Abstract:BackgroundThe purpose was retrospectively to investigate functional and clinical outcomes after anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) reconstruction using a single allograft.MethodsPatients with severe chronic lateral instability of the ankle underwent surgery after conservative treatment failed. Ultrasounds of the ankle were performed, and if the AFTL and CFL were completely torn without enough soft tissue for repair, the ligaments were reconstructed using allograft tendon. O… Show more
“…Surgery is recommended in patients with chronic lateral ankle instability resistant to conservative methods, so as to restore stability, prevent intra-articular derangement and avoid early osteoarthritis [1,8,9,15,17]. The Broström technique, possibly associated with the Gould modification, is the gold standard of all proposed surgical repair techniques for chronic lateral ankle instability [1,12,31,32].…”
Section: Discussionmentioning
confidence: 99%
“…Anatomical repairs and reconstructions aim to restore as close as possible the normal anatomy. In non-anatomical reconstructions, autografts or allografts are used: the normal biomechanics of the ankle may be slightly altered in favour of greater stability [12,[16][17][18]. Recently, arthroscopic and combined arthroscopic-percutaneous approaches have been developed [2,[19][20][21][22].…”
<p>Background: Ankle sprains are common, affecting especially the lateral ligament complex of the ankle, often leading to chronic symptoms and instability. Many procedures have been described for chronic ankle instability. This study analyses clinical outcomes and returns to sport in patients who underwent minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus tendon autograft.</p><p>Methods: Twenty-three patients (mean age: 33.9 years) with grade 3 lesion of both anterior-talofibular (ATFL) and calcaneofibular (CFL) ligaments, underwent minimally invasive reconstruction of the ATFL and CFL ligaments with an ipsilateral semitendinosus tendon autograft. They were retrospectively reviewed and return to sport was evaluated with the Halasi ankle activity scale.</p><p>Results: The mean follow-up was 30 months (range 26-53 months). The mean AOFAS score increased from 68.6 to 95.3 point. The average VAS decreased from 3.6 to 1.3. The Halasi score changed from 5.0 to 5.1. Excepts for Halasi, the differences were statistically significant (p <0.001).19 patients judged the received treatment as excellent, 2 as good. No revision procedures were performed. No major complications were reported.</p> <p>Conclusions: This study confirms good clinical and sports outcomes following minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus autograft.</p>
“…Surgery is recommended in patients with chronic lateral ankle instability resistant to conservative methods, so as to restore stability, prevent intra-articular derangement and avoid early osteoarthritis [1,8,9,15,17]. The Broström technique, possibly associated with the Gould modification, is the gold standard of all proposed surgical repair techniques for chronic lateral ankle instability [1,12,31,32].…”
Section: Discussionmentioning
confidence: 99%
“…Anatomical repairs and reconstructions aim to restore as close as possible the normal anatomy. In non-anatomical reconstructions, autografts or allografts are used: the normal biomechanics of the ankle may be slightly altered in favour of greater stability [12,[16][17][18]. Recently, arthroscopic and combined arthroscopic-percutaneous approaches have been developed [2,[19][20][21][22].…”
<p>Background: Ankle sprains are common, affecting especially the lateral ligament complex of the ankle, often leading to chronic symptoms and instability. Many procedures have been described for chronic ankle instability. This study analyses clinical outcomes and returns to sport in patients who underwent minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus tendon autograft.</p><p>Methods: Twenty-three patients (mean age: 33.9 years) with grade 3 lesion of both anterior-talofibular (ATFL) and calcaneofibular (CFL) ligaments, underwent minimally invasive reconstruction of the ATFL and CFL ligaments with an ipsilateral semitendinosus tendon autograft. They were retrospectively reviewed and return to sport was evaluated with the Halasi ankle activity scale.</p><p>Results: The mean follow-up was 30 months (range 26-53 months). The mean AOFAS score increased from 68.6 to 95.3 point. The average VAS decreased from 3.6 to 1.3. The Halasi score changed from 5.0 to 5.1. Excepts for Halasi, the differences were statistically significant (p <0.001).19 patients judged the received treatment as excellent, 2 as good. No revision procedures were performed. No major complications were reported.</p> <p>Conclusions: This study confirms good clinical and sports outcomes following minimally invasive reconstruction of the lateral ligaments complex of the ankle with a semitendinosus autograft.</p>
Background: The surgical management of chronic lateral ankle instability (CLAI) has evolved since the 1930s, but for the past 50 years, the modified Broström technique of ligament repair has been the gold standard. However, with the development of arthroscopic techniques, significant variation remains regarding when and how CLAI is treated operatively, which graft is the optimal choice, and which other controversial factors should be considered. Purpose: To develop clinical guidelines on the surgical treatment of CLAI and provide standardized guidelines for indications, surgical techniques, rehabilitation strategies, and assessment measures for patients with CLAI. Study Design: A consensus statement of the Chinese Society of Sports Medicine. Methods: A total of 14 physicians were queried for their input on guidelines for the surgical management of CLAI. After 9 clinical topics were proposed, a comprehensive systematic search of the literature published since 1980 was performed for each topic through use of China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, EMBASE, and the Cochrane Library. The recommendations and statements were drafted, discussed, and finalized by all authors. The recommendations were graded as grade 1 (strong) or 2 (weak) based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Based on the input from 28 external specialists independent from the authors, the clinical guidelines were modified and finalized. Results: A total of 9 topics were covered with regard to the following clinical areas: surgical indications, surgical techniques, whether to address intra-articular lesions, rehabilitation strategies, and assessments. Among the 9 topics, 6 recommendations were rated as strong and 3 recommendations were rated as weak. Each topic included a statement about how the recommendation was graded. Conclusion: This guideline provides recommendations for the surgical management of CLAI based on the evidence. We believe that this guideline will provide a useful tool for physicians in the decision-making process for the surgical treatment of patients with CLAI.
“…Dong et al reported the surgical effects of 20 cases receiving remnant-preserving lateral ankle ligament reconstruction, and suggested that, the ATFL-preserving remnant better recovered the function after ankle ligament reconstruction, and emphasized the importance of remnant-preserving surgery and favorable clinical follow-up results [28]. However, Wang et al performed ATFL reconstruction to treat 19 CLAI cases, no ATFL ligament remnant was preserved introperatively, and patients were followed up for an average of 30 months after surgery; their results suggested that, the AOFAS score was improved from 64.00 to 90.32 points, and the authors indicated that remnant-preservation was unnecessary in ATFL reconstruction [29]. Jiang et al…”
Background Anterior talofibular ligament (ATFL) reconstruction is a valid treatment of chronic lateral ankle instability (CLAI). The purpose of this study was to evaluate the significance of preserving and not preserving remnant in ATFL reconstruction, as well as the clinical efficacy.Methods From January 2015 to July 2017, fifty-three admitted remnant-preserving CLAI patients with ATFL injury were prospectively randomized as remnant-preserving group (preservation of ATFL) and non-preserving group (no preservation of ATFL). All patients received anatomic reconstruction of ATFL using the semitendinosus tendon autograft. The Visual Analogue Scale (VAS) score, the American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), Anterior Talar Translation (ATT), and ankle proprioceptive recovery in both groups were compared.Results All patients were followed up for at least 2 years, and difference in the follow-up time between two groups was not statistically significant. Differences in VAS, AOFAS, KAFS, ATT and ankle proprioceptive recovery between two groups were not statistically significant.Conclusions Compared with non-remnant-preserving surgery, there are no short-term follow-up differences in postoperative ankle function, stability and proprioceptive recovery when semitendinosus tendon autograft is used to treat CLAI through remnant-preserving ATFL reconstruction.Level of Evidence: Level III, a prospective comparative study.Trial registration: Xuzhou Central Hospital, ZXYY-2015090. Registered 21 November 2014
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