Evans' Repair of Lateral Instability of the Ankle Joint

Abstract

A follow-up study is presented of 26 ankle joints with recurrent lateral instability, treated with surgical repair by the Evans method. The median follow-up period was 3.1 (range 1.1-6.9) years. Normal stability was achieved in 73 per cent of the ankles, and another 12 per cent were improved. Similar results are obtained with other methods of surgical repair. Preoperatively 82 per cent of the joints had a positive anterior drawer symptom. This was only found in 12 per cent postoperatively, and these ankles were all classified as having poor results, indicating the importance of reconstruction of the anterior talofibular ligament.

Arthroscopic Findings in Patients with Chronic Ankle Instability

“…9 Approximately the same percentage of patients with symptomatic ankle instability will be shown to be stable on stress radiographs. 19…”

Current Concepts: Lateral Ankle Instability

“…Since then, many early clinical studies with short-term followup have reported good subjective results after the procedure, although residual anterior talar instability and reduced subtalar motion were observed. 39,66,82,101,126,138,140,148 Biomechanical analysis of the Evans procedure identified a propensity for increased anterior displacement, internal rotation, and tilt of the talus, as well as restriction of subtalar motion when compared to anatomic repair. 29,114 Ankle joint kinematics also can be permanently altered with the procedure.…”

Chronic instability of the ankle

“…All the patients were called for re-examination 2 to 16 years postoperatively (average 8 years); 107 (94.7%) ankles of 103 patients could be reached for clinical re-evaluation. Three patients had died during the follow-up period and 3 could not be located.…”