A Ligament Reattachment Technique for High-Demand Athletes With Chronic Ankle Instability

Cho, Byung-Ki; Kim, Yong-Min; Shon, Hyun-Chul; Park, Kyoung-Jin; Cha, Jung-Kwon; Ha, Yoon-Won

doi:10.1053/j.jfas.2014.09.008

Cited by 31 publications

(33 citation statements)

References 32 publications

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“…Then, 41 articles were critically reassessed, and 28 articles remained after the secondary screen. Of the 28 articles identified for study inclusion, 8 studies utilized EM 8,10,22,23,[28][29][30][31] for their postoperative rehabilitation protocol, and 21 studies utilized DM. || Only 1 study looked at the comparison between EM and DM postoperative protocols.…”

Section: Resultsmentioning

confidence: 99%

Early Versus Delayed Mobilization Postoperative Protocols for Lateral Ankle Ligament Repair: A Systematic Review and Meta-analysis

Vopat

Tarakemeh

Morris

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: The majority of patients with an acute lateral ankle ligamentous injury are successfully treated nonoperatively with functional rehabilitation; however, a small proportion of these patients experience persistent chronic instability and may require surgical intervention. Delayed primary repair of the ruptured ligaments is most commonly indicated for these patients. Optimal rehabilitation after lateral ankle ligament repair remains unknown, as surgeons vary in how they balance protection of the surgical repair site with immobilization against the need for ankle joint mobilization to restore optimal postoperative ankle range of motion. Purpose: To compare early and delayed mobilization (EM and DM, respectively) postoperative protocols in patients undergoing primary lateral ankle ligament repair to determine optimal evidence-based rehabilitation recommendations. Study Design: Systematic review; Level of evidence, 4. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a meta-analysis using the PubMed/Ovid MEDLINE database was performed (October 11, 1947 to October 16, 2017), searching for articles involving lateral ankle ligament repair. Postoperative protocols were reviewed and divided into 2 categories: EM (within 3 weeks of surgery) and DM (more than 3 weeks post surgery). Return to sport (RTS), outcome scores (American Orthopaedic Foot and Ankle Society [AOFAS] ankle-hindfoot scale and Karlsson score), radiographic outcomes (talar tilt and anterior drawer), and complications of both populations were recorded and statistically analyzed. Results: A total of 28 of 1574 studies met the criteria for the final analysis, comprising 1457 patients undergoing primary lateral ankle ligament repair. The postoperative AOFAS score was significantly greater in the EM versus DM group (98.8 vs 91.9, respectively; P < .001), as was the postoperative Karlsson score (92.2 vs 90.0, respectively; P < .001). However, the EM group had significantly greater postoperative laxity on both the anterior drawer test (6.3 vs 3.9 mm, respectively; P < .001) and talar tilt test (5.1° vs 4.5°, respectively; P < .001). Also, the DM group had significantly lower rates of overall complications (3.1% vs 11.4%, respectively; P < .001) and skin wound complications (1.3% vs 3.8%, respectively; P = .005). RTS was not significantly different between groups ( P = .100). Conclusion: Patients with EM postoperative protocols demonstrated improved functional outcomes; however, the EM group had increased objective laxity and a higher complication rate. Additional randomized studies are needed to definitively evaluate early versus delayed rehabilitation protocol timetables to optimize functional outcomes without compromising long-term stability.

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Section: Resultsmentioning

confidence: 99%

Early Versus Delayed Mobilization Postoperative Protocols for Lateral Ankle Ligament Repair: A Systematic Review and Meta-analysis

Vopat

Tarakemeh

Morris

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…The Broström procedure has been modified to obtain better clinical outcomes, superior mechanical stability, early rehabilitation, and rapid return to preinjury activity levels. 6,7 Ligament repair augmentation using suture-tape is a recently developed procedure for chronic ankle instability. Although recent biomechanical studies 24,26,28 reported mechanical superiority of an augmented anterior talofibular (ATF) ligament reconstruction using suture-tape, clinical evidence regarding its usefulness is still insufficient.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of the Modified Broström Procedure Augmented With Suture-Tape for Ankle Instability in Patients With Generalized Ligamentous Laxity

Cho

Park

et al. 2016

Foot Ankle Int.

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“…References 2 –4, 6 –13, 15 –17, 19, 20, 24 –33, 35 –37, 40 –46, 51, 53, 54, 56 –58, 64, 67, 69, 72 –81, 85 –87, 90 –97, 99, 102 –…”

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confidence: 99%

“…eReferences 2, 3, 7, 8, 12, 26 –29, 35, 36, 38, 42 –44, 46, 69, 73, 74, 86, 90, 93, 95, 97, 102, 103, 105, 107, 114, 117 –119, 132, 134, 139, 142, 151, 153, 156, 157, 166, 179, 180, 184, 189, 191, 196, 197, 199, 206, 215, 216, 226, 229, 234.…”

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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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A Ligament Reattachment Technique for High-Demand Athletes With Chronic Ankle Instability

Cited by 31 publications

References 32 publications

Early Versus Delayed Mobilization Postoperative Protocols for Lateral Ankle Ligament Repair: A Systematic Review and Meta-analysis

Early Versus Delayed Mobilization Postoperative Protocols for Lateral Ankle Ligament Repair: A Systematic Review and Meta-analysis

Outcomes of the Modified Broström Procedure Augmented With Suture-Tape for Ankle Instability in Patients With Generalized Ligamentous Laxity

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

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