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

2010 ◽  
Vol 34 (7) ◽  
pp. 991-996 ◽  
Author(s):  
Tomáš Trč ◽  
Milan Handl ◽  
Vojtech Havlas
Keyword(s):  
Surgical Treatment ◽  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability

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

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711987385 ◽  
Author(s):  
Yujie Song ◽  
Hongyun Li ◽  
Chao Sun ◽  
Jian Zhang ◽  
Jianchao Gui ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Management ◽  
Clinical Guidelines ◽  
Ankle Instability ◽  
Surgical Techniques ◽  
Cochrane Library ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Rehabilitation Strategies

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.

Percutaneous Lateral Ligament Reconstruction with Allograft for Chronic Lateral Ankle Instability

2012 ◽  
Vol 33 (2) ◽  
pp. 99-104 ◽  
Author(s):  
Hyunkook Youn ◽  
Yong Sang Kim ◽  
Jongseok Lee ◽  
Woo Jin Choi ◽  
Jin Woo Lee
Keyword(s):  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Lateral Ligament ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability

Associated Injuries Found in Chronic Lateral Ankle Instability

2000 ◽  
Vol 21 (10) ◽  
pp. 809-815 ◽  
Author(s):  
Benedict F. DiGiovanni ◽  
Carlos J. Fraga ◽  
Bruce E. Cohen ◽  
Michael J. Shereff
Keyword(s):  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Osteochondral Lesion ◽  
Lateral Ligament ◽  
Peroneal Tendon ◽  
Associated Injuries ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Anterolateral Impingement

Sixty-one patients underwent a primary ankle lateral ligament reconstruction for chronic instability between 1989 and 1996. In addition to the ligament reconstruction, all patients had evaluation of the peroneal retinaculum, peroneal tendon inspection by routine opening of the tendon sheath, and ankle joint inspection by arthrotomy. A retrospective review of the clinical history, physical exam, MRI examination, and intraoperative findings was conducted on these 61 patients. The purpose was to determine the type and frequency of associated injuries found at surgery and during the preoperative evaluation. At surgery no patients were found to have isolated lateral ligament injury. Fifteen different associated injuries were noted. The injuries found most often by direct inspection included: peroneal tenosynovitis, 47/61 patients (77%); anterolateral impingement lesion, 41/61 (67%); attenuated peroneal retinaculum, 33/61 (54%); and ankle synovitis, 30/61 (49%). Other less common but significant associated injuries included: intra-articular loose body, 16/61 (26%); peroneus brevis tear, 15/61 (25%); talus osteochondral lesion, 14/61 (23%); medial ankle tendon tenosynovitis, 3/61 (5%). The findings of this study indicate there is a high frequency of associated injuries in patients with chronic lateral ankle instability. Peroneal tendon and retinacular pathology, as well as anterolateral impingement lesions, occur most often. A high index of suspicion for possible associated injuries may result in more consistent outcomes with nonoperative and operative treatment of patients with chronic lateral ankle instability.

Chronic Lateral Ankle Instability

2008 ◽  
Vol 36 (11) ◽  
pp. 2167-2172 ◽  
Author(s):  
Woo Jin Choi ◽  
Jin Woo Lee ◽  
Seung Hwan Han ◽  
Bom Soo Kim ◽  
Su Keon Lee
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Multivariate Logistic Regression ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability

Background There has been no attempt to correlate the type and number of intra-articular lesions with the results of ligament reconstruction for chronic lateral ankle instability. Hypothesis Certain intra-articular lesions affect the clinical outcome of ligament reconstruction. Study Design Case series; Level of evidence, 4. Methods Sixty-five ankles from 64 patients underwent a modified Broström operation for chronic lateral ankle instability with a mean follow-up of 28.7 months (range, 12–67). The results were assessed according to the Karlsson-Peterson Ankle Score. The type of intra-articular lesions and the association of clinical outcome were investigated using Pearson's correlation coefficient and multivariate logistic regression analysis. Results The average Karlsson-Peterson Ankle Score was improved from 53 ± 14.63 preoperatively to 85.21 ±11.97 at final follow-up ( P < .001). Five different intra-articular lesions were described in 63 ankles (96.9%), and the ankle score negatively correlated with the number of lesions ( r = −.604; P < .001). Multivariate logistic regression showed that syndesmosis widening (odds ratio, 11.1; 95% confidence interval: 2.2–55.4; P = .003), osteochondral lesions of the talus (odds ratio, 8.5; 95% confidence interval: 1.7–42.3; P = .008), and ossicles (odds ratio, 4.5; 95% confidence interval: 1.0–20.2; P = .046) are significant predictors of unsatisfactory results after ligament reconstruction. Conclusion Arthroscopic diagnosis and treatment of intra-articular lesions associated with chronic lateral ankle instability is a safe and effective method. The presence of any combination of associated intra-articular lesions can result in a poor outcome.

454 Brace Brace: Modified Brsotrom-Gould Procedure with and Without Internal Brace for the Treatment of Chronic Lateral Ankle Instability

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J McGuigan ◽  
A Pillai ◽  
A Hall
Keyword(s):  
Clinical Outcomes ◽  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Nonoperative Treatment ◽  
Lateral Ligament ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Significant Difference ◽  
Internal Brace

Abstract Introduction The most common ankle injury is a sprain. Surgical management is only indicated when nonoperative treatment fails. Modified Broström-Gould (MBG) is the gold standard surgical technique. MBG technique may be augmented with an internal brace. This study aims to compare the clinical outcomes of MBG with and without internal brace for the treatment of chronic lateral ankle instability using validated patient recorded outcome measures. Method Retrospective analysis of patients that underwent lateral ankle ligament reconstruction between January 2012 and June 2019 were reviewed at and asked to complete the Manchester oxford foot and ankle questionnaire (MOXFQ). 29 patients (30 ankles) underwent lateral ligament reconstruction between these dates and completed the questionnaire, 20 patients (21 ankles) without internal brace and 9 patients with internal brace. Results The group with internal brace displayed significantly better results in the MOXFQ summary index score (20.49 ± 13.15 vs 43.53 ± 34.72, P = 0.014) and standing/walking subscale (15.48 ± 13.00 vs 45.92 ± 36.60, P = 0.023) compared to group without internal brace. There was no significant difference between Pain and Social interactions subscales. Conclusions Our results show that the addition of an internal brace to the MBG procedure for the management of chronic lateral ankle instability improves clinical outcomes.

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