Delayed reconstruction of lateral complex structures of the ankle

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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“…aReferences [38, 39, 44, 45, 49, 50, 77, 78, 82, 84, 88–90, 107–113, 117, 120–127, 129, 130, 132–134, 136]. …”

Section: Resultsmentioning

confidence: 99%

“…aReferences [12, 14, 17, 20–24, 26–29, 31, 32, 34, 44, 48, 51, 73, 75–78, 81, 83, 85, 87, 89, 93–96, 99, 100, 103, 109–111, 114, 117, 119–121, 123, 131, 134–137]. …”

Section: Resultsmentioning

confidence: 99%

Evaluation modalities for the anatomical repair of chronic ankle instability

Spennacchio

Meyer

Karlsson

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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“…Recent studies have also shown a significant incidence of associated injuries identified with arthroscopy, thus supporting its role as an adjuvant to surgical repair [33][34][35] Those patients that go on to surgical repair for chronic instability with anatomic techniques, such as a modified Brostrom, tend to have satisfaction rates greater than 85%. Other techniques, which use either tissue from another location in the patient's ankle or tissue from a cadaver, tend to have lower satisfaction rates when compared to anatomic repair techniques 33,[36][37][38] . No strong evidence exists to suggest that nonanatomic reconstruction leads to better outcomes.…”

Section: Outcomes/results Of Treatment/prognosismentioning

confidence: 99%

Ankle Sprains

Pino¹

2014

Rev LibrOfMed

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An ankle sprain is one of the most common injuries seen in professional and recreational athletes 1,2 . The injury usually involves inversion (turning in) of the ankle with some amount of injury to the lateral (outer) ligaments. Most of these injuries heal with little to no treatment, and infrequently develop long term instability and pain. Long-lasting problems have been found in up to 20% of patients who get twisting injuries and typically are a result of stiffness (lack of motion) or instability (loose joints).

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“…Pacientes com instabilidade do tornozelo habitualmente apresentam-se para o tratamento após sofrer uma entorse severa de tornozelo que progrediu para recorrente (9,10) . O diagnóstico é baseado nos achados clínicos e é realizado quando há elevada frouxidão nas manobras de gaveta anterior e inversão quando comparadas ao tornozelo contralateral.…”

Section: Introductionunclassified

“…O tratamento pode ser cirúrgico ou conservador com analgesia associada à fisioterapia para propriocepção e reforço de fibulares, tornozeleiras e adequações nas modalidades esportivas. Dentre as diversas técnicas cirúrgicas existem, por exemplo, o reparo direto ligamentar chamado de Brostrom, a reconstrução não anatômica chamada de Chrisman-Snook e a reconstrução anatômica com enxerto tendíneo que é o foco deste estudo (10)(11)(12) . O objetivo deste trabalho é avaliar os resultados clínicos e radiográficos dos pacientes operados por instabilidade la teral crônica do tornozelo com a técnica de reconstrução anatômica com autoenxerto de tendões flexores do joelho, através da melhora dos marcadores radiográficos de estresse em varo e gaveta anterior, bem como do escore AOFAS, comparando os resultados encontrados na literatura mundial (13,14) .…”

Section: Introductionunclassified