Lateral Ankle Instability and Revision Surgery Alternatives in the Athlete

Schenck, Robert C.; Coughlin, Michael J.

doi:10.1016/j.fcl.2009.01.002

Cited by 43 publications

(45 citation statements)

References 53 publications

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“…Major advantages of this method are its simplicity and small incision size [ 105 ]. The Bröstrom procedure also avoids use of tendon grafts, maintains normal ligamentous anatomy, and preserves physiologic tibiotalar and subtalar motion.…”

Section: Lateral Ligament Instabilitymentioning

confidence: 97%

Epidemiology and Mechanisms of Ankle Pathology in Football

Anderson

Engebretsen

Kennedy³

et al. 2014

Sports and Traumatology

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The ankle is one of the most commonly injured joints in football and represents a signifi cant cost to the healthcare system due to time lost from play. The ligaments that stabilize the ankle joint determine its biomechanics, and alterations of those normal biomechanics result from various football-related injuries. Acute sprains are generally treated conservatively, with emphasis placed on secondary prevention to reduce the risk of future sprains and progression to chronic ankle stability. Repetitive ankle injuries in footballers may cause chronic ankle instability, which include both mechanical ligamentous laxity and functional changes. Chronic ankle pathology often requires surgery to repair ligamentous damage and remove

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Section: Lateral Ligament Instabilitymentioning

confidence: 97%

Epidemiology and Mechanisms of Ankle Pathology in Football

Anderson

Engebretsen

Kennedy³

et al. 2014

Sports and Traumatology

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“…The anatomical reconstruction techniques reported in the literature vary in terms of the drill hole configuration, graft insertion sites, choice of graft, and graft anchoring technique [7, 8, 23-25, 27, 29, 36, 43-45]. Three of the techniques use a single bone tunnel in the fibula [8,24,25,36]. Three employ two bone tunnels in the fibula [7,23,27,44], while two others use an incomplete bone tunnel and secure a split graft at the tendon-bone interface [29] or use biotenodesis screws, respectively [45].…”

Section: Discussionmentioning

confidence: 99%

“…2). A tibiotalar tilt of more than 10°was considered abnormal [36]. Anterior displacement of the talus with respect to the tibia was assessed on the lateral stress radiograph (Fig.…”

Section: Methodsmentioning

confidence: 99%

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Results of Anatomic Lateral Ankle Ligament Reconstruction with Tendon Allograft

Ellis

Williams

Pavlov

et al. 2011

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Chronic ankle instability can be addressed surgically through direct lateral ligament repair, nonanatomic reconstruction, or anatomic reconstruction. The goal of this study was to assess the radiographic, functional, and clinical results of patients undergoing an anatomic lateral ankle ligament reconstruction using an anterior tibial tendon allograft. Eleven patients (12 feet; mean age, 48.9 ± 11.4 years) undergoing lateral ankle ligament reconstruction were followed at a mean of 3.5 ± 1.7 years after surgery (range, 1.2 to 5.0 years). Indications for surgery were previous failed repair (i.e., Broström; one case), hyperlaxity (seven cases), and high-demand patients (four cases). Subjective outcomes including the Foot and Ankle Outcome Score (FAOS), SF-36, and activity level were assessed. Mortise and lateral ankle stress radiographs were performed. The FAOS daily activity and sports activity subscores were 93.4 (range, 77.9 to 100) and 78.6 (range, 30 to 100), respectively. The SF-36v2 physical health and mental health components were 50.4 (range, 30.6 to 65.7) and 45.0 (range, 24.8 to 68.0), respectively. Four patients (five feet) reported no restriction; six patients reported mild restrictions, and one patient reported moderate activity restrictions. Tibiotalar tilt improved significantly from 20.2°to 4.6°after surgery (p<0.01). The radiographic anterior displacement of the talus from the tibia was 6.5 mm postoperatively. The technique described restores mechanical stability in patients with chronic lateral ankle instability and may be considered in a select group of patients.

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“…Anatomic ligament reconstruction has become popular in certain subgroups such as heavier athletes, revision cases, and patients with ligamentous laxity, hindfoot varus, or inadequate residual ligament for direct repair [82]. Objective indications include greater than 20 degrees of varus or 15-mm translation on stress radiographs.…”

Section: Anatomic Ligament Reconstructionmentioning

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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Lateral Ankle Instability and Revision Surgery Alternatives in the Athlete

Cited by 43 publications

References 53 publications

Epidemiology and Mechanisms of Ankle Pathology in Football

Epidemiology and Mechanisms of Ankle Pathology in Football

Results of Anatomic Lateral Ankle Ligament Reconstruction with Tendon Allograft

Operative treatment of lateral ligament instability

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