Assessment of the feasibility of arthroscopic visualization of the lateral ligament of the ankle: a cadaveric study

Thès, André; Klouche, Shahnaz; Ferrand, Michèle; Hardy, Philippe; Bauer, Thomas

doi:10.1007/s00167-015-3804-4

Cited by 51 publications

(39 citation statements)

References 14 publications

(18 reference statements)

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“…There is also a published technique to perform an arthroscopic ligament reconstruction using gracilis autograft which could be used in patients with moderate to severe ankle instability [79]. A cadaver study demonstrated that tunnels could realistically be placed within 4 mm of the true ATFL and CFL footprints [80]. Despite positive results published in the literature, the highest recommendation in a systematic review on minimally invasive surgical techniques for chronic lateral ankle instability was grade C (poor-quality evidence) [81].…”

Section: Arthroscopic Ligament Repairmentioning

confidence: 99%

Operative treatment of lateral ligament instability

Shakked

Karnovsky

Drakos

2017

Curr Rev Musculoskelet Med

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Purpose of review Ankle sprains, which account for 40% of sports injuries in the USA, can lead to chronic ankle instability. Chronic ankle instability can be classified as functional, mechanical, or a combination of both and is diagnosed using a combination of a physical exam, an MRI, and stress radiographs. This review focuses on different approaches to treatment, including non-operative and operative techniques, of chronic ankle instability, including reviewing traditional procedures as well as more novel and newer techniques. Recent findings Based on existing literature, non-operative treatment should always precede operative treatment of chronic ankle instability. If rehabilitation fails, Brostrom-Gould type ankle stabilization has been the preferred surgical option. Recent literature suggests that arthroscopic repair might reduce recovery time and improve outcomes in certain populations; however, there are higher rates of complication following these surgeries. In more high-risk populations, some literature reports that ligament repair with peroneus brevis transfer could be a more effective treatment option. Summary Currently, varying surgical techniques exist for the treatment of chronic ankle instability. While the more recently reported techniques show promise, it is important to note that there is little evidence showing they are more successful than traditional techniques. It is imperative that future studies focus on outcomes and complication rates of these newer procedures.

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Section: Arthroscopic Ligament Repairmentioning

confidence: 99%

Operative treatment of lateral ligament instability

Shakked

Karnovsky

Drakos

2017

Curr Rev Musculoskelet Med

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“…One of the difficulties in performing arthroscopic ankle ligament reconstruction is the limited working space. 13 Although extensive extra-articular dissection may be helpful to enlarge the working space, it is harmful for tissue healing. Sustained fluid exudates and incision dehiscence would be highly anticipated.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Because the anterior talofibular and calcaneofibular ligaments are both extra-articular structures, there is very little room for visualization and instrument maneuverability even though an extra-articular working space has been made. 13 We have explored this technique from 2010, and many complications, such as tunnel malposition, cartilage injury, graft loosening, and incision dehiscence, have been found. Therefore, we have revised this technique repeatedly, and the complications have been decreased.…”

mentioning

confidence: 99%

All Arthroscopic Remnant-Preserving Technique to Reconstruct the Lateral Ankle Ligament Complex

Gui

Jiang

et al. 2017

Arthroscopy Techniques

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Arthroscopic lateral ankle ligament reconstruction has been recently advocated. But this technique has not been popularized because of the technical complexity and potential iatrogenic injury. Because the talocalcaneal and calcaneofibular ligaments are extra-articular structures, how to efficiently view and address them is a difficult task. Limited dissection outside the capsule to form a working space is required, but aggressive dissection is harmful for tissue healing although it is helpful for visualization and instrumentation. Because almost the entire talar body is covered by articular cartilage, it is very difficult to safely make a bone tunnel without damaging the cartilage. The remnants of the lateral ankle ligament have proprioceptive sensors that are important for functional stability, but it is difficult to perform anatomical reconstruction arthroscopically while preserving them because of the narrow working space. Furthermore, how to properly tension the reconstructed ligaments in such a narrow working space is also a very difficult task. We have designed a technique that preserves the remnants of lateral ankle ligaments, and all of the above-mentioned problems have been successfully addressed. We have used this technique clinically, and only minor complications occurred.

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“…Operacijsko liječenje mekotkivnog anterolateralnog sindroma sraza sastoji se od artroskopske anterolateralna sinovijektomije i redukcije nabujalog vezivnog tkiva. Uz sinovijektomiju, artroskopija omogućava identifikaciju i stupnjevanje lezija prednjeg talofibularnog ligamenta te njihovo adekvatno liječenje 28,29 . Artroskopsko liječenje omogućuje brži oporavak pacijenata te raniji povratak u punu radnu i sportsku aktivnost.…”

Section: Etiologijaunclassified

Anterolateralni sindrom sraza

Mokrović

Komen

2020

Med. Flum. (Online)

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Anterolateralni mekotkivni sindrom sraza gležnja je stanje kod kojeg dolazi do uklještenja kronično upalno promijenjenih hipertrofiranih mekih tkiva unutar zgloba između prednjega ruba tibije i vrata talusa pri dorzalnoj fleksiji stopala. Predstavlja jedan od češćih uzroka kroničnog bola u gležnju zaostalih nakon ozljede. Javlja se kao komplikacija uganuća gležnja u 1 do 2 % slučajeva. Ozljeda ligamenata i prednje zglobne kapsule, kao i okolnog masnog tkiva, dovodi do lokalne upalne reakcije tkiva te zbog ponavljajuće mikrotraume do kroničnog sinovitisa uz hiperplaziju i fibrozu mekih tkiva. Dijagnoza se temelji na anamnezi i kliničkom pregledu te rendgenološkoj obradi, upotpunjenima ultrazvučnom pretragom i magnetskom rezonancijom (MR). U većini slučajeva anterolateralni mekotkivni sraz zahtijeva operacijsko liječenje. Artroskopija gležnja predstavlja zlatni standard u operacijskom liječenju.

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Assessment of the feasibility of arthroscopic visualization of the lateral ligament of the ankle: a cadaveric study

Abstract: Arthroscopic identification of the ATFL, CFL and their corresponding footprints can be considered safe and reliable. Tunnels entrances, in preparation for arthroscopic ligament reconstruction, are precisely positioned. Arthroscopic anatomical ligament reconstruction is a feasible option.

Cited by 51 publications

References 14 publications

Operative treatment of lateral ligament instability

Operative treatment of lateral ligament instability

All Arthroscopic Remnant-Preserving Technique to Reconstruct the Lateral Ankle Ligament Complex

Anterolateralni sindrom sraza

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