Modified Watson-Jones technique for chronic lateral ankle instability in athletes: Clinical and radiological mid- to long-term follow-up

Morelli, Federico; Perugia, Dario; Vadalà, Antonio; Serlorenzi, Pierluigi; Ferretti, Andrea

doi:10.1016/j.fas.2010.08.006

Cited by 16 publications

(7 citation statements)

References 34 publications

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“…cReferences 2, 4, 6 –9, 12, 13, 15 –17, 19, 20, 25, 28, 35, 40 –45, 51, 57, 58, 64, 67, 69, 72, 73, 76, 77, 79 –81, 85, 86, 96, 98, 109 –111, 114, 117 –119, 132, 136, 142, 144 –146, 154, 156, 164, 166, 168, 170, 174, 179, 180, 185, 191, 194, 196 –…”

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Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Song

Liu

Sun

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: The surgical management of chronic lateral ankle instability (CLAI) has evolved since the 1930s, but for the past 50 years, the modified Broström technique of ligament repair has been the gold standard. However, with the development of arthroscopic techniques, significant variation remains regarding when and how CLAI is treated operatively, which graft is the optimal choice, and which other controversial factors should be considered. Purpose: To develop clinical guidelines on the surgical treatment of CLAI and provide standardized guidelines for indications, surgical techniques, rehabilitation strategies, and assessment measures for patients with CLAI. Study Design: A consensus statement of the Chinese Society of Sports Medicine. Methods: A total of 14 physicians were queried for their input on guidelines for the surgical management of CLAI. After 9 clinical topics were proposed, a comprehensive systematic search of the literature published since 1980 was performed for each topic through use of China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, EMBASE, and the Cochrane Library. The recommendations and statements were drafted, discussed, and finalized by all authors. The recommendations were graded as grade 1 (strong) or 2 (weak) based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Based on the input from 28 external specialists independent from the authors, the clinical guidelines were modified and finalized. Results: A total of 9 topics were covered with regard to the following clinical areas: surgical indications, surgical techniques, whether to address intra-articular lesions, rehabilitation strategies, and assessments. Among the 9 topics, 6 recommendations were rated as strong and 3 recommendations were rated as weak. Each topic included a statement about how the recommendation was graded. Conclusion: This guideline provides recommendations for the surgical management of CLAI based on the evidence. We believe that this guideline will provide a useful tool for physicians in the decision-making process for the surgical treatment of patients with CLAI.

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“…eReferences 2, 3, 7, 8, 12, 26 –29, 35, 36, 38, 42 –44, 46, 69, 73, 74, 86, 90, 93, 95, 97, 102, 103, 105, 107, 114, 117 –119, 132, 134, 139, 142, 151, 153, 156, 157, 166, 179, 180, 184, 189, 191, 196, 197, 199, 206, 215, 216, 226, 229, 234.…”

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confidence: 99%

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Song

Liu

Sun

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…These techniques can be classified into two basic categories: anatomical reconstruction 2-8 and tenodesis stabilization. [9][10][11][12][13] Anatomical reconstruction includes midsubstance imbrication and suturing of the ruptured ligament ends, 2 augmentation using the extensor retinaculum, 3 and shortening or reattachment of the ligament using drill holes in the fibula. [4][5][6][7][8] Anatomical reconstruction is an excellent treatment option because it is simple to perform and complications are rare.…”

Section: Discussionmentioning

confidence: 99%

“…These procedures are classified into two general categories: (1) anatomical reconstructions, i.e., procedures that repair the ligaments directly from remnants, with or without augmentation, [2][3][4][5][6][7][8] and (2) tenodesis stabilizations, i.e., procedures that reconstruct the ligaments using a free or a split tendon graft. [9][10][11][12][13] Anatomical reconstructions are an excellent option because they are simple to perform and complications are rare. However, if the remnants of the ligaments are severely damaged, anatomical reconstruction using the remnants is not easy to perform, and tenodesis stabilization may be needed.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Tenodesis Reconstruction Using Free Split Peroneal Brevis Tendon for Severe Chronic Lateral Ankle Instability

Hashimoto

Kokubo

2022

Keio J. Med.

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Many operative procedures have been reported for the management of chronic lateral ankle instability, and anatomical reconstructions are an excellent option. However, if the remnants of the ligaments are considerably damaged, anatomical reconstructions using such remnants can be difficult. In cases such as these, tenodesis stabilization may be required. However, tenodesis stabilization often restricts the range of ankle movement. The purpose of this study was to determine the effectiveness of a new procedure that we developed to mitigate the problems associated with tenodesis stabilization procedures. We installed grafts in the original anatomical position by devising a system for positioning the drill holes in the bones so that our procedure did not restrict the range of ankle movement. A retrospective review of 37 patients (13 men, 24 women) with a mean age of 30.2 (range, 16-66) years was performed at an average of 69 (range, 47-77) months after the surgery. The average American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved significantly from 65.6 (range, 47-77) points preoperatively to 98.0 (range, 87-100) points postoperatively (P < 0.001). With the number of subjects available, no significant differences were detected between the postoperative mean ranges of movement of the ankle and subtalar joints and those of the preoperative ankle. Patients who underwent anatomical tenodesis reconstructions with a free split peroneal brevis tendon showed good outcomes after a 69-month followup period.

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“…Nevertheless, patients who develop CAI after this protocol require surgical treatment. 4,[10][11][12] Historically, 2 types of techniques are been described: (a) nonanatomic or tenodesis and (b) anatomic reconstructions, specifically Bröstrom-Gould technique, which has been considered the gold standard. 4,9 Advancements in arthroscopic techniques in orthopedic surgery, specifically in diagnosis and treatment of CAI-associated lesions, has brought into play new techniques to repair ligaments arthroscopically, with several publications describing lateral ankle ligament repair, trying to minimize wound complications and recovery time.…”

Section: Historical Perspectivementioning

confidence: 99%

Arthroscopically Assisted Technique for Combined Medial and Lateral Ligament Repair in Multidirectional Ankle Instability

Gerstner

Lavergne

Blanco

et al. 2021

Techniques in Foot &Amp; Ankle Surgery

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An ankle sprain is one of the most common orthopedic injuries, frequently associated with sporting activities. Acute treatment has a traditional standard protocol, but even after undergoing a good rehabilitation program, up to 20% to 40% of patients develop chronic ankle instability. Arthroscopy is a rapidly evolving surgical procedure indicated for the management of this pathology as a diagnostic and therapeutic tool. The objective of this study was to describe an arthroscopically assisted technique for combined medial and lateral ligament repair in patients with multidirectional ankle instability. Clinical and functional results were described in 14 cases (8 female, 6 male) with a minimum 12-month follow-up. The average age was 35.8 years (range: 20 to 57 y), only 1 case of neuritis was reported and resolved without invasive procedures. At the final follow-up, 13 cases had good-excellent results with AOFAS (American Orthopedic Foot and Ankle Score) > 80 points. We believe that the arthroscopic technique described is as a viable treatment option in patients with multidirectional ankle instability, with similar or better results than open techniques.

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Modified Watson-Jones technique for chronic lateral ankle instability in athletes: Clinical and radiological mid- to long-term follow-up

Cited by 16 publications

References 34 publications

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Clinical Guidelines for the Surgical Management of Chronic Lateral Ankle Instability: A Consensus Reached by Systematic Review of the Available Data

Anatomical Tenodesis Reconstruction Using Free Split Peroneal Brevis Tendon for Severe Chronic Lateral Ankle Instability

Arthroscopically Assisted Technique for Combined Medial and Lateral Ligament Repair in Multidirectional Ankle Instability

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