Arthroscopic Internal Brace Augmentation With Arthroscopic Modified Broström Operation for Chronic Ankle Instability

Nishimura, Akinobu; Nakazora, Shigeto; Senga, Yoshiyuki; Kitaura, Yukie; Fukuda, Aki; Kato, Ko; Sudo, Akihiro

doi:10.1016/j.eats.2020.11.021

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…In another study that used internal brace augmentation, which is believed to further increase the strength of the repair, the patient was put into a plaster shell for 1 week, and weightbearing was avoided. 24 Postoperative immobilization in a cast and avoidance of weightbearing for a certain period after ALLR may help stabilize the ligament repair, but its temporary effects include reduced joint ROM and muscle strength around the ankle, as well as diminished proprioceptive sensory input, potentially delaying athletes' return to competitive sport. Ideally, proactive postoperative care should be provided that avoids placing the repaired ligament and the anchor under strain.…”

Section: Discussionmentioning

confidence: 99%

Effect of Accelerated Rehabilitation on Early Return to Sport After Arthroscopic Ankle Lateral Ligament Repair

Teramoto

Murahashi

Takahashi

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Although the minimal invasiveness of arthroscopic ankle lateral ligament repair (ALLR) means that an early return to sporting activities can be anticipated, studies have described postoperative cast immobilization and the avoidance of weightbearing for a certain period. Accelerated rehabilitation may be helpful for an early return to sport. Purpose: To investigate clinical outcomes of ALLR and accelerated rehabilitation with a minimum duration of postoperative ankle immobilization and proactive early weightbearing. Study Design: Case series; Level of evidence, 4. Methods: This study investigated 23 ankles of 22 patients (11 men, 11 women; mean age, 38.7 years) who underwent ALLR for chronic lateral ankle instability. Postoperative management included the avoidance of weightbearing until postoperative day 3, after which full weightbearing walking with a brace was permitted. The objective was to return to competitive sport 8 weeks after surgery. The following were evaluated: pre- and postoperative instability and pain symptoms, ankle range of motion, anterior drawer distance on stress radiograph, anterior translation measured with a capacitance-type strain sensor, the Ankle-Hindfoot Scale from the Japanese Society for Surgery of the Foot, and the SAFE-Q (Self-Administered Foot Evaluation Questionnaire). Results: Two male patients dropped out and were excluded from analysis. Postoperatively, instability and pain resolved or improved in all patients. There was no significant postoperative change in range of motion. There were significant pre- to postoperative improvements in talar tilt angle (from 12.2°-5.6°, P < .01), anterior drawer distance (8.2-4.4 mm, P < .01), and anterior translation (10.5-4.6 mm, P < .01) as well as the Ankle-Hindfoot Scale score (68.8-96.8, P < .01) and all subscales of the SAFE-Q ( P ≤ .01 for all). Complete return to sport was achieved by 75% of the patients at 8 weeks postoperatively. Conclusion: When accelerated rehabilitation with proactive weightbearing exercises was implemented from postoperative day 3 without ankle immobilization after ALLR, there were significant improvements in objective assessments of ankle stability and clinical scores, and as many as 75% of the patients were able to make a complete return to sport within 8 weeks.

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Section: Discussionmentioning

confidence: 99%

Effect of Accelerated Rehabilitation on Early Return to Sport After Arthroscopic Ankle Lateral Ligament Repair

Teramoto

Murahashi

Takahashi

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…Finally, a K-wire is inserted into the talar drill hole and the knotless anchor can be inserted into the talus. Positioning of the holes must be confirmed under arthroscopy to insure correct insertion 27…”

Section: Discussionmentioning

confidence: 99%

“…Although the modified Brostrom procedure is the gold standard for surgical treatment of CLAI, success of this repair depends on the quality of the ligament. In cases where the ligament is severely attenuated, surgeons often decide to augment it using the Gould modification or hamstring graft 27. However, more recently, augmentation with suture tape has been used to supplement poor quality ligament.…”

Section: Discussionmentioning

confidence: 99%

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Modern Surgical Techniques for Treatment of Chronic Lateral Ankle Instability

Kukadia

Murphy²,

Shah³

et al. 2022

Techniques in Foot &Amp; Ankle Surgery

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: Ankle sprains are among the most common injuries sustained during sports and physical activity. Around 2 million ankle sprains occur per year with ~85% of them being lateral ankle sprains. Lateral ankle sprains involve damage to the lateral ligamentous complex of the ankle. Patients with a history of lateral ankle sprains are at a 3.5× greater risk of re-injury than those who do not have a history of lateral ankle sprain. Repeated damage to the lateral ligamentous complex can result in the development of chronic lateral ankle instability (CLAI). CLAI can be managed conservatively or surgically. Given the frequency with which sprains occur, and the relative infrequency of symptoms requiring an operation, 80 to 85% of patients can be managed conservatively with good results and minimal disability. However, even with conservative treatment, a 56 to 74% recurrence rate of ankle sprain has been reported. Patients with CLAI who continue to display persistent symptoms after rehabilitation through conservative measures may require surgical intervention. These surgical techniques include direct ligament repair, anatomic reconstruction, and nonanatomic reconstruction. In this chapter we will discuss these procedures, along with their implications and associated risks. We offer different surgical techniques to manage CLAI and available outcome data. Level of Evidence: Diagnostic level 4, case series.

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“…1 3 [1,12,16,18,22,24], but few studies made a comparison between the diferent arthroscopic methods. Simple suture techniques have been widely used [6,11,15,23,25]; however, lasso-loop techniques have also become popular since Takao and colleagues irst introduced the lasso-loop stitch in arthroscopic ATFL repair [20][21][22]26].…”

Section: Introductionmentioning

confidence: 99%

The lasso-loop technique is equivalent to the simple suture technique in arthroscopic anterior talofibular ligament repair

Guo

Chen

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To compare the clinical outcomes of the lasso-loop and simple suture techniques in arthroscopic anterior taloibular ligament (ATFL) repair for the treatment of chronic lateral ankle instability (CLAI). Methods From 2018 to 2020, patients with CLAI who underwent arthroscopic ATFL repair using the lasso-loop or simple suture technique were matched 1:1 (arthroscopic lasso-loop [AL] group, n = 29; simple arthroscopic suture [AS] group, n = 29) based on age, sex, afected side, body mass index, and follow-up duration using propensity score matching and retrospectively evaluated. Karlsson score, visual analogue scale (VAS) score, Tegner score, anterior drawer test (ADT) results, complications, patient-reported satisfaction, and magnetic resonance (MR) re-evaluation indings of ATFL quality were used to describe the outcomes. ResultsThe patient characteristics or follow-up durations did not signiicantly difer between the two groups. The Karlsson score, VAS score, and Tegner score improved signiicantly in both groups after a mean follow-up duration of 29.6 ± 2.8 months. The postoperative clinical scores, ADT results, satisfaction rates, complication rates and MR re-evaluation indings were not signiicantly diferent between the two groups at the latest follow-up. ConclusionThe lasso-loop technique was equivalent to the simple suture technique in arthroscopic ATFL repair for the treatment of CLAI after a minimum follow-up of 2 years, suggesting that the simple suture technique is suicient for arthroscopic ATFL repair in most patients without the need to add a lasso loop. Level of evidence Level III.

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Arthroscopic Internal Brace Augmentation With Arthroscopic Modified Broström Operation for Chronic Ankle Instability

Cited by 10 publications

References 11 publications

Effect of Accelerated Rehabilitation on Early Return to Sport After Arthroscopic Ankle Lateral Ligament Repair

Effect of Accelerated Rehabilitation on Early Return to Sport After Arthroscopic Ankle Lateral Ligament Repair

Modern Surgical Techniques for Treatment of Chronic Lateral Ankle Instability

The lasso-loop technique is equivalent to the simple suture technique in arthroscopic anterior talofibular ligament repair

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