The anterior talo-fibular ligament reconstruction in surgical treatment of chronic lateral ankle instability

Trč, Tomáš; Handl, M; Havlas, Vojtěch

doi:10.1007/s00264-010-0995-7

Cited by 24 publications

(10 citation statements)

References 21 publications

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“…12,14,16,17 However, to the best of our knowledge, this is the first report to examine the use of MRI in the quantitative evaluation of residual ligamentous tissues in CAI patients. In this study, patients were categorised into three groups according to maximum diameters of residual ATFLs measured by pre-operative MRI.…”

Section: Discussionmentioning

confidence: 95%

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The use of MRI in pre-operative evaluation of anterior talofibular ligament in chronic ankle instability

Kanamoto

Shiozaki²,

Tanaka

et al. 2014

Bone & Joint Research

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ObjectivesTo evaluate the applicability of MRI for the quantitative assessment of anterior talofibular ligaments (ATFLs) in symptomatic chronic ankle instability (CAI).MethodsBetween 1997 and 2010, 39 patients with symptomatic CAI underwent surgical treatment (22 male, 17 female, mean age 25.4 years (15 to 40)). In all patients, the maximum diameters of the ATFLs were measured on pre-operative T2-weighted MR images in planes parallel to the path of the ATFL. They were classified into three groups based on a previously published method with modifications: ‘normal’, diameter = 1.0 - 3.2 mm; ‘thickened’, diameter > 3.2 mm; ‘thin or absent’, diameter < 1.0 mm. Stress radiography was performed with the maximum manual force in inversion under general anaesthesia immediately prior to surgery. In surgery, ATFLs were macroscopically divided into two categories: ‘thickened’, an obvious thickened ligament and ‘thin or absent’. The imaging results were compared with the macroscopic results that are considered to be of a gold standard.ResultsAgreement was reached when comparison was made between groups, based on MRI and macroscopic findings. ATFLs were abnormal in all 39 cases and classified as ten ‘thickened’ and 29 ‘thin or absent’. As to talar tilt stress radiography, a clear cut-off angle, which would allow discrimination between ‘thickened’ and ‘thin or absent’ patients, was not identified.ConclusionMRI is valuable as a pre-operative assessment tool that can provide the quantitative information of ATFLs in patients with CAI.Cite this article Bone Joint Res 2014;3:241–5.

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Section: Discussionmentioning

confidence: 95%

“… 10 , 11 Although various imaging techniques such as stress radiography and MRI have been used for diagnosis, 12 - 15 few studies have examined the sensitivities of evaluation methods in providing information about residual ligamentous tissue. 16 …”

Section: Introductionmentioning

confidence: 99%

The use of MRI in pre-operative evaluation of anterior talofibular ligament in chronic ankle instability

Kanamoto

Shiozaki²,

Tanaka

et al. 2014

Bone & Joint Research

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“…Two musculoskeletal radiologists (18 years of experience in musculoskeletal radiology and five years of experience in musculoskeletal radiology) who were blinded to the clinical diagnoses reviewed the MR images in consensus to determine the status of ATFL and CFL and other pathologic conditions. On fat saturation-proton density images, the MRI findings of ligament injury included laxity, waviness, thickening and irregularity with abnormal signal intensity, nonvisualization, and discontinuity ( 32 33 ). The ligament was considered to be normal if it had intact continuity and uniform low signal intensity ( 34 35 ).…”

Section: Methodsmentioning

confidence: 99%

Impact of Chronic Lateral Ankle Instability with Lateral Collateral Ligament Injuries on Biochemical Alterations in the Cartilage of the Subtalar and Midtarsal Joints Based on MRI T2 Mapping

Tao

Lü

et al. 2021

Korean J Radiol

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Objective To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores ( r = −0.687, p = 0.007; r = −0.609, p = 0.021, respectively). Conclusion CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

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“…Broström Karlsson NA Li et al [ 32 ] 2009 52 2.4 AR Mod. Broström/Gould Karlsson/Tegner NA Ateşalp et al [ 2 ] 2009 9 NA NAR Evans NA NA Hua et al [ 19 ] 2010 81 2.4 AR Broström/Gould AOFAS NA Trc et al [ 52 ] 2010 47 3.9 AR Mod. Broström Good 100 Mabit et al [ 34 ] 2010 310 13 AR/NAR Multiple techniques Karlsson/Good 71.2–92.2 Shahrulazua et al [ 45 ] 2010 30 0.3 AR Mod.…”

Section: Discussionmentioning

confidence: 99%

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

Schepers

Vogels

Lieshout

2011

International Orthopaedics (SICOT)

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PurposeIn the treatment of chronic ankle instability, most non-anatomical reconstructions use the peroneus brevis tendon. This, however, sacrifices the natural ankle stabilising properties of the peroneus brevis muscle. The aim of this study was to evaluate the functional outcome of patients treated with a hemi-Castaing procedure, which uses only half the peroneus brevis tendon.MethodsWe performed a retrospective cohort study of patients who underwent hemi-Castaing ligamentoplasty for chronic lateral ankle instability between 1993 and 2010, with a minimum of one year follow-up. Patients were sent a postal questionnaire comprising five validated outcome measures: Olerud-Molander Ankle Score (OMAS), Karlsson Ankle Functional Score (KAFS), Tegner Activity Level Score (pre-injury, prior to surgery, at follow-up), visual analog scale on pain (VAS) and the Short Form 36 (SF-36).ResultsTwenty patients completed the questionnaire on functional outcome. The OMAS showed good to excellent outcome in 80% and the KAFS in 65%, the Tegner Score improved from surgery but did not reach pre-injury levels, the VAS on pain was 1 of 10 and the SF-36 returned to normal compared with the average population.ConclusionsEven though most patients were satisfied with the results, outcome at long-term follow-up was less favourable compared with the literature on anatomical reconstructions. In accordance with the literature, we therefore conclude that the initial surgical treatment of chronic lateral ankle instability should be an anatomical repair with augmentation (i.e. the Broström-Gould technique) and the non-anatomical repair should be reserved for unsuccessful cases after anatomical repair or in cases where no adequate ligament remnants are available for reconstruction.

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The anterior talo-fibular ligament reconstruction in surgical treatment of chronic lateral ankle instability

Cited by 24 publications

References 21 publications

The use of MRI in pre-operative evaluation of anterior talofibular ligament in chronic ankle instability

The use of MRI in pre-operative evaluation of anterior talofibular ligament in chronic ankle instability

Impact of Chronic Lateral Ankle Instability with Lateral Collateral Ligament Injuries on Biochemical Alterations in the Cartilage of the Subtalar and Midtarsal Joints Based on MRI T2 Mapping

Hemi-Castaing ligamentoplasty for the treatment of chronic lateral ankle instability: a retrospective assessment of outcome

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