Arthroscopic-Assisted Repair of Chronic Lateral Ankle Instability

Côrte-Real, Nuno; Nery, Caio; Raduan, Fernando; Guerra-Pinto, Francisco

doi:10.1007/978-3-662-62763-1_23

Cited by 25 publications

(39 citation statements)

References 28 publications

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“…Arthroscopic repair or reconstruction of the lateral ligament(s) of the ankle has developed rapidly and has become increasingly popular. 14,43 To date, arthroscopic repair or augmentation has focused on the ATFL 1,2,9,10,[21][22][23]25,29,40 ; however, few reports have described arthroscopic repair of the CFL 42 because of its anatomical characteristics outside the capsule. Favorable results of arthroscopic repair have been reported in patients with a remnant isolated ATF injury.…”

Section: Discussionmentioning

confidence: 99%

Advancement of Periosteal and Capsular Complexes With or Without Augmentation Using a Free Graft From Lower Extensor Retinaculum: A Comparative Study With Propensity Score Matching

Sugimoto

Isomoto

Miura

et al. 2023

Foot & Ankle Orthopaedics

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Background: This study compared the outcome of the L-shaped (L-AD) advancement of the periosteal and capsular complexes with or without augmentation using a free graft of the lower extensor retinaculum (AUG) in patients with chronic lateral ankle instability. Methods: A matched pair analysis was performed of retrospectively collected medical records of patients undergoing lateral ankle ligament repair who had completed at least 2 years of follow-up. Patients who underwent L-AD with AUG and patients undergoing L-AD alone were matched for age, sex, stress radiography findings, and body mass index. Patients with general joint laxity, osteoarthritic changes in the ankle, and subtalar symptoms and who underwent simultaneous surgical treatment for conditions other than that for lateral ankle ligament were excluded. A total of 46 patients were included in the study (23 patients in each group). Clinical outcome scores and postoperative mechanical instability were compared. Results: The median American Orthopaedic Foot & Ankle Society (AOFAS) score improved significantly ( P < .001) from 72 to 97 in the L-AD alone group and from 77 to 100 in the L-AD with AUG group. The mean (±SD) talar tilt angles improved significantly from 11.1 to 4.7 degrees postoperatively ( P < .001) in the L-AD alone group vs 9.7 to 5.2 degrees ( P < .001) in the L-AD with AUG group. The mean anterior drawer distances were improved significantly postoperatively from 6.4 to 4.7 mm ( P < .001) in the L-AD alone group, and from 6.5 to 4.5 mm ( P < .001) in the L-AD with AUG group. Conclusion: The L-AD technique significantly improved AOFAS scores and mechanical instability of ankles with chronic lateral instability with a very low complication rate. Additional augmentation using a free graft showed no advantages in the ankle with a talar tilt of <20 degrees. Level of Evidence: Level III, retrospective case-control series.

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Section: Discussionmentioning

confidence: 99%

Advancement of Periosteal and Capsular Complexes With or Without Augmentation Using a Free Graft From Lower Extensor Retinaculum: A Comparative Study With Propensity Score Matching

Sugimoto

Isomoto

Miura

et al. 2023

Foot & Ankle Orthopaedics

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“…However, 1 patient in each group developed neurologic complications. Pain or discomfort due to a prominent suture knot is a frequent complication 8,10 . Vega et al introduced all-inside arthroscopic repair with a knotless suture anchor technique to prevent such complications 8 .…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic All-Inside Anterior Talofibular Ligament Repair with and without Inferior Extensor Retinacular Reinforcement

Jo¹,

Lee

Kim

et al. 2021

Journal of Bone and Joint Surgery

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Background: The utility of inferior extensor retinacular (IER) reinforcement for arthroscopic repair of a lateral ankle injury is debatable. We hypothesized that the outcomes would not differ significantly between arthroscopic all-inside anterior talofibular ligament (ATFL) repair with and without IER reinforcement. Methods: We prospectively randomized 73 patients who had arthroscopic all-inside ATFL repair into 2 groups: those who had IER reinforcement (37 patients) and those who had no IER reinforcement (36 patients). The primary outcome was the Karlsson Ankle Functional Score (KAFS). The secondary outcomes included the Foot and Ankle Outcome Score (FAOS), Tegner activity score (TAS), ankle range of motion, and radiographic parameters. The functional outcomes were evaluated preoperatively and at 6 and 12 months postoperatively. Stress radiographs were obtained preoperatively and at 12 months postoperatively. Results: The KAFS, all FAOS subscale scores, and TAS improved significantly at 1 year postoperatively in both groups, with no significant differences between the groups with respect to the preoperative and postoperative values. Significant differences were not observed between the ankle range of motion values recorded preoperatively and at 1 year postoperatively in both groups; the preoperative and postoperative range of motion values did not differ significantly between the groups. The mean talar tilt and talar anterior translation decreased significantly at 1 year postoperatively in both groups, with no significant differences between the groups preoperatively and postoperatively. One patient in each group had neuralgia of the superficial peroneal nerve; 2 patients in the IER reinforcement group had knot irritation causing mild discomfort. Conclusions: Arthroscopic all-inside ATFL repair with and without IER reinforcement showed comparable functional and stress radiographic outcomes at 1 year. Performing IER reinforcement in addition to all-inside arthroscopic direct ATFL remnant repair is not necessary. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

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“…Potential benefits of arthroscopic repair of the lateral ankle ligaments include decreased surgical morbidity and quicker recovery time (97). Clinical studies focusing on the effectiveness of arthroscopic techniques performed on lateral ankle ligaments have reported different outcomes (24,43,84). Some studies have reported positive functional scores, but complications were also reported in the form of superficial peroneal nerve injury, deep vein thrombosis, and wound issues (43), whereas other clinical studies reported no wound or nerve complications (24,84).…”

Section: Treatmentmentioning

confidence: 99%

“…Clinical studies focusing on the effectiveness of arthroscopic techniques performed on lateral ankle ligaments have reported different outcomes (24,43,84). Some studies have reported positive functional scores, but complications were also reported in the form of superficial peroneal nerve injury, deep vein thrombosis, and wound issues (43), whereas other clinical studies reported no wound or nerve complications (24,84). Arthroscopic techniques have shown to be successful in various clinical studies but are continuing to be refined.…”

Section: Treatmentmentioning

confidence: 99%

The Role of Strength and Conditioning in the Prevention and Treatment of Chronic Lateral Ankle Instability

Young

Morris

Herda

2021

Strength &Amp; Conditioning Journal

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Lateral ankle sprains are one of the most common injuries sustained during sport or physical activity. Up to 40% of individuals can develop chronic lateral ankle instability (CLAI) after a lateral ankle sprain. CLAI occurs when functional or mechanical insufficiencies of the lateral ankle ligamentous complex persist. The purpose of this article is to identify characteristics of CLAI and describe strength and conditioning strategies that can be used to treat lateral ankle ligamentous injuries, preventing them from progressing on to CLAI (See Video, Supplemental Digital Content 1, http://links.lww.com/SCJ/A306).

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Arthroscopic-Assisted Repair of Chronic Lateral Ankle Instability

Cited by 25 publications

References 28 publications

Advancement of Periosteal and Capsular Complexes With or Without Augmentation Using a Free Graft From Lower Extensor Retinaculum: A Comparative Study With Propensity Score Matching

Advancement of Periosteal and Capsular Complexes With or Without Augmentation Using a Free Graft From Lower Extensor Retinaculum: A Comparative Study With Propensity Score Matching

Arthroscopic All-Inside Anterior Talofibular Ligament Repair with and without Inferior Extensor Retinacular Reinforcement

The Role of Strength and Conditioning in the Prevention and Treatment of Chronic Lateral Ankle Instability

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