Arthroscopic treatment of chronic ankle instability: Prospective study of outcomes in 286 patients

Lopes, Ronny; Andrieu, Michaël; Cordier, Guillaume; Molinier, F.; Benoist, Jonathan; Colin, Fabrice; Thès, André; Elkaïm, Marc; Boniface, Olivier; Guillo, Stéphane; Bauer, Thomas

doi:10.1016/j.otsr.2018.09.005

Cited by 78 publications

(59 citation statements)

References 73 publications

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“…compared arthroscopic ATFL repair with open repair of ATFL in 207 patients with CLAI and obtained the same ligament fixation strength and clinical effect. Arthroscopic repair of ATFL can comprehensively evaluate the ligament condition of ATFL, deal with the complicated lesions, and realize satisfactory anatomical repair. Based on the clinical evaluation of this group, all 37 patients included in the study achieved satisfactory clinical results.…”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…6 The ATTL can be observed arthroscopically. 7 There are already several reports of arthroscopic lateral ankle ligament reconstruction for the anterior talofibular ligament, [8][9][10][11] calcaneofibular ligament, [12][13][14][15][16][17] posterior talofibular ligament, 18 and lateral talocalcaneal ligament. 19 Here we describe the arthroscopic reconstruction of the ATTL using a free tendon graft (ARATTL).…”

Section: Introduction (With Video Illustration)mentioning

confidence: 99%

Arthroscopic Reconstruction of the Anterior Tibiotalar Ligament Using a Free Tendon Graft

Higashiyama

Sekiguchi

Takata

et al. 2020

Arthroscopy Techniques

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Deltoid ligament injuries account for 5.1% to 15.8% of ankle sprains and occur with concomitant lateral ankle sprains. The anterior tibiotalar ligament (ATTL), located within the deep layer of the deltoid ligament complex, connects the talus and the tibia on the medial side of the ankle and controls ankle eversion and rotation. If conservative treatment for chronic medial ankle instability after an ankle sprain fails, ATTL repair or reconstruction might be necessary. Arthroscopic reconstruction techniques of the lateral ankle ligaments recently have been reported. Here, we describe arthroscopic reconstruction of the ATTL using a free tendon graft (ARATTL). This technique is less invasive than other treatments and results in a more stable medial ankle joint.

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“…Several technical reports 5-9 and short-term clinical results [10][11][12][13] of arthroscopic lateral ankle ligament reconstruction have been published. Although the remnant-preserving technique has already been reported in 2 studies, 32,33 neither study repaired the remnant.…”

Section: Discussionmentioning

confidence: 99%

“…A ligament reconstruction method using a free tendon is indicated in such cases. 3,4 A few technical reports [5][6][7][8][9] and short-term clinical results [10][11][12][13] of arthroscopic lateral ankle ligament reconstruction have been published. Recently, remnant-preserved anterior cruciate ligament (ACL) reconstruction has gained popularity because the remnant-preservation effect may be advantageous for graft remodeling, proprioceptive recovery, and clinical outcomes.…”

mentioning

confidence: 99%

Anatomical Arthroscopic Anterior Talofibular Ligament Repair and Reconstruction Using a Free Tendon

Higashiyama

Sekiguchi

Takata

et al. 2020

Arthroscopy Techniques

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Arthroscopic techniques for anterior talofibular ligament (ATFL) repair and reconstruction have been developed in recent years. We simultaneously performed anatomical arthroscopic ATFL repair and reconstruction using a free tendon graft. The ATFL remnant is carefully dissected only at the footprint of the superior limb of the ATFL, and a bone tunnel is created on each side of the fibula and talus. A soft suture anchor with 2 sets of threads is inserted into the fibular tunnel. One set of threads is used to grab the ATFL remnant via a lasso-loop technique, whereas the other set of threads is used to introduce the ATFL graft. The graft is first fixed with a screw in the talar tunnel. Subsequently, the ATFL remnant and the graft are tightened simultaneously by pulling the 2 sets of suture anchor threads at the fibular tunnel and are fixed with a screw. This technique provides the possible advantages of remnant preservation and promotion of load sharing by the repaired ATFL remnant and the reconstructed ATFL graft.

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Arthroscopic treatment of chronic ankle instability: Prospective study of outcomes in 286 patients

Cited by 78 publications

References 73 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

Arthroscopic Reconstruction of the Anterior Tibiotalar Ligament Using a Free Tendon Graft

Anatomical Arthroscopic Anterior Talofibular Ligament Repair and Reconstruction Using a Free Tendon

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