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Badell JS, Cottom JM. Postoperative Magnetic Resonance Evaluation of Anterior Talofibular Ligament Following Arthroscopic Brostrom Procedure: Analysis and Outcomes of 40 Repairs at 12 Months. J Foot Ankle Surg 2024; 63:250-255. [PMID: 38061624 DOI: 10.1053/j.jfas.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 01/06/2024]
Abstract
Lateral ankle sprains are one of the most common orthopedic injuries. When conservative treatment fails, surgical correction is often performed using either open or arthroscopic techniques. We hypothesize that MRI evaluation of the arthroscopic brostrom repair will show intact repair and decrease in thickness of the anterior talofibular ligament (ATFL) at 1 year, with statistically significant improvement of patient function and pain scores. Postoperative MRI was utilized at minimum 1-year follow-up to evaluate the integrity of the arthroscopic brostrom repair, as well as comparison of ATFL thickness to literature validated average thickness. A musculoskeletal fellowship trained radiologist performed all MRI reads. In addition, 3 fellowship trained foot and ankle specialists from a single institution all performed measurements of the ATFL. Surgical satisfaction using 1 to 100 scale, and Karlsson-Peterson (KP) were measured at 1 year postoperatively. In addition, pre- and postoperative Foot Function Index (FFI), American Orthopedic Foot and Ankle (AOFAS) hindfoot scores, and Visual Analog Scale (VAS) were measured using unpaired t tests. All repairs were shown to be intact at minimum 1-year follow-up via MRI evaluation, with ATFL thickness of 2.21 mm. Preoperative FFI, AOFAS, and VAS were 54.9, 46.4, and 7.1 respectively. Postoperative scores were 11.0, 91.7, and 1.3 respectively. Surgical satisfaction was 88.2, KP was 75.3. Comparison of pre- and postoperative scores (VAS, FFI, AOFAS) were shown to be statistically significant, p < .05. No significant difference in demographic data was observed at 1 year. The data from this study offers evidence that the arthroscopic brostrom repair provides patients with good outcomes as well as an intact ATFL with normal morphology at 1 year postoperatively.
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Affiliation(s)
- Jay S Badell
- Florida Orthopedic Foot & Ankle Center, Sarasota, FL.
| | - James M Cottom
- Director, Florida Orthopedic Foot & Ankle Center Fellowship, Sarasota, FL
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Sethi M, Limaye R, Rai A, Limaye N. Anterior Talo-Fibular Ligament Reconstruction With InternalBrace™ for Chronic Lateral Ankle Instability in Pediatric Patients. Cureus 2023; 15:e44979. [PMID: 37822443 PMCID: PMC10563824 DOI: 10.7759/cureus.44979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION Ankle injuries and instability in a pediatric age group are common problems and often underreported. The injuries can range from a relatively benign ankle sprain to pain-limiting ankle instability that can inhibit the child from participating in sporting activities. However, conservative management and physiotherapy are the mainstay of treatment; a small group of patients present with persistent instability and benefit from surgical intervention in lateral ligament reconstruction. Our study looked at pediatric patients who had instability following failed conservative management. METHODS Retrospective analysis of 14 patients with Chronic lateral Ankle instability (CLAI) who underwent Modified Brostrom-Gould repair( MBG) with or without Internal brace augmentation between January 2015 and October 2020. Patients were evaluated for the visual analogue scale (VAS), Manchester-oxford foot questionnaire (MOxFQ), subjective satisfaction, and return to preinjury activity level. RESULTS Pain score improved from 8 (average 5-9) to 1 (average 0-3) following surgery. Functional assessment was made by assessing the Manchester Oxford questionnaire pre-and postoperatively. MOxFQ scores improved from 64 (8 SD) to 7 (15 SD). Thirteen of fourteen patients returned to normal sporting activities at the final follow-up. CONCLUSION Modified Brostrom-Gould with InternalBrace™ augmentation is an excellent procedure for chronic lateral ligament injuries in the Paediatric population. It can be safely performed if we respect the anatomy and the physeal growth plate. It allows faster rehabilitation and return to preinjury activity level.
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Affiliation(s)
- Mohit Sethi
- Orthopaedics and Trauma, North Tees and Hartlepool NHS Foundation Trust, Stockton, GBR
| | - Rajiv Limaye
- Orthopaedics and Trauma, North Tees and Hartlepool NHS Foundation Trust, Stockton, GBR
| | - Avinash Rai
- Orthopaedics and Trauma, North Tees and Hartlepool NHS Foundation Trust, Stockton, GBR
| | - Neil Limaye
- Orthopaedics and Trauma, North Tees and Hartlepool NHS Foundation Trust, Stockton, GBR
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do Amaral E Castro A, Godoy-Santos AL, Taneja AK. Advanced Imaging in the Chronic Lateral Ankle Instability: An Algorithmic Approach. Foot Ankle Clin 2023; 28:265-282. [PMID: 37137622 DOI: 10.1016/j.fcl.2022.12.005] [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: 05/05/2023]
Abstract
Imaging examinations are a fundamental part of assessing chronic lateral ankle instability (CLAI). Plain radiographs are used in the initial examination, whereas stress radiographs can be requested to actively search for instability. Ultrasonography (US) and Magnetic Resonance Imaging (MRI) allow direct visualization of ligamentous structures, with the advantage of dynamic evaluation for US, and assessment of associated lesions and intra-articular abnormalities for MRI, which plays an essential role in surgical planning. This article reviews imaging methods to diagnose and follow up on CLAI, along with illustrative cases and an algorithmic approach.
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Affiliation(s)
- Adham do Amaral E Castro
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Jardim Leonor, São Paulo - SP, 05652-900, Brasil; Universidade Federal de São Paulo, Rua Napoleão de Barros, 800 - Vila Clementino - CEP 04024-002 - São Paulo, SP, Brasil
| | - Alexandre Leme Godoy-Santos
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Jardim Leonor, São Paulo - SP, 05652-900, Brasil; Faculdade de Medicina, USP, R. Dr. Ovídio Pires de Campos, 333 - Cerqueira César, São Paulo - SP, 05403-010, Brasil
| | - Atul K Taneja
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Jardim Leonor, São Paulo - SP, 05652-900, Brasil; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9316, USA.
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Muacevic A, Adler JR, Alharbi ZM, Saif S, Nejaim K, Almutairi M, Batouk O. Approach to Ankle Instability in Patients With a Negative Ankle MRI: A Case Series. Cureus 2023; 15:e34047. [PMID: 36824538 PMCID: PMC9941408 DOI: 10.7759/cureus.34047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2023] [Indexed: 01/23/2023] Open
Abstract
Objectives Injuries to the ankle ligaments are some of the most common musculoskeletal sports injuries. Ankle magnetic resonance imaging (MRI) is the standard diagnostic procedure in today's practice, but its reliability and validity remain controversial. The aim of this study was to explore the approach for patients with negative ankle MRI who continue to have symptoms of ankle instability despite conservative therapy. Methods A total of eight patients who were 14 years or older with negative ankle MRI who continue to have symptoms of ankle instability despite conservative therapy were admitted to our institution from January 1, 2015 to December 31, 2021. Results Eight patients with a mean age of 36, and a mean body mass index (BMI) of 37.7. All patients presented with ankle pain, locking, and giving way in variable severity. All the patients had a radiograph followed by an ankle MRI, which showed normal alignment of ankle joints without abnormality. Initially, all patients were treated conservatively but did not show any improvement. After that, they underwent an operation of lateral ankle ligament reconstruction by modified Brostrom technique, followed by casting and physiotherapy. The symptoms of ankle instability resolved in all patients. The ankle pain resolved completely in six patients, improved in one patient, and did not improve in one patient. Conclusion Based on our results, we advocate reconstruction surgery by modified Brostrom technique for ligament repair in patients with clinical evidence of chronic ankle instability who have failed a trial of conservative management, even in the context of a normal ankle MRI.
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Liu Z, Li J, Chen G, Gao S, Feng E, Su H, Chen H, Jiang T. Crochet Hook Technique for Arthroscopic Anterior Talofibular Ligament Repair: Technique Note. J Clin Med 2022; 11:jcm11236922. [PMID: 36498499 PMCID: PMC9740159 DOI: 10.3390/jcm11236922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/15/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022] Open
Abstract
Ankle sprains can lead to chronic lateral ankle instability caused by an injured anterior talofibular ligament (ATFL), and surgery is often required when conservative treatments fail. BROSTROM surgery is considered the gold standard and has a definite curative effect. Advancements in arthroscopic surgery and improvements in implanted anchors have led to an increase in ATFL repairs using arthroscopic surgery. Arthroscopic AFTL repair is less invasive, and patients could experience faster recovery compared to open AFTL repair. To simplify the complicated suture-passing processes in arthroscopic AFTL repair, we developed a crochet hook and loop wire technique, which is described in this paper.
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Affiliation(s)
- Zitao Liu
- Department of Orthopaedics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510261, China; (Z.L.); (G.C.); (E.F.); (H.S.)
| | - Jing Li
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.L.); (S.G.)
| | - Gengxin Chen
- Department of Orthopaedics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510261, China; (Z.L.); (G.C.); (E.F.); (H.S.)
| | - Shihua Gao
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou 510006, China; (J.L.); (S.G.)
| | - Enhui Feng
- Department of Orthopaedics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510261, China; (Z.L.); (G.C.); (E.F.); (H.S.)
| | - Haitao Su
- Department of Orthopaedics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510261, China; (Z.L.); (G.C.); (E.F.); (H.S.)
| | - Haiyun Chen
- Department of Orthopaedics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510261, China; (Z.L.); (G.C.); (E.F.); (H.S.)
- Correspondence: (H.C.); (T.J.)
| | - Tao Jiang
- Department of Orthopaedics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510261, China; (Z.L.); (G.C.); (E.F.); (H.S.)
- Correspondence: (H.C.); (T.J.)
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Return to sports: Rate and time after arthroscopic surgery for chronic lateral ankle instability. Orthop Traumatol Surg Res 2022; 108:103398. [PMID: 36084915 DOI: 10.1016/j.otsr.2022.103398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/05/2021] [Accepted: 09/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Arthroscopic surgery for treating ankle instability is increasingly popular. Several studies showed similar functional outcomes to those seen after open surgery, with no increase in complications. The objective of this study was to evaluate the return-to-sports (RTS) rate and time after arthroscopic surgery to treat chronic lateral ankle instability. HYPOTHESIS The rate and time of RTS are satisfactory after arthroscopic surgery to treat chronic lateral ankle instability. MATERIAL AND METHODS This single-centre retrospective study included patients managed arthroscopically for chronic lateral ankle instability, with no other procedures, between February 2014 and May 2017. We evaluated the time and rate of RTS, as well as factors associated with RTS such as motivation, athletic level before surgery and whether the injury was work-related. Follow-up was at least 1 year. RESULTS Of the 40 included patients, 30 (75%) returned to their main sport, after a median of 6 months. Moreover, 22 (55%) patients resumed their main sport at the same or a higher level within 12 months after surgery, their median postoperative follow-up being 29 months (range, 13-61). The AOFAS score improved significantly, from 67 (30-90) before surgery to 88.5 (39-100) at last follow-up (p<0.001). The numerical pain score decreased significantly between these two timepoints, from 6 (0-10) to 1 (0-10) (p<0.001). By multivariate analysis, a high level of motivation before surgery was the main factor significantly associated with RTS at the same or a higher level within 12 months after surgery (odds ratio, 16.47; 95%CI, 3.33-81.20; p=0.007). Persistent pain was more common in patients with work-related injuries (p=0.016). CONCLUSION At 12 months, the RTS rate was 75% overall, with 55% of patients returning to the same or a higher level. Median time to RTS was 6 months (4-8). Both the rate of and the time to RTS were independently associated with greater preoperative motivation. LEVEL OF EVIDENCE IV, retrospective observational cohort study.
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Preoperative Lymphocyte-to-Monocyte Ratio Can Indicate the Outcomes in Repair of I-III Degree Injury of Lateral Ankle Ligament. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6234561. [PMID: 35496050 PMCID: PMC9042596 DOI: 10.1155/2022/6234561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/23/2022] [Indexed: 11/17/2022]
Abstract
Background. This study is aimed at exploring the prognostic value of preoperative lymphocyte-to-monocyte ratio (LMR), an index of systemic inflammation before operation, in ankle lateral ligament repair (ALLR). Methods. A total of 213 I-III degrees injuries of lateral ankle ligament patients received ALLR and were followed up for more than 2 years. Univariate and multivariable linear regression analysis was used to determine the relationship between preoperative LMR and postoperative recovery. The evaluations of postoperative recovery include American Orthopaedic Foot and Ankle Society (AOFAS) score, Karlsson-Peter ankle score (KPAS), Cumberland Ankle Instability Tool (CAIT) score, Visual Analog Scale (VAS) score, and range of motion (ROM). The prognostic value of preoperative LMR was measured by receiver operating characteristic (ROC) curve. Results. 178 patients (178 ankles) were followed up successfully, with a follow-up of
years. Overall, the mean AOFAS, KPAS, CAIT and VAS scores, and ankle varus angle were significantly improved at the final follow-up. Univariate and multiple linear regression analysis showed that preoperative LMR was the only independent factor associated with postoperative function, ROM, and pain. The preoperative LMR of patients with poor recovery was significantly lower than that of patients with good recovery. Based on the ROC analysis, the cutoff value of preoperative LMR was 3.824. The clinical outcomes of patients with
were significantly lower than that of patients with
. The corresponding specificity and sensitivity were 84.6% and 71.4%. Conclusion. The clinical outcomes of open or arthroscopic repair for ATFL injury are satisfactory. As a marker of systemic inflammation, preoperative LMR can be used as a prognostic indicator for ALLR.
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Jain NP, Ayyaswamy B, Griffiths A, Alderton E, Kostusiak M, Limaye RV. Is Internal brace augmentation a gold standard treatment compared to isolated Modified Brostrom Gould repair for chronic lateral ligament ankle instability? Effect on functional outcome and Return to preinjury activity: A retrospective analysis. Foot (Edinb) 2022; 50:101865. [PMID: 35248918 DOI: 10.1016/j.foot.2021.101865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/09/2021] [Accepted: 09/19/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Modified Brostrom Gould (MBG) repair is widely accepted procedure for chronic lateral ankle instability (CLAI), but there are limitations with regards to strength of repair and risk of reinjury and complications. Internal brace has been recently used as augmentation of standard MBG repair. It provides stronger construct, facilitates early mobilisation and protects repaired ligament with minimal surgical morbidity. The aim of present study is to compare the outcome of MBG repair without and with Internal brace augmentation (IB) in CLAI. METHODS Retrospective analysis of 172 patients with CLAI who underwent MBG repair with or without IBA between November 2017 and October 2019. Patients were evaluated for Visual analogue scale (VAS), Manchester-oxford foot questionnaire (MOxFQ), Patients subjective satisfaction and return to preinjury activity level. RESULTS 148 patients were included in the study with 87 in MBG group and 61 in IB group. The mean age, average injury-surgery interval and mean follow up duration was 40.6 ± 11.2 vs 37.5 ± 14.7 years, 13.1 ± 10.3 vs 14.1 ± 8 months and mean follow up duration of 24.2 ± 5.1 vs 20.7 ± 6.0 months respectively (p > 0.05). The mean time to return to preinjury activity level was significantly better in IB group compared to MBG group of 12.1 ± 2.3 vs 20.3 ± 3.9 weeks, p < 0.001. 55 (90.2%) patients in IB and 73 (83.7%) in MBG group return to preinjury activity level. Mean postoperative VAS score (1.9 ± 1.5 vs. 1.7 ± 1.4, p = 0.428), Mean MOxFQ score (19.7 ± 22.2 vs. 18.2 ± 15.4, p = 0.674) showed no significant difference between MBG and IB group respectively, at final follow up. CONCLUSION The use of IB augmentation with MBG repair showed significantly better outcome in terms of early rehabilitation and return to preinjury activity level compared to isolated MBG repair. The functional outcome and VAS score were better in IB group compared to MBG group with no significant difference. LEVEL OF EVIDENCE Level IV retrospective study.
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Affiliation(s)
- Nimesh P Jain
- Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom.
| | - Brijesh Ayyaswamy
- Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom
| | - Alexandra Griffiths
- Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom
| | - Elizabeth Alderton
- Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom
| | - Milosz Kostusiak
- Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom
| | - Rajiv V Limaye
- Department of Trauma and Orthopaedics, North Tees & Hartlepool University Hospital and NHS Foundation Trust, Stockton on Tees, United Kingdom
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Wheaton AJ. Editorial for "Cartilage Matrix Changes in Hindfoot Joints in Chronic Ankle Instability Patients After Anatomic Repair Using T2-Mapping: Initial Experience With 3-Year Follow-Up". J Magn Reson Imaging 2021; 55:244-245. [PMID: 34319634 DOI: 10.1002/jmri.27835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 11/12/2022] Open
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Tao H, Zhang Y, Hu Y, Li Q, Hua Y, Lu R, Xie Y, Li X, Zhang B, Chen S. Cartilage Matrix Changes in Hindfoot Joints in Chronic Ankle Instability Patients After Anatomic Repair Using T2-Mapping: Initial Experience With 3-Year Follow-Up. J Magn Reson Imaging 2021; 55:234-243. [PMID: 34189805 DOI: 10.1002/jmri.27809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Anatomic repair is widely accepted as the primary surgical treatment for chronic lateral ankle instability (CLAI). T2-mapping is a powerful tool for quantitative assessment of biochemical changes in cartilage matrix. PURPOSE To longitudinally evaluate cartilage matrix changes in the hindfoot joints of CLAI patients before and after anatomic repair by using T2-mapping with magnetic resonance imaging (MRI). STUDY TYPE Prospective. SUBJECTS Thirty-two CLAI patients (males/females = 20/12) and 21 healthy controls (males/females = 13/7). FIELD STRENGTH/SEQUENCE 3 T; sagittal multi-echo spin-echo technique (T2-mapping), coronal, sagittal, and axial spin-echo PD-FS, and sagittal T1WI sequences. ASSESSMENT MRI examinations were performed in CLAI patients at baseline (prior to surgery) and 3 years after anatomic repair and in healthy controls. On T2-maps, the hindfoot joints were segmented into 16 cartilage subregions. The T2 value of each subregion was measured. All patients were evaluated with the American Orthopedic Foot and Ankle Society (AOFAS) scale at baseline and after surgery. STATISTICAL TESTS Analysis of variance (ANOVA) and Student's t-test were used. The differences corresponding to P < 0.05 were considered statistically significant. RESULTS At baseline, the T2 values in most cartilage subregions of talar dome and medial posterior subtalar joint (pSTJ) were higher in CLAI patients than in healthy controls. After surgery, only the T2 value of anteriomedial talar dome decreased from that at baseline (31.11 ± 3.88 msec vs. 34.27 ± 5.30 msec). The T2 values of other subregions with elevated T2 values remained higher than healthy controls. There were no significant differences in T2 values in the midtarsal joints between CLAI patients and healthy controls (P = 0.262, 0.104, 0.169, 0.103). Postoperatively, the patients' AOFAS scores improved significantly from 67.81 to 89.13. DATA CONCLUSION CLAI patients exhibited elevated T2 values in most subregions of talar dome and medial pSTJ. After anatomic repair, although the patients exhibited good clinical outcomes, the elevated T2 values could not be fully recovered. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 4.
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Affiliation(s)
- Hongyue Tao
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyang Zhang
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiwen Hu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Rong Lu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuxie Xie
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiangwen Li
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Bo Zhang
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuang Chen
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
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Su BY, Yi SY, Peng T, Yi G, Zhang L. Comparison of Arthroscopic Surgery Versus Open Surgical Repair of the Anterior Talofibular Ligament: A Retrospective Study of 80 Patients from a Single Center. Med Sci Monit 2021; 27:e928526. [PMID: 33587726 PMCID: PMC7893828 DOI: 10.12659/msm.928526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background This retrospective study from a single center aimed to compare the safety and clinical outcomes of arthroscopic surgery vs open surgical repair of the anterior talofibular ligament (ATFL). Material/Methods We randomly divided 80 patients with ATFL injury divided into 2 groups: an open surgery group and an arthroscopic group. The operation time, intraoperative bleeding volume, and the postoperative recovery time of all patients were analyzed. The anterior displacement and talus tilt angle, the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), the Jersey Shore Science Fair (JSSF) ankle-hindfoot scale score, and the Karlsson Ankle Functional Score (KAFS) were compared at 6 months, 1 year, and 2 years after surgery. We collected data on the incidence of postoperative complications during follow-up. All significant results were supported with a P value. Results The operation time, intraoperative bleeding volume, and postoperative recovery time in the arthroscopic group were better than in the open group (P<0.05). The AOFAS, JSSF, and KAFS in the arthroscopic group were better than in the open group at 6 months after the operation (P<0.05). The AOFAS, JSSF, and KAFS scale scores were not significantly different between the 2 groups at 1 year and 2 years after the operation (P<0.05). Conclusions The findings from this retrospective study showed that the use of arthroscopic surgical repair of the ATFL is a safe minimally invasive technique with reduced blood loss and surgical duration and good clinical outcomes.
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Affiliation(s)
- Bo-Yuan Su
- Department of Orthopedics, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China (mainland)
| | - Shu-Yun Yi
- Department of Orthopedics, Zengcheng Branch of South Hospital of Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Ting Peng
- Clinical Medical College of Southwest Medical University, Luzhou, Sichuan, China (mainland)
| | - Gang Yi
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Expert Workstation in Luzhou, Luzhou, Sichuan, China (mainland).,Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou, Sichuan, China (mainland)
| | - Lei Zhang
- Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China (mainland).,Expert Workstation in Luzhou, Luzhou, Sichuan, China (mainland).,Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou, Sichuan, China (mainland)
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Tao H, Hu Y, Lu R, Zhang Y, Xie Y, Chen T, Chen S. Impact of Chronic Lateral Ankle Instability with Lateral Collateral Ligament Injuries on Biochemical Alterations in the Cartilage of the Subtalar and Midtarsal Joints Based on MRI T2 Mapping. Korean J Radiol 2020; 22:384-394. [PMID: 32932561 PMCID: PMC7909862 DOI: 10.3348/kjr.2020.0021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/31/2020] [Accepted: 06/03/2020] [Indexed: 02/07/2023] Open
Abstract
Objective To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = −0.687, p = 0.007; r = −0.609, p = 0.021, respectively). Conclusion CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.
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Affiliation(s)
- Hongyue Tao
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiwen Hu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Rong Lu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyang Zhang
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuxue Xie
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Tianwu Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuang Chen
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China.
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13
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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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Xu DL, Gan KF, Li HJ, Zhou SY, Lou ZQ, Wang Y, Li GQ, Ruan CY, Hu XD, Chen YL, Ma WH. Modified Broström Repair With and Without Augmentation Using Suture Tape for Chronic Lateral Ankle Instability. Orthop Surg 2020; 11:671-678. [PMID: 31456322 PMCID: PMC6712379 DOI: 10.1111/os.12516] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 06/27/2019] [Accepted: 07/19/2019] [Indexed: 12/26/2022] Open
Abstract
Objective To compare the clinical and radiological outcome between the modified Broström repair with augmentation using suture tape (MBA) and the modified Broström repair (MB) for patients with chronic lateral ankle instability. Methods A retrospective study was performed in Ningbo No. 6 Hospital. The study included 53 patients who underwent surgical treatment from March 2014 to July 2016 and were followed for 2 years. A total of 25 patients underwent modified Broström repair with augmentation using suture tape, and 28 patients were treated with modified Broström repair. Patients were evaluated using the American Orthopedic Foot and Ankle Scale (AOFAS) hindfoot scale, the Foot and Ankle Ability Measure (FAAM) score, range of motion (ROM), and the visual analogue scale (VAS). The talar tilt angle (TTA) and anterior talar translation (ATT) were used to evaluate the mechanical stability. All radiological outcomes were measured by two orthopaedic surgeons, with the measurements repeated 3 days later. Results The mean age of the patients was 26.6 ± 17.8 years in the MBA group and 28.1 ± 19.4 years in the MB group, and no statistical difference in preoperative data was found between two groups. There were significant differences before and after the operation within the groups. Both groups achieved satisfactory outcomes, and significant improvements (VAS, FAAM, AOFAS, TTA, and ATT) were observed between the 1‐year follow‐up and final follow‐up (P < 0.05). The MBA group showed significant improvement in the FAAM Sport (87.1 ± 5.4 vs 78.2 ± 12.0, P = 0.001) and total scores (93.1 ± 2.3 vs 90.5 ± 5.1, P = 0.027) at the final follow‐up compared with the MB group, and for the other outcomes, there were no significant differences between the two groups. Conclusion The modified Broström repair with augmentation using suture tap for chronic lateral ankle instability achieves a better outcome; however, further research is necessary.
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Affiliation(s)
- Ding-Li Xu
- Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China
| | - Kai-Feng Gan
- Department of Orthopaedic, Ningbo Medical Centre Lihuili Hospital, Ningbo, China
| | - Hao-Jie Li
- Department of Orthopaedic, Medical College of Ningbo University, Ningbo, China
| | - Shu-Yi Zhou
- Department of Orthopaedic, Medical College of Ningbo University, Ningbo, China
| | - Zhen-Qi Lou
- Department of Orthopaedic, Medical College of Ningbo University, Ningbo, China
| | - Yang Wang
- Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China
| | - Guo-Qin Li
- Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China
| | - Chao-Yue Ruan
- Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China
| | - Xu-Dong Hu
- Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China
| | - Yun-Lin Chen
- Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China
| | - Wei-Hu Ma
- Department of Orthopaedic, Ningbo No.6 Hospital, Ningbo, China
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15
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Evaluation modalities for the anatomical repair of chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 2020; 28:163-176. [PMID: 31646350 DOI: 10.1007/s00167-019-05755-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/07/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE Several evaluation modalities are reported in the literature dealing with the operative treatment of chronic ankle instability (CAI) both to establish the CAI diagnosis leading to the surgical indication and to assess the effectiveness of ankle stabilisation procedure. The purpose of this study is to present an overview of the pre- and postoperative evaluation modalities reported in the literature dealing with CAI operative treatment. The comprehensive analysis of the different modalities chosen by researchers is expected to suggest critical points in current evaluation ability of CAI surgical treatment. METHODS Systematic review of the literature on surgical treatment of CAI through anatomic procedures. Pubmed, Embase and Cochrane electronic databases were analysed, from 2004 to 2018. RESULTS One-hundred-and-four studies met inclusion in this systematic review. 88 out of 104 studies analysed preoperative mechanical laxity of the ankle to depict the ligamentous insufficiency related to the subjective feeling of functional instability. Stress radiographs and manual stress examination of the ankle were the two most common modalities to evaluate joint laxity, reported in 67 and 53 studies, respectively. Clinical Outcome Measurement Scales (COMs) is the most common evaluation modality (102 out of 104 studies) to assess CAI surgical outcome. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale (AOFAS) and the Karlsson score are the most frequent COMs, reported in the 66% and 33%, respectively of the included literature. The radiographic analysis of ankle laxity after stabilisation procedures is the second most frequent postoperative evaluation modality, reported in 55 out 104 studies. CONCLUSIONS There is a lack of standardization among researchers related to both the criteria to establish the CAI diagnosis leading to the surgical indication and the modality chosen to evaluate the effectiveness of surgical treatment. Future standardization of evaluation modalities in the CAI population is desirable to increase consistency of reported data. LEVEL OF EVIDENCE Level IV, review of level I, II, III and IV studies.
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16
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Yi G, Fu S, Yang J, Wang G, Liu Y, Guo X, Shi J, Zhang L. [A comparative study of all-arthroscopic technique and modified open Broström technique in repair of anterior talofibular ligament with anchors]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2019; 33:1503-1509. [PMID: 31823548 PMCID: PMC8355784 DOI: 10.7507/1002-1892.201905072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/26/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare the effectiveness of all-arthroscopic technique and modified open Broström technique in repair of anterior talofibular ligament (ATFL) for lateral instability of the ankle (LIA). METHODS A retrospective analysis was made on 65 patients who underwent ATFL repair with anchors for LIA between January 2014 and January 2017. The ATFL was repaired by all-arthroscopic technique in 35 patients (arthroscopic group) and modified open Broström technique in 30 patients (open group). There was no significant difference in age, gender, the side of injured ankle, the time from injury to operation, and preoperative anterior displacement of talus, tilt angle of talus, the Karlsson Ankle Functional (KAF) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Japanese Society for Surgery of the foot ankle-hindfoot (JSSF) scale score between the two groups (P>0.05). The operation time, the intraoperative bleeding volume, and the length of time for surgery recovery were recorded. The anterior displacement of talus, the tilt angle of talus, KAF score, AOFAS score, and JSSF scale score were evaluated at 2 weeks, 3 months, and the last follow-up. RESULTS All patients were followed up 24-30 months, with an average of 26 months. The operation time, intraoperative bleeding volume, and the length of time for surgery recovery of arthroscopic group were superior to open group (P<0.05). There were 2 cases of temporary ankle and dorsum numbness and 1 case of thread reaction in arthroscopic group; and there were 2 cases of temporary ankle and dorsum numbness and 2 cases of thread reaction in open group. The AOFAS score, KAF score, and JSSF scale score in arthroscopic group were significantly higher than those in open group (P<0.05) at 2 weeks after operation; there was no significant difference between the two groups at 3 months and the last follow-up (P>0.05). There was no significant difference in the anterior displacement of talus and the tilt angle of talus between the two groups at 2 weeks, 3 months, and last follow-up (P>0.05). CONCLUSION Compared with the modified open Broström technique, the all-arthroscopic technique, as a minimally invasive technique, can achieve the same effectiveness, and has the advantages of shorter operation time, less intraoperative bleeding, and less pain in the early stage.
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Affiliation(s)
- Gang Yi
- Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Academician Workstation in Luzhou, Luzhou Sichuan, 646000, P.R.China
| | - Shijie Fu
- Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Academician Workstation in Luzhou, Luzhou Sichuan, 646000, P.R.China
| | - Jing Yang
- Department of Gynaecology and Obstetrics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China
| | - Guoyou Wang
- Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Academician Workstation in Luzhou, Luzhou Sichuan, 646000, P.R.China
| | - Yang Liu
- Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Academician Workstation in Luzhou, Luzhou Sichuan, 646000, P.R.China
| | - Xiaoguang Guo
- Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Academician Workstation in Luzhou, Luzhou Sichuan, 646000, P.R.China
| | - Jie Shi
- Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Academician Workstation in Luzhou, Luzhou Sichuan, 646000, P.R.China
| | - Lei Zhang
- Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Academician Workstation in Luzhou, Luzhou Sichuan, 646000,
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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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