Arthroscopic Repair of Lateral Ankle Ligament for Chronic Lateral Ankle Instability: A Systematic Review

Brown, Alexandra J.; Shimozono, Yoshiharu; Hurley, Eoghan T.; Kennedy, John G.

doi:10.1016/j.arthro.2018.02.034

Cited by 38 publications

(33 citation statements)

References 23 publications

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“…Exclusion criteria: (i) patients with symptomatic lateral instability of the ankle or instability of other joints (subtalar joint); (ii) patients with complicated diseases such as foot and ankle deformities, abnormal line of force, fracture, joint stiffness, or other ligament injuries; (iii) patients with complicated central and peripheral neuromuscular atrophy or ligament relaxation; (iv) patients who underwent ATFL reconstruction or had higher requirements for exercise; (v) patients with abnormal bone structure around the insertion of the distal fibular ATFL ligament that could not be implanted with anchors; (vi) patients with osteoarthritis of the ankle or osteochondral injury requiring osteochondral transplantation; (vii) patients who had received follow‐up within less than 12 months or those with complicated, serious underlying diseases and could not tolerate the operation; (viii) patients who had complicated rupture of the calcaneofibular ligament or posterior talofibular ligament; and (ix) patients who had an avulsion fracture of lateral malleolus and a diameter of fracture block greater than 5 mm.…”

Section: Methodsmentioning

confidence: 99%

“…With heightened requirements for postoperative aesthetic appearance and functional recovery, minimally invasive treatment of ankle sports injury is increasingly sought by both doctors and patients. With the development of arthroscopic technology in recent years, arthroscopic repair of the lateral ankle ligament has become one of the hotspots in foot and ankle surgery and sports medicine. Through systematic analysis, Guelfi et al .…”

Section: Introductionmentioning

confidence: 99%

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Arthroscopic Anatomical Repair of Anterior Talofibular Ligament for Chronic Lateral Instability of the Ankle: Medium‐ and Long‐Term Functional Follow‐Up

Feng

Sun

Wang

et al. 2020

Orthopaedic Surgery

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Objective: To evaluate the functional outcomes of arthroscopic anatomical repair of anterior talofibular ligament (ATFL) in the treatment of chronic lateral ankle instability (CLAI) during medium-and long-term follow-up.Methods: From September 2014 to August 2017, the data of 37 patients (23 males, 14 females; 12 left ankles, 25 right ankles) aged between 21 and 56 years, with an average age of 32.17 AE 6.35 years, presenting with CLAI, was retrospectively analyzed. Among them, 32 injuries were caused by sprain and five injuries were caused by car accidents. The course of the disease lasted for 12 to 60 months, with an average of 26.07 AE 13.29 months. All patients had intact skin around the ankle and no skin lesions. All patients underwent arthroscopic anatomical repair of ATFL, with the fixation of one to two anchors. Pre-and post-operative visual analogue scales (VAS), the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), and the Karlsson Ankle Functional Score (KAFS) were compared to evaluate the curative effect of the operation. Results:The operation was successful in all 37 cases. The operation time ranged from 40 to 75 min, with an average of 51.25 AE 11.49 min. After surgery, all incisions healed in stage I and there were no complications such as nerve, blood vessel and tendon injury, implant rejection, or suture rejection. Hospital stays of postoperative patients were 3 to 5 days, with an average of 3.77 AE 1.36 days. All patients were followed for 24 to 45 months, averaging 33.16 AE 10.58 months. For three patients with CLAI combined with mild limitation of subjective ankle movement, joint activity was normal after rehabilitation function exercise and proprioceptive function training for 2 months. At the final follow-up, ankle pain had disappeared completely. The ankle varus stress test and ankle anterior drawer test were both negative. Range of joint motion was good. There was no lateral instability of the ankle and all patients returned to normal gait. The mean VAS score decreased to 1.12 AE 0.13, the AOFAS score increased to 92.53 AE 4.87, and the KAFS score increased to 93.36 AE 6.15. All the follow-up indexes were significantly different from those before surgery.Conclusion: Arthroscopic anatomical repair of ATFL for CLAI is precise, with less surgical trauma and reliable medium-and long-term effect.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arthroscopic Anatomical Repair of Anterior Talofibular Ligament for Chronic Lateral Instability of the Ankle: Medium‐ and Long‐Term Functional Follow‐Up

Feng

Sun

Wang

et al. 2020

Orthopaedic Surgery

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“…Nonanatomical repairs provide poor long-term results and are not recommended as the first choice for treatment. 2,6 The Broström technique is an anatomic repair technique and has been a standard procedure for chronic lateral ankle instability. However, it soon became clear that this procedure was insufficient, and changes were then described to tighten and strengthen the repair.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment is indicated in cases of chronical instability, after the failure of conservative treatment. The technique established today worldwide consists in repairing the ligament (Broström technique 2 ) and strengthening the repair by adding extensor retinaculum (Gould technique 3,4 ). An arthroscopic technique recently has been developed to treat ankle instability.…”

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confidence: 99%

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All-Inside Endoscopic Broström–Gould Technique

Guillo

Odagiri

2020

Arthroscopy Techniques

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Ankle sprain is the most frequent sports trauma. Surgical treatment is needed in case of chronical instability, after failure of conservative treatment. The technique established today worldwide consists in repairing the ligament (Broström technique) and strengthening the repair by adding extensor retinaculum (Gould technique). An arthroscopic technique recently has been developed; nevertheless, no published technique has proposed a total endoscopic Broström technique associated with a Gould augmentation because of difficulty in visualizing the retinaculum by anterior ankle arthroscopy. Lateral ankle endoscopy can provide a view of this area that is superior to open surgery. In this technique, the procedure is able to be performed safely and reproducible under perfect viewing. The purpose of this study is to describe an all-inside endoscopic BroströmeGould technique.

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Arthroscopic treatment of ankle multiligamentous injuries provides similar clinical outcomes to the treatment of isolated lateral ligament injury at the 2‐year follow‐up

Guelfi,

Vega,

Dalmau‐Pastor

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeRotational ankle instability is a multiligamentous injury defined as an overload injury of the deltoid ligament caused by a long‐standing injury of the lateral collateral ligament in patients affected by chronic ankle instability. The purpose of the study was to compare the clinical outcomes of combined arthroscopic repair of lateral and medial ankle ligaments for rotational ankle instability versus isolated arthroscopic lateral ligament repair for lateral ankle instability at 2 years' follow‐up.MethodsBetween 2019 and 2021, 108 patients with chronic ankle instability were consecutively treated by arthroscopy. Of this group, 83 patients (77%) [median age: 26 (range, 14–77) years] underwent an isolated all‐inside lateral ligament repair for lateral ankle instability (group A). In the remaining 25 patients (23%) [median age: 27 (range, 17–58) years], rotational ankle instability was clinically suspected and confirmed during arthroscopy; thus, a combined all‐inside repair of lateral and medial ligaments was performed (group B). The same postoperative protocol was utilised for both groups. Patients were prospectively evaluated before surgery, at 3, 6, 12 and 24 months with Foot Functional Index (FFI) score, visual analogue scale (VAS) and Foot and Ankle Ability Measure–Sports subscale (FAAM‐SS). At the latest follow‐up, the satisfaction rate and complications were also recorded.ResultsIn both groups, FFI, VAS and FAAM‐SS scores significantly improved compared to preoperative values (p < 0.001). In addition, according to all the scores evaluated, there was no significative difference (n.s) between groups at the final follow‐up or at any of the intermediate follow‐up. No major complications were observed in both groups.ConclusionsArthroscopic ligament repair in case of ankle multiligamentous injuries, such as in rotational ankle instability, provides excellent clinical outcomes and is comparable to isolated lateral ligament repair at 2 years' follow‐up. Therefore, when treating ankle instability, arthroscopic repair of each and every ligament that appears injured provides the best potential outcomes and is the recommended treatment.Level of EvidenceLevel II, prospective comparative.

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Arthroscopic Repair of Lateral Ankle Ligament for Chronic Lateral Ankle Instability: A Systematic Review

Cited by 38 publications

References 23 publications

Arthroscopic Anatomical Repair of Anterior Talofibular Ligament for Chronic Lateral Instability of the Ankle: Medium‐ and Long‐Term Functional Follow‐Up

Arthroscopic Anatomical Repair of Anterior Talofibular Ligament for Chronic Lateral Instability of the Ankle: Medium‐ and Long‐Term Functional Follow‐Up

All-Inside Endoscopic Broström–Gould Technique

Arthroscopic treatment of ankle multiligamentous injuries provides similar clinical outcomes to the treatment of isolated lateral ligament injury at the 2‐year follow‐up

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