Arthroscopic debridement of anterior ankle impingement in patients with chronic lateral ankle instability

Yang, Qin; Zhou, Yongwei; Xu, Youjia

doi:10.1186/s12891-018-2168-6

Cited by 17 publications

(16 citation statements)

References 24 publications

(30 reference statements)

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“…The ankle joint is the most commonly injured part of the human motion system. The most vulnerable part is the lateral collateral ligament of the ankle joint (21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

A comparison of the modified Broström procedure and modified Karlsson procedure in treating chronic lateral ankle instability: a systematic review and meta-analysis

Deng¹,

Zou²,

Zhu³

et al. 2021

Ann Palliat Med

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Background: This study sought to compare the efficacy and surgery complications of the modified Broström procedure and the modified Karlsson procedure in treating patients with chronic lateral ankle instability (CLAI).Methods: Full-text publications on the clinical efficacy of Broström's and Karlsson's procedures were retrieved from multiple databases. Review Manager 5.0 was adopted for the meta-analysis, sensitivity analysis, and bias analysis. Results: Nine studies comprising a total of 643 patients were identified. The meta-analysis suggested that the American Orthopedic Foot and Ankle Society (AOFAS) scores of patients in the Karlsson group were higher than those of patients in the Broström group [mean deviation (MD) =6.31, 95% confidence interval (CI): 2.31-10.30, P=0.002; P for heterogeneity <0.00001, I2=58%]. The Tegner scores of patients in the Karlsson group were higher than those of patients in the Broström group (MD =0.72, 95% CI: 0.48-0.95, P=0.24; P for heterogeneity <0.00001, I2=23%). Operation times in the Broström group were higher than those in the Karlsson group (MD =−15.50, 95% CI: −19.98-−11.02, P<0.00001; P for heterogeneity <0.00001, I2=63%). Patients in the Karlsson group had higher levels of satisfaction than those in the Broström group (MD =0.63, 95% CI: 0.47-0.79, P<0.00001; P for heterogeneity =0.91, I2=0%). No significant difference was observed in surgery complications between the Karlsson and Broström groups [odds ratio (OR) =1.71, 95% CI: 0.79-3.71, P=0.18; P for heterogeneity =0.99, I2=0%].Discussion: Based on the heterogeneity analysis results, this study showed that Karlsson's procedure was more efficient and safer than Broström's treatment in the treatment of CLAI patients.

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“…The ankle joint is the most commonly injured part of the human motion system. The most vulnerable part is the lateral collateral ligament of the ankle joint (21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

A comparison of the modified Broström procedure and modified Karlsson procedure in treating chronic lateral ankle instability: a systematic review and meta-analysis

Deng¹,

Zou²,

Zhu³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

show abstract

“…For patients with ankle instablity, taking advantage of the anterior median view portal and using the three‐portal approach, it was easy to position the distal fibula through the lateral working portal. The factors related to the poor treatment of ankle impact arthroscopy include patients being older, longer delay from trauma to surgical treatment, ankle joint relaxation, and osteoarthritis joint space narrowing 18,19 .…”

Section: Discussionmentioning

confidence: 99%

Three‐Portal Approach of Arthroscopy for Anterior Ankle Impingement Syndrome: A Propensity Score‐Matched Analysis

Wang

Cui

2021

Orthopaedic Surgery

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Objective To introduce a 3‐portal approach of arthroscopic for anterior ankle impingement syndrome and to compare this method with 2‐portal arthroscopy. Methods From July 2011 to April 2019, a total of 52 patients (30 females, 22 males) with anterior ankle impingement syndrome underwent surgery with 2‐portal approach (anterior medial and anterior lateral approach; N = 26) and modified 3‐portal approach (anterior medial, anterior lateral, and an accessory anterior median approach; N = 26) of arthroscopic were recruited retrospectively after we performed a propensity score‐matched analysis (PSMA). The mean age at operation time was 44.1 years (range from 22 years to 74 years) and the mean follow‐up duration was more than two years (range from 2 years to 9 years). Clinical outcomes of all patients were evaluated according to the range of motion (ROM, dorsal flex angle), the American Orthopaedic Foot and Ankle Society lesser metatarsophalangeal interphalangeal scale (AOFAS), the visual analogue scale (VAS), and the operation time before and after the surgery. Results During the follow‐up period, both two groups indicated significant improvement in these function scores. Clinical assessment showed that for the 2‐portal approach of arthroscopic the total average of AOFAS scores were significantly increased from preoperative 59.91 ± 5.281 points to postoperative 76.18 ± 1.471 points (P = 0.02), the VAS scores were significantly decreased from preoperative 7.64 ± 0.924 points to postoperative 4.18 ± 0.982 points (P = 0.04), and the dorsal flex angle was significantly increased from preoperative 12.27° ± 6.467° to postoperative 21.36° ± 3.931° at the last follow‐up (P = 0.035). However, for the 3‐portal approach of arthroscopic the total average of AOFAS scores were significantly increased from preoperative 48.64 ± 9.646 points to postoperative 79.18 ± 6.555 points (P = 0.015), the VAS scores were significantly decreased from preoperative 7.82 ± 0.751 points to postoperative 2.64 ± 1.629 points (P = 0.01), and the dorsal flex angle was significantly increased from preoperative 13.64° ± 7.775° to postoperative 20.45° ± 6.502° at the last follow‐up (P = 0.045). There were no significant differences among the dorsal flex angle, the AOFAS scores, and the VAS scores between the two groups at the last follow‐up (P > 0.05). Although the operation time of the 3‐portal approach of arthroscopic (74.82 ± 18.395 min) was longer than that of the 2‐portal approach of arthroscopic (92.55 ± 27.153 min), the difference was not significant (P > 0.05). Conclusion Both the 2‐portal and the 3‐portal approach of arthroscopic provides almost the same satisfactory clinical outcomes for anterior ankle impingement syndrome, but we strongly suggest the 3‐portal approach of arthroscopic which can supply greater joint contact area to treat advanced impingement syndrome for a good result.

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“…Of the 7 studies that evaluated sex as a variable, 4 (57%) reported a difference in findings. 5,9,29,50 In the study by Baums et al, 5 68% of male patients and 80% of female patients had AMI/ALI with a traumatic ankle sprain. Buda et al 9 conducted a multivariate analysis and showed that male patients had a significantly worse outcome at a 6-year follow-up (P = .03).…”

Section: Sex-related Outcomesmentioning

confidence: 97%

“…Of the 28 studies, 7 (25%) included sex-specific analysis when evaluating outcomes. 5,9,11,29,46,47,50 However, 4 (14%) failed to report sex even as a demographic variable. 3,25,32,34 Of the 24 studies that included demographic information, there were 1053 (61%) male patients and 685 (39%) female patients.…”

Section: Sex-related Outcomesmentioning

confidence: 99%

Outcomes After Arthroscopic Surgery for Anterior Impingement in the Ankle Joint in the General and Athletic Populations: Does Sex Play a Role?

et al. 2021

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Background: Although anterior ankle impingement is a common pathology within the athletic population, there have been limited data evaluating outcomes of arthroscopic intervention and whether patient sex affects treatment outcomes. Purpose: To provide an overview of the clinical outcomes of arthroscopic procedures used as a treatment strategy for anterior ankle impingement and to determine if patient sex affects outcomes. Study Design: Systematic review. Methods: A systematic literature search of the MEDLINE, Embase, and Cochrane databases was performed during August 2019. The following combination of search terms was utilized: “ankle,” “impingement,” “talus,” “osteophyte,” “arthroscopy,” “surgery,” “procedures,” and “treatment.” Two reviewers independently performed data extraction. Results: A total of 28 articles evaluating 1506 patients were included in this systematic review. Among the studies, 60% (17/28) and 14% (4/28) assessed anterolateral and anteromedial impingement, respectively. Good to excellent results were reported after arthroscopy in patients with anterior ankle impingement, with a success rate of 81.04%. All studies that evaluated functional outcomes (16/16; 100%) cited improvements in American Orthopaedic Foot & Ankle Society scale, visual analog scale, and Foot Function Index. The average complication rate was 4.01%, with the most common complications being mild nerve symptoms and superficial infection. The most common concomitant pathologies included synovitis, osteophytes, meniscoid lesions, and anterior inferior tibiofibular ligament injury. Four studies (15%) failed to report sex as a demographic variable. Only 7 (25%) studies included analysis by sex, with 4 (57%) of these demonstrating differences when comparing outcomes by patient sex. When compared with male patients, female patients exhibited higher rates of traumatic ankle sprains, chondral injury, and chronic ankle instability associated with anterior ankle impingement. Conclusion: Our systematic review demonstrates that arthroscopic treatment for anterior ankle impingement provides good to excellent functional outcomes, low complication rates, and good return-to-sports rates in both the general and the athletic population. This study also reports a lack of statistical analysis evaluating outcomes comparing male and female populations. The included studies demonstrate that, compared with male patients, female patients have higher rates of traumatic ankle sprains, chondral injury, and chronic ankle instability associated with anterior ankle impingement; therefore, particular attention should be paid to addressing such concomitant pathology.

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Arthroscopic debridement of anterior ankle impingement in patients with chronic lateral ankle instability

Cited by 17 publications

References 24 publications

A comparison of the modified Broström procedure and modified Karlsson procedure in treating chronic lateral ankle instability: a systematic review and meta-analysis

A comparison of the modified Broström procedure and modified Karlsson procedure in treating chronic lateral ankle instability: a systematic review and meta-analysis

Three‐Portal Approach of Arthroscopy for Anterior Ankle Impingement Syndrome: A Propensity Score‐Matched Analysis

Outcomes After Arthroscopic Surgery for Anterior Impingement in the Ankle Joint in the General and Athletic Populations: Does Sex Play a Role?

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