Late results of surgical repair in recent ruptures of the lateral ligament of the ankle

Agoropoulos, Z.; Papachristou, G.; Efstathopoulos, Nicolas; Kokoroghiannis, Constantine

doi:10.1016/s0020-1383(97)00065-x

Cited by 14 publications

(13 citation statements)

References 24 publications

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“…Two studies38 39 reported the number of athletes returning to sport at specified time intervals. One study40 reported a range time for all athletes. RTP metrics and results for all included studies are shown in table 1.…”

Section: Resultsmentioning

confidence: 99%

Return to sport following lateral ankle ligament repair is under-reported: a systematic review

et al. 2017

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ImportanceAnkle sprains are the most commonly occurring musculoskeletal injury. Reconstruction of the lateral ligament complex is often required for athletes with recurrent instability, or high-grade acute sprains, in order to return to their pre-injury level of sport.ObjectiveThe purpose of this systematic review was to evaluate the spectrum, prevalence and quality of evidence regarding return to sport timeline following lateral ligament surgery.Evidence reviewA search was conducted of Embase and Medline databases from the earliest possible entry to November 2016. Studies reporting a timeline regarding return to play (RTP) following lateral ankle ligament reconstruction were included in this review.FindingsOf 3184 total articles, 20 articles evaluating 489 athletes met the criteria and were included for review. Thirteen of the 20 papers were used to calculate a weighted mean time to RTP of 4.7 months. Overall, both the frequency and quality of RTP criteria and reporting were very low.Conclusions and relevanceThe current review identifies a clear deficiency in the literature pertaining to consistent, meaningful postoperative RTP timeline following lateral ankle ligament repair. Published studies vary considerably in the metrics used for measuring patient-reported outcomes, and very few actually track them. Further studies on outcomes following ankle ligament repair should include clear and consistent metrics for return to sport and level of play. Standardised and reproducible criteria for reporting RTP for athletes will improve the utility and applicability of outcomes data as surgical and rehabilitative techniques continue to advance.Level of evidenceSystematic review of level I–IV studies, level IV.

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Section: Resultsmentioning

confidence: 99%

Return to sport following lateral ankle ligament repair is under-reported: a systematic review

et al. 2017

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“…It is not possible to determine whether these would have developed inevitably in an injured ankle or whether they were due to altered biomechanics after surgery. 3 Although the operation alters the biomechanics of the subtalar joint, degenerative changes were seen radiologically in only four cases. This would dispel concerns about such a procedure regularly leading to subtalar osteoarthritis.…”

Section: Discussionmentioning

confidence: 96%

“…The latter is the mainstay of treatment with emphasis on early mobilisation rather than immobilisation in a cast. [1][2][3] A large number of methods of reconstruction have been described, many being slight variations of the same technique. The techniques are either non-anatomical with a tendon graft or fascia lata, [4][5][6][7][8] or anatomical in which the remnants of the ligaments are either repaired or sutured to bone, with or without augmentation with another structure such as the inferior extensor retinaculum.…”

mentioning

confidence: 99%

A long-term review of a modified Evans procedure

Nimon

Dobson

Angel

et al. 2001

The Journal of Bone and Joint Surgery. British volume

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O f 111 primary ankle ligament arthroplasties (modified Evans procedure) performed between 1983 and 1994, we were able to identify 89 patients (94 ankles) for follow-up. All were under 50 years of age. Two had died and one refused to co-operate; 86 patients (91 ankles) were therefore reviewed, 25 by telephone and the remainder by clinical examination with all but three also undergoing radiological review.Of the 91 ankles, 70 had no or very mild pain and 72 had no or rare episodes of instability and when considered together only 59 (65%) had no or mild pain and minimal instability. Injuries of the lateral ligament complex of the ankle are common.1 Opinions on the treatment of an acute disruption of the lateral ligament complex have varied between early repair and non-operative management. The latter is the mainstay of treatment with emphasis on early mobilisation rather than immobilisation in a cast. 1-3A large number of methods of reconstruction have been described, many being slight variations of the same technique. The techniques are either non-anatomical with a tendon graft or fascia lata, 4-8 or anatomical in which the remnants of the ligaments are either repaired or sutured to bone, with or without augmentation with another structure such as the inferior extensor retinaculum. 9Anatomical reconstructions have been shown to reduce talar tilt and the anterior-drawer sign to a greater extent than occurs with non-anatomical reconstructions.7-9 While the short-term results are good, the long-term results are unknown.The short-and long-term results for various non-anatomical reconstructions have, however, been well documented and vary considerably. [10][11][12][13] The Evans procedure is a nonanatomical reconstruction which was first described in 1953 4 as a dynamic stabilisation of the ankle. The tendon of peroneus brevis is divided below the musculotendinous junction and passed through a tunnel drilled in the fibula, starting distally at the tip of the fibula and emerging posteriorly and superiorly. The tendon is then re-attached to its muscle belly. Since the initial description the procedure has been modified by two main variations. One involves routing the tendon of peroneus brevis posterosuperiorly through the tunnel so that it emerges at the tip of the fibula, and then attaching it alongside its insertion at the base of the fifth metatarsal. 11,12 The second variation follows the original procedure, but all or part of the tendon is taken through the tunnel and sutured to the fibular periosteum, thus allowing it to act as a tenodesis rather than a dynamic stabiliser. The senior authors (PJD, KRA, PLL, TMS) have used the second modification of the Evans procedure since 1983. We have studied retrospectively all such patients to determine long-term satisfaction, stability, hindfoot biomechanics and the rate of degenerative changes.

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“…Our literature review showed only 2 studies with level 1 evidence. 24,42 Further, only 8 studies randomized their patient cohorts. 14,19,24,26,30,36,42,45 Porter et al 44 randomized their cohort and compared outcomes between PR and STA and demonstrated a low risk for bias.…”

Section: Quality Bias Assessmentmentioning

confidence: 99%

“…24,42 Further, only 8 studies randomized their patient cohorts. 14,19,24,26,30,36,42,45 Porter et al 44 randomized their cohort and compared outcomes between PR and STA and demonstrated a low risk for bias. However, the majority of studies were case series.…”

Section: Quality Bias Assessmentmentioning

confidence: 99%

Primary Repair, Reconstruction, and Suture Tape Augmentation All Provide Excellent Outcomes for Lateral Ligament Instability: A Systematic Review

Vopat

Lee

Mok

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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Late results of surgical repair in recent ruptures of the lateral ligament of the ankle

Cited by 14 publications

References 24 publications

Return to sport following lateral ankle ligament repair is under-reported: a systematic review

Return to sport following lateral ankle ligament repair is under-reported: a systematic review

A long-term review of a modified Evans procedure

Primary Repair, Reconstruction, and Suture Tape Augmentation All Provide Excellent Outcomes for Lateral Ligament Instability: A Systematic Review

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