Prospective study of the “ Inside-Out” arthroscopic ankle ligament technique: Preliminary result

Nery, Caio; Fonseca, Lucas Furtado da; Raduan, Fernando; Moreno, Marcus Vinícius Mota Garcia; Baumfeld, Daniel

doi:10.1016/j.fas.2017.03.002

Cited by 24 publications

(21 citation statements)

References 26 publications

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“…cReferences 2, 4, 6 –9, 12, 13, 15 –17, 19, 20, 25, 28, 35, 40 –45, 51, 57, 58, 64, 67, 69, 72, 73, 76, 77, 79 –81, 85, 86, 96, 98, 109 –111, 114, 117 –119, 132, 136, 142, 144 –146, 154, 156, 164, 166, 168, 170, 174, 179, 180, 185, 191, 194, 196 –…”

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confidence: 99%

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Song

Liu

Sun

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: The surgical management of chronic lateral ankle instability (CLAI) has evolved since the 1930s, but for the past 50 years, the modified Broström technique of ligament repair has been the gold standard. However, with the development of arthroscopic techniques, significant variation remains regarding when and how CLAI is treated operatively, which graft is the optimal choice, and which other controversial factors should be considered. Purpose: To develop clinical guidelines on the surgical treatment of CLAI and provide standardized guidelines for indications, surgical techniques, rehabilitation strategies, and assessment measures for patients with CLAI. Study Design: A consensus statement of the Chinese Society of Sports Medicine. Methods: A total of 14 physicians were queried for their input on guidelines for the surgical management of CLAI. After 9 clinical topics were proposed, a comprehensive systematic search of the literature published since 1980 was performed for each topic through use of China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, EMBASE, and the Cochrane Library. The recommendations and statements were drafted, discussed, and finalized by all authors. The recommendations were graded as grade 1 (strong) or 2 (weak) based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Based on the input from 28 external specialists independent from the authors, the clinical guidelines were modified and finalized. Results: A total of 9 topics were covered with regard to the following clinical areas: surgical indications, surgical techniques, whether to address intra-articular lesions, rehabilitation strategies, and assessments. Among the 9 topics, 6 recommendations were rated as strong and 3 recommendations were rated as weak. Each topic included a statement about how the recommendation was graded. Conclusion: This guideline provides recommendations for the surgical management of CLAI based on the evidence. We believe that this guideline will provide a useful tool for physicians in the decision-making process for the surgical treatment of patients with CLAI.

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confidence: 99%

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Song

Liu

Sun

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…Nery et al prospectively presented a series of 26 patients who underwent arthroscopic repair for chronic lateral ankle instability. They showed that the postoperative AOFAS scores increased from 58 to 90 within a follow-up period of 27 months 24 . Yeo et al compared the open modified Broström-Gould method with the arthroscopic method.…”

Section: Discussionmentioning

confidence: 99%

Can American Orthopaedic Foot and Ankle Society (AOFAS) score prevent unnecessary MRI in isolated ankle ligament injuries?

Kandemir

Akar

Yigit

et al. 2022

J Orthop Surg (Hong Kong)

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Introduction and Objective Ankle injuries are the most common musculoskeletal injuries. Its incidence is also high among sports injuries. Direct X-ray, ultrasound and MRI can be requested after the history and physical examination in the patient who presents with ankle ligament injury. Some classifications are used for requesting direct X-ray after ankle injury. Since clear limits are not specified in the literature for MRI, the rate of unnecessary MRI examinations is high. We argue that the decision can be made according to the AOFAS score to be checked before MR is requested, and thus unnecessary MR requests can be reduced. Material and Method Ankle MRI images of patients who underwent ankle MRI due to ankle trauma between January 2018 and December 2020 were scanned. 328 patients who met the criteria were included in the study. Patients with AOFAS scores in their outpatient clinic records were identified. AOFAS scores of patients with at least one ligament injury and those with normal MR images were statistically compared. Sensitivity and specificity were determined for the AOFAS score using ROC analysis. Results Patients with ligament damage as a result of MRI examination were 21.3% (n=70), and patients without any ligament damage were 78.7% (n=258). There was a statistically significant difference in terms of AOFAS between the group with ligament damage and the group without ligament damage (p< 0.05). In the ROC analysis, the AOFAS threshold value for MR request was determined as 80.5 (84.3% sensitivity and 72.3% specificity). Based on the determined threshold value, 73 patients who had unnecessary MRI would have been eliminated, thus reducing the number of MRIs by 42.6%. Conclusion The AOFAS scores of patients with ligament damage were statistically significantly lower than those of patients without ligament pathology. Unnecessary MRI can be significantly prevented by using the AOFAS score in ankle traumas without bone fractures.

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“…With regard to the MINORS score, consensus was reached between the reviewers in all studies. Six noncomparative studies 5,8,17,27,28,46 had an average score of 8.8 out of 16 points (range, [7][8][9][10][11]. Six comparative studies [18][19][20]23,32,38 scored an average of 17 out of 24 points (range, [15][16][17][18][19].…”

Section: Methodological Qualitymentioning

confidence: 99%

One in Three Patients With Chronic Lateral Ankle Instability Has a Cartilage Lesion

et al. 2022

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Background: Chronic lateral ankle instability (CLAI) is associated with the presence or development of intra-articular pathologies such as chondral or osteochondral lesions, or (O)CLs. Currently, the incidence of (O)CLs in patients with CLAI is unknown. Purpose: To determine the incidence of (O)CLs in patients with CLAI. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A literature search was conducted in the PubMed (MEDLINE), Embase (Ovid), and Cochrane databases for articles published from January 2000 until December 2020. Two authors independently screened the search results and conducted the quality assessment using the methodological index for non-randomized studies (MINORS) criteria. Clinical studies were included that reported findings on the presence of ankle (O)CLs based on pre- or intraoperative diagnostic measures in patients with CLAI (>6 months of symptoms). Patient and lesion characteristics were pooled using a simplified method. Lesion characteristics included localization and chondral and osteochondral involvement. The primary outcome was the incidence of (O)CLs in ankles with CLAI. A random-effects model with 95% CIs was used to analyze the primary outcome. The distribution of (O)CLs in the ankle joint was reported according to talar or tibial involvement, with medial and lateral divisions for talar involvement. Results: Twelve studies were included with 2145 patients and 2170 ankles with CLAI. The pooled incidence of (O)CLs in ankles with CLAI was 32.2% (95% CI, 22.7%-41.7%). Among all lesions, 43% were chondral and 57% were osteochondral. Among all (O)CLs, 85% were located on the talus and 17% on the distal tibia. Of the talar (O)CLs, 68% were located medially and 32% laterally. Conclusion: (O)CLs were found in up to 32% of ankles with CLAI. The most common location was the talus (85%). Furthermore, most lesions were located on the medial talar dome (68%). These findings will aid physicians in the early recognition and treatment of ankle (O)CLs in the context of CLAI.

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Prospective study of the “ Inside-Out” arthroscopic ankle ligament technique: Preliminary result

Cited by 24 publications

References 26 publications

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Can American Orthopaedic Foot and Ankle Society (AOFAS) score prevent unnecessary MRI in isolated ankle ligament injuries?

One in Three Patients With Chronic Lateral Ankle Instability Has a Cartilage Lesion

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