be safe and may shorten time to return to play. Surgeons may consider using these novel techniques in the management of lateral ankle instability.
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Feng SM, Wang AG, Sun QQ, Zhang ZY. Functional Results of All-Inside Arthroscopic Broström-Gould Surgery With 2 Anchors Versus Single Anchor. Foot Ankle Int 2020; 41:721-727. [PMID: 32129096 DOI: 10.1177/1071100720908858] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The all-inside arthroscopic Broström-Gould technique gained particular attention among clinicians and researchers due to its high rate of satisfactory results. Thus far, there is a lack of evidence regarding the differences in clinical outcomes between the use of 1 anchor and 2 anchors. The purpose of this study was to compare the differences in clinical function and activity levels in patients treated with 1 or 2 anchors in all-inside arthroscopic Broström-Gould surgery for chronic lateral ankle instability (CLAI). METHODS The data of 75 patients with CLAI (unilateral) admitted from May 2013 to July 2016 were retrospectively analyzed. All patients were treated with all-inside arthroscopic Broström-Gould surgery. The patients were divided into a single-anchor group (n = 36) and double-anchor group (n = 39) according to the number of anchors used. There was no statistical difference in general characteristics between the 2 groups before surgery. After 36 to 72 months of follow-up, the pain visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), and Foot and Ankle Outcome Score (FAOS) were used to evaluate and compare the clinical function results between the 2 groups. RESULTS The incidence of wound complications; reaction to the suture; injury to the nerve, blood vessel, or tendon; and length of postoperative hospitalization were similar between the 2 groups. At the last follow-up, there was no significant difference in the VAS and AOFAS scores between single- and double-anchor groups, but the KAFS and FAOS in the double-anchor group were significantly higher than in the single-anchor group. Additionally, more patients in the double-anchor group returned to preinjury sports activities. CONCLUSION All-inside arthroscopic Broström-Gould surgery for the treatment of CLAI yielded a better functional effect and better recovery to preinjury mobility when 2 anchors were used instead of a single anchor. LEVEL OF EVIDENCE Level III, comparative study.
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Affiliation(s)
- Shi-Ming Feng
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.,Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| | - Ai-Guo Wang
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.,Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| | - Qing-Qing Sun
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
| | - Zai-Yi Zhang
- Hand and Foot Microsurgery Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China
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Krause F, Seidel A. Malalignment and Lateral Ankle Instability: Causes of Failure from the Varus Tibia to the Cavovarus Foot. Foot Ankle Clin 2018; 23:593-603. [PMID: 30414655 DOI: 10.1016/j.fcl.2018.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A lower leg or hindfoot varus malalignment is a frequently encountered but underestimated cause of chronic ankle instability and ankle arthritis in the long term. When evaluating patients with ankle instability, a high index of clinical suspicion for tibia and hindfoot malalignment and subsequent biomechanics should be maintained. Management of lateral ankle instability in the presence of varus malalignment must comprise a generous indication for accurate hindfoot realignment. In young and active patients, realignment should be combined with formal lateral ligamentous repair.
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Affiliation(s)
- Fabian Krause
- Department of Orthopaedic Surgery, Inselspital, University of Berne, Freiburgstrasse, Berne 3010, Switzerland.
| | - Angela Seidel
- Department of Orthopaedic Surgery, Inselspital, University of Berne, Freiburgstrasse, Berne 3010, Switzerland
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Lopes R, Andrieu M, Cordier G, Molinier F, Benoist J, Colin F, Thès A, Elkaïm M, Boniface O, Guillo S, Bauer T. Arthroscopic treatment of chronic ankle instability: Prospective study of outcomes in 286 patients. Orthop Traumatol Surg Res 2018; 104:S199-S205. [PMID: 30245066 DOI: 10.1016/j.otsr.2018.09.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/03/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chronic ankle instability (CAI) is the main complication of ankle sprains and requires surgery if non-operative treatment fails. Surgical ankle stabilisation techniques can be roughly classified into two groups, namely, repair involving retensioning and suturing of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) and reconstruction using a tendon graft. Arthroscopic repair and reconstruction techniques for CAI have been introduced recently. The objective of this prospective multicentre study was to assess the feasibility, morbidity, and short-term outcomes of these arthroscopic ankle-stabilisation techniques. MATERIAL AND METHODS Consecutive patients scheduled for arthroscopic treatment of CAI were included prospectively. Of the 286 included patients, 115 underwent ligament repair and 171 ligament reconstruction. Mean follow-up was 9.6 months (range, 6-43 months). We recorded the AOFAS and Karlsson scores, patient satisfaction, complications, and time to return to sports. RESULTS The overall patient satisfaction score was 8.5/10. The AOFAS and Karlsson scores improved significantly between the pre- and postoperative assessments, from 62.1 to 89.2 and from 55 to 87.1, respectively. These scores were not significantly different between the groups treated by repair and by reconstruction. Neurological complications occurred in 10% of patients and consisted chiefly in transient dysesthesia (with neuroma in 3.5% of patients). Cutaneous or infectious complications requiring surgical revision developed in 4.2% of patients. DISCUSSION Arthroscopic treatment is becoming a method of choice for patients with CAI, as it allows a comprehensive assessment of the ligament lesions, the detection and treatment of associated lesions, and repair or reconstruction of the damaged ligaments. These simple, reliable, and reproducible arthroscopic techniques seem as effective as conventional surgical techniques. The rate of cutaneous complications is at least halved compared to open surgery. CONCLUSION Arthroscopic ankle stabilisation repair and reconstruction techniques hold considerable promise but require further evaluation to better determine the indications of repair versus reconstruction and to obtain information on long-term outcomes.
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Affiliation(s)
- Ronny Lopes
- Polyclinique de l'atlantique (PCNA), avenue Claude-Bernard, 44800 Saint-Herblain, France
| | - Michael Andrieu
- Clinique Pont-de-Chaume, 330, avenue Marcel-Unal, 82000 Montauban, France
| | - Guillaume Cordier
- Clinique du Sport Bordeaux-Mérignac, 2, rue Georges-Negrevergne, 33700 Mérignac, France
| | - François Molinier
- Clinique des Cèdres, route de Mondonville, 31700 Cornebarrieu, France
| | - Jonathan Benoist
- CHP Saint-Grégoire, 7, boulevard de la Boutière, 35760 Saint-Grégoire, France
| | - Fabrice Colin
- Clinique Mutualiste Catalane, 60, rue Louis-Mouillard, 66000 Perpignan, France
| | - André Thès
- Hôpital privé d'Eure-et-Loir, 2, rue Roland-Buthier, 28300 Mainvilliers, France; Service de chirurgie orthopédique et traumatologique, CHU Ambroise-Paré, AP-HP, groupe hospitalier universitaire Paris Île-de-France Ouest, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - Marc Elkaïm
- Clinique de Tournan, 2, rue Jules-Lefebvre, 77220 Tournan-en-Brie, France
| | - Olivier Boniface
- Clinique Générale-Annecy, 4, chemin de la Tour-la-Reine, 74000 Annecy, France
| | - Stéphane Guillo
- Clinique du Sport Bordeaux-Mérignac, 2, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Thomas Bauer
- Service de chirurgie orthopédique et traumatologique, CHU Ambroise-Paré, AP-HP, groupe hospitalier universitaire Paris Île-de-France Ouest, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
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- 15, rue Ampère, 92500 Rueil Malmaison, France
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Mavrogenis AF, Quaile A, Pećina M, Scarlat MM. Citations, non-citations and visibility of International Orthopaedics in 2017. INTERNATIONAL ORTHOPAEDICS 2018; 42:2499-2505. [PMID: 30298386 DOI: 10.1007/s00264-018-4198-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Marko Pećina
- Department of Orthopaedics, School of Medicine, University of Zagreb, Zagreb, Croatia
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