Comparison of Two Anatomic Reconstructions for Chronic Lateral instability of the Ankle Joint

Abstract

Two anatomic reconstructions for correction of chronic lateral ankle joint instability were compared. In a prospective, randomized study, 60 patients were allocated to one of two treatment groups: reconstruction of the ligaments as described by Karlsson et al. (Group I) or with the modification of the Broström procedure as described by Gould et al. (Group II). The functional results were evaluated with a scoring scale, and the mechanical stability with standardized stress radiographs. The minimum follow-up period was 2 years. The functional results were satisfactory in 27 of 30 (90%) patients in Group I and 25 of 30 (83%) in Group II. There was no significant difference between the groups regarding mechanical stability. The mean anterior talar translation in Group I was 7.1 mm (range, 4 to 10) at followup, compared with 6.7 mm (range, 3 to 9) in Group II. The corresponding values for talar tilt were 4.9 degrees (range, 0 degree to 8 degrees) in Group I and 4.4 degrees (range, 0 degree to 8 degrees) in Group II. The duration of operation time was significantly longer in Group II and surgical complications were more frequent, probably due to the more extensive surgical exposure. This study showed that the majority of patients with chronic ankle instability can be successfully treated with anatomic reconstruction of the lateral ankle ligaments. Mechanical stability was restored with both methods.

A novel reconstruction technique for chronic lateral ankle instability: comparison to primary repair

“…The functional results in both groups were good between 2 and 4 years after surgery. These results are comparable with many previous reports [4,8,12,14,16,17].…”

“…During that time they could not play sports, and afterwards, it was difficult for them to return to their previous sporting level. These results are similar to those from previous studies using anatomical reconstruction [14,16]. Liu and Jacobson [18] treated 45 patients with their new reconstructive procedure (the capsule-ligament shift technique) for chronic lateral ankle instability.…”

“…Only two patients at follow-up had an unstable ankle, one in each group. Karlsson et al [16] have recently reported similar results with regard to stability in a prospective randomised study comparing two anatomical reconstruction techniques with a mean of 3 years follow-up. The standardised stress radiographic examination we used is generally considered a valid and reliable method for evaluation of the anterior talo-fibular ligament [9,10,21].…”

“…The lateral ligamentous complex of the ankle may be the most commonly damaged structure in sports injuries [3,13,16]. Primary repair of the ligaments was previously recommended, and good long-term results have been reported [1,12].…”

Late-term reconstruction of lateral ankle ligaments using a split peroneus brevis tendon graft (Colville's technique) in patients with chronic lateral instability of the ankle

“…good results out of 152 ankles treated with direct repair by shortening [18,19]. Jarvela reported a success rate of 93% in his series in which he used the inferior part of the tibiofibular ligament for augmentation of the anterior talofibular ligament [16].…”