Medial and Lateral Combined Ligament Arthroscopic Repair for Multidirectional Ankle Instability

Mansur, Nacime Salomão Barbachan; Lemos, André Vitor Kerber Cavalcante; Baumfeld, Daniel; Baumfeld, Tiago; Prado, Marcelo Pires; Raduan, Fernando; Nery, Caio

doi:10.1177/2473011420986150

Cited by 15 publications

(10 citation statements)

References 45 publications

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“…AOFAS post op values showed a statistically significant mean difference (91.9) from pre-op baseline (49.7). 67 A randomized prospective trial of 20 arthroscopically treated chronic syndesmotic injuries defined as > 2 mm of diastasis on arthroscopic exam treated with (Group 1; n = 10) and without (Group 2; n = 10) transfixation with a screw was reviewed. Patients in both treatment arms of this study demonstrate increased AOFAS hindfoot scores from baseline irrespective of transfixation at the time of arthroscopic debridement (Group 1 AOFAS hindfoot score 52 pre-op to 87 post-op vs group 2 AOFAS hindfoot score 63-90) without any significant difference among the two (P = 0.6453).…”

Section: Results and Complicationsmentioning

confidence: 99%

“…Mansur and colleagues’ retrospective review of 30 ankles undergoing medial and lateral combined arthroscopic repair for multidirectional ankle instability noted complications occurred in 16% of patients recorded as dehiscence, nerve injury, infection, and re-rupture. AOFAS post op values showed a statistically significant mean difference (91.9) from pre-op baseline (49.7) 67. A randomized prospective trial of 20 arthroscopically treated chronic syndesmotic injuries defined as >2 mm of diastasis on arthroscopic exam treated with (Group 1; n=10) and without (Group 2; n=10) transfixation with a screw was reviewed.…”

Section: Results and Complicationsmentioning

confidence: 99%

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Treatment of the Deltoid and Syndesmotic Ligaments in Chronic Ankle Instability

Chrea

Johnson

2022

Techniques in Foot &Amp; Ankle Surgery

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Historically, ankle instability research has focused primarily on the lateral ligament complex. However, more recently there has been an increased attention on the role of the deltoid ligament and syndesmosis in chronic ankle instability. We describe historical perspectives as well as the current state of evidence and techniques for a more comprehensive approach to ankle instability. Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.

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Section: Results and Complicationsmentioning

confidence: 99%

Section: Results and Complicationsmentioning

confidence: 99%

Treatment of the Deltoid and Syndesmotic Ligaments in Chronic Ankle Instability

Chrea

Johnson

2022

Techniques in Foot &Amp; Ankle Surgery

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“…Infection was defined as a discharge of purulent matter from the wound at any time. Any recurrence of the lesion during the study period was included in the analysis (14) .…”

Section: Discussionmentioning

confidence: 99%

Partial plantar fasciectomy for the treatment of plantar fibromatosis

et al. 2021

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Objective: We describe a series of patients treated with resection of the affected band. We assessed functional outcome, recurrence rate, and surgical wound complications, comparing these data with the available literature. Methods: This retrospective study (level of evidence IV) included 14 patients (17 feet) diagnosed with plantar fibromatosis in the medial portion of the fascia that was refractory to conservative treatment. All operations were performed between December 2016 and November 2018. All patients were assessed for symptom improvement and major and minor complications, in addition to recurrence during the study period.Results: Our sample included 9 men and 5 women, whose mean age was 40.6 years (15-63). All of the patients underwent partial fasciectomy of the medial fascial band with margins of at least 2 cm. There was recurrence in 5 of the 17 feet (29%), but only two required further intervention. Wound dehiscence occurred in 3 patients (17%), and one of the cases was severe, requiring plastic surgery. Two feet showed signs of injury to the digital branch of the medial plantar nerve. Conclusion: Partial plantar fasciectomy is an alternative treatment for plantar fibromatosis (Ledderhose’s disease). Our results agree with the literature in terms of recurrence and postoperative complications. The moderate rate of complications must be taken into account when indicating this procedure. Level of Evidence IV; Therapeutic Studies; Case Series.

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“…Complications were defined as any sustained clinical complaint related to the surgery and during postoperative follow-up. 10 Any nerve injury, either provisional or definitive, was documented. Wound problems encompassed any hypertrophic scar formation, dehiscence, hematoma, or infection.…”

Section: Assessmentsmentioning

confidence: 99%

Risks Associated With Posterior Ankle Hindfoot Arthroscopy Complications

et al. 2023

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Background: The use of posterior ankle and hindfoot arthroscopy (PAHA) has been expanding over time. Many new indications have been reported in the literature. The primary objective of this study was to report the rate of PAHA complication in a large cohort of patients and describe their potential associations with demographical and surgical variables. Methods: In this IRB-approved retrospective comparative study, patients who underwent posterior ankle and/or hindfoot arthroscopy in a single institution from December 2009 to July 2016 were studied. Three fellowship-trained orthopaedic foot and ankle surgeon performed all surgeries. Demographic data, diagnosis, tourniquet use, associated procedures, and complications were recorded. To investigate a priori factors predictive of neurologic complication after PAHA, univariate and multivariable logistic regression was utilized. Where appropriate, sparse events sensitivity analysis was tested by fitting models with Firth log-likelihood approach. Results: A total of 232 subjects with 251 surgeries were selected. Indications were posterior ankle impingement (37%), flexor hallux longus disorders (14%), subtalar arthritis (8%), and osteochondral lesions (6%). Complications were observed in 6.8% (17/251) of procedures. Neural sensory lesions were noted in 10 patients (3.98%), and wound complications in 4 ankles (1.59%). Seven neurologic lesions resolved spontaneously and 3 required further intervention. In a multivariable regression model controlled for confounders, the use of accessory posterolateral portal was the significant driver for neurologic complications (odds ratio [OR] 32.19, 95% CI 3.53-293.50). Conclusion: The complication rate in this cohort that was treated with posterior ankle and/or hindfoot arthroscopy was 6.8%. Most complications were due to neural sensorial injuries (sural 5, medial plantar nerve 4, medial calcaneal nerve 1 ) and 3 required additional operative treatment. The use of an accessory posterolateral portal was significantly associated with neurologic complications. The provided information may assist surgeons in establishing diagnoses, making therapeutic decisions, and instituting surgical strategies for patients that might benefit from a posterior arthroscopic approach. Level of Evidence: Level III, retrospective comparative study.

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Medial and Lateral Combined Ligament Arthroscopic Repair for Multidirectional Ankle Instability

Cited by 15 publications

References 45 publications

Treatment of the Deltoid and Syndesmotic Ligaments in Chronic Ankle Instability

Treatment of the Deltoid and Syndesmotic Ligaments in Chronic Ankle Instability

Partial plantar fasciectomy for the treatment of plantar fibromatosis

Risks Associated With Posterior Ankle Hindfoot Arthroscopy Complications

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