A Review of Lateral Ankle Ligamentous Reconstructions

Foot & Ankle ◽  
1982 ◽  
Vol 3 (2) ◽  
pp. 114-123 ◽  
Author(s):  
Rick St. Pierre ◽  
Fred Allman ◽  
Frank H. Bassett ◽  
J. Leonard Goldner ◽  
Lamar L. Fleming
Keyword(s):  
Tilt Angle ◽  
Clinical Results ◽  
Grading System ◽  
Chi Square ◽  
Reconstructive Procedures ◽  
Lateral Ankle ◽  
Institutional Review ◽  
Significant Difference ◽  
Talar Tilt

We have performed an ongoing retrospective and prospective multi-institutional review of 50 patients who underwent 53 lateral ligamentous reconstructive procedures of the ankle. The point grading system used for postoperative evaluation of our patients allowed for classification of functional activity. The grading system included evaluation of the patient's return to preinjury activities and athletics, degree of pain, degree of swelling, number of recurrent sprains, and any disability that the patient incurred secondary to the tendon transfer. Preoperative and postoperative stress radiographs were obtained to evaluate the talar tilt angle. Of our 53 lateral ankle ligamentous reconstructions, we consider 45 to be excellent, with the patients returning to full activity and athletics. Our results show no statistically significant difference in long-term function among the five ligamentous repairs employed in this series (Pearson Chi-square test; χ2 = 2.30, df = 4, P = 0.68). No correlation could be made between the long-term clinical response of the various procedures and the postoperative talar tilt angle. We conclude that lateral ligamentous reconstructive repairs of the ankle are indicated, and that good or excellent clinical results, greater than 91 %, can be obtained with any of the five reconstructive procedures, performed correctly.

scholarly journals Demographic Predictors of Concomitant Osteochondral Lesion of the Talus in Patients With Chronic Lateral Ankle Instability

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110133
Author(s):  
Yong Sang Kim ◽  
Tae Yong Kim ◽  
Yong Gon Koh
Keyword(s):  
Tilt Angle ◽  
Ankle Instability ◽  
Osteochondral Lesion ◽  
Case Series ◽  
Level Of Evidence ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Female Patients ◽  
Lateral Ankle Instability ◽  
Talar Tilt

Background: Osteochondral lesion of the talus (OLT) is commonly found as a concomitant pathologic lesion in a large proportion of patients with chronic lateral ankle instability (CLAI). This study investigated which characteristics in a patient with CLAI increase the risk for OLT. Methods: Three hundred sixty-four patients who underwent a modified Broström operation for their CLAI were reviewed retrospectively. The characteristics of each patient and variables associated with OLTs were investigated. Statistical analyses were performed to determine the effect of each potential predictor on the incidence of OLT, and to evaluate the associations between the patient characteristics and variables associated with OLTs. Results: Patients with OLTs were more frequently female (female vs male: 63.1% vs 43.9%, P = .003). In addition, the lesion sizes were larger in female patients (female vs male: 113.9 ± 24.9 mm2 vs 100.7 ± 18.0 mm2, P = .002), and medial lesions were more common in female patients (female vs male; 93.3% vs 81.8%, P = .036). The lesion sizes were larger in patients with a wider talar tilt angle ( P < .001), and patients with a medial OLT showed a wider talar tilt angle (12.0 ± 2.0 degrees vs 10.3 ± 2.2 degrees, P = .002). Conclusion: In this CLAI patient cohort, we found female patients to be at greater risk for OLTs than male patients. Furthermore, CLAI female patients with concomitant OLT had on average a larger lesion size, more frequent OLT medial position, and were associated with wider talar tilt angles, suggesting that females had more intrinsic ankle instability than males. Level of Evidence: Level IV, retrospective case series.

Early clinical results of minimally invasive coracoclavicular ligament reconstruction can be maintained at a minimum of five years’ follow-up

2020 ◽  
Vol 102-B (7) ◽  
pp. 918-924
Author(s):  
Steffen B. Rosslenbroich ◽  
Katharina Heimann ◽  
Jan Christoph Katthagen ◽  
Clemens Koesters ◽  
Oliver Riesenbeck ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Constant Score ◽  
Clinical Results ◽  
Long Term Results ◽  
Short Term ◽  
Ac Joint ◽  
Ac Joint Dislocation ◽  
Significant Difference

Aims There is a lack of long-term data for minimally invasive acromioclavicular (AC) joint repair. Furthermore, it is not clear if good early clinical results can be maintained over time. The purpose of this study was to report long-term results of minimally invasive AC joint reconstruction (MINAR) and compare it to corresponding short-term data. Methods We assessed patients with a follow-up of at least five years after minimally invasive flip-button repair for high-grade AC joint dislocation. The clinical outcome was evaluated using the Constant score and a questionnaire. Ultrasound determined the coracoclavicular (CC) distance. Results of the current follow-up were compared to the short-term results of the same cohort. Results A total of 50 patients (three females, 47 males) were successfully followed up for a minimum of five years. The mean follow-up was 7.7 years (63 months to 132 months). The overall Constant score was 94.4 points (54 to 100) versus 97.7 points (83 to 100) for the contralateral side showing a significant difference for the operated shoulder (p = 0.013) The mean difference in the CC distance between the operated and the contralateral shoulder was 3.7 mm (0.2 to 7.8; p = 0.010). In total, 16% (n = 8) of patients showed recurrent instability. All these cases were performed within the first 16 months after introduction of this technique. A total of 84% (n = 42) of the patients were able to return to their previous occupations and sport activities. Comparison of short-term and long-term results revealed no significant difference for the Constant Score (p = 0.348) and the CC distance (p = 0.974). Conclusion The clinical outcome of MINAR is good to excellent after long-term follow-up and no significant differences were found compared to short-term results. We therefore suggest this is a reliable technique for surgical treatment of high-grade AC joint dislocation. Cite this article: Bone Joint J 2020;102-B(7):918–924.

Ankle Arthrodesis: A Long-term Study

Foot & Ankle ◽  
1992 ◽  
Vol 13 (6) ◽  
pp. 307-312 ◽  
Author(s):  
Richard V. Abdo ◽  
Stephen A. Wasilewski
Keyword(s):  
Ankle Arthrodesis ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Grading System ◽  
Term Study ◽  
Evaluation Score ◽  
Long Term Study ◽  
Significant Difference

Few studies of ankle arthrodesis have assessed tarsal mobility. This study was performed to evaluate radiographically the effect of ankle arthrodesis on tarsal motion. Thirty patients (31 ankles) returned for clinical and radiographic examination, review of charts, and completion of questionnarie forms. Radiographs were evaluated for success of fusion, position of fusion, tarsal motion, hindfoot position, and subtalar and midtarsal arthritis. The median follow-up time was 7.0 years (range 2–20 years). Results showed that fusion was achieved in 22 patients (71%). The evaluation score based on the grading system of Mazur et al. 16 correlated with success of fusion and patient satisfaction. However, no correlation existed between evaluation score and tarsal motion or position of fusion in the sagittal or coronal planes. Radiographic evaluation showed no significant difference between tarsal motion of the fused side and the unfused side. Tarsal mobility was not affected by ankle arthrodesis or by the techniques performed to achieve fusion.

scholarly journals Comparison of Clinical Outcomes in Patients with Generalized Ligamentous Laxity and without Generalized Laxity in the Arthroscopic Modified Broström Operation for Chronic Lateral Ankle Instability

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
YoungKoo Lee ◽  
Jungwoo Yoo ◽  
Keon Hee Yun ◽  
Ji Yong Park
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Tilt Angle ◽  
Ankle Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Ligamentous Laxity ◽  
Lateral Ankle Instability ◽  
Talar Tilt

Category: Sports Introduction/Purpose: The arthroscopic modified Broström operation (MBO) has been developed and frequently used to treat chronic lateral ankle instability (CLAI). Clinical outcome of arthroscopic MBO was reported as good or excellent. But there were no report about comparison of clinical outcomes between patients with generalized ligamentous laxity (laxity) and without generalized ligamentous laxity (no laxity). The purpose of this study is to compare the clinical outcomes of the group with generalized ligamentous laxity and without generalized ligamentous laxity in chronic lateral ankle instability. Methods: From January 2013 to November 2015, Arthroscopic MBO was performed in 99 patients for CLAI. We retrospectively analyzed 99 consecutive patients were included in terms of inclusion criteria. All patients had giving way, persistent pain and an inability to resume one’s preinjury activity level for more than 6 months. Patients were divided into 2 groups: laxity group (24 ankles) and no laxity group (75 ankles). Evaluation was performed preoperatively and at a final follow-up a minimum of 12 months postoperatively using the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot ankle score, pain Visual Analogue Scale (VAS)(0~100), and talar tilt angle. Results: In terms of radiological outcomes, the preoperatively talar tilt angle was greater in patients in laxity group than in no laxity group (p < .001). The last follow-up talar tilt angle was the same between in patients in laxity group and in no laxity group (p=0.413). But preoperative-last follow up difference was found between two groups (p=0.03). The variation from preoperative to last follow up talar tilt angle showed significant greater value in laxity group (-6.9 ± 5.2) than in no laxity group (-4.2 ± 4.2)(p=0.03). In terms of clinical outcome, last follow up AOFAS and VAS in all groups were improved than preoperative scores (27.5 ± 23.7, 24.1 ± 18.4, respectively). But preoperative-last follow up differences were not found between two groups (P=0.52). Conclusion: In terms of radiologic outcomes, there was difference outcome variation between two groups, in terms of clinical outcomes, there were no difference outcome variations between two groups. All groups achieved successful clinical and radiological last follow up outcomes even though there was difference outcome variation in talar tilt. Arthroscopic MBO should be considered as a reasonable method in patients who have chronic lateral ankle instability regardless of generalized ligamentous laxity.

scholarly journals Evaluation of Invasive Intra-abdominal Candidiasis in Crohn Disease at the Time of Surgery

2020 ◽  
Vol 36 (1) ◽  
pp. 12-16
Author(s):  
Martin Šašala ◽  
Emeše Majorová ◽  
Andrej Vrzgula ◽  
Iveta Fandáková
Keyword(s):  
Crohn Disease ◽  
Invasive Candidiasis ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Chi Square ◽  
Sabouraud Agar ◽  
Significant Difference ◽  
Chi Square Test ◽  
Possible Cause

Purpose: The aim of this study was to determine whether a connection exists between Crohn disease and fungi, specifically Candida albicans, because one possible cause of disease is thought to be the presence of fungi in the intra-abdominal cavity. The diagnosis of invasive candidiasis is difficult due to the lack of specific clinical manifestations of the disease. A retrospective evaluation of the presence of invasive candidiasis was done in a group of 54 patients with Crohn disease and in a group of 31 patients who received surgery primarily for right-sided cancer of the colon.Methods: Culture samples were obtained from the wall of the extraluminal portion of the terminal ileum and the adjacent mesenterium, and then sent to the microbiology laboratory for further investigation. Sabouraud agar (SGC2) and chromID Candida agar (CAN2) were used for both short-term (48 hours) and long-term (10 days) cultivation.Results: Pearson chi-square test revealed a statistically significant difference in the prevalence of fungi and yeast between the 2 groups of patients (χ<sup>2</sup> = 4.3873, P < 0.05).Conclusion: Patients with Crohn disease had a significantly higher prevalence of fungi and yeasts in the intra-abdominal cavity compared with cancer patients.

Extensor Retinaculum Flap and Fibular Periosteum Ligamentoplasty After Failed Surgery for Chronic Lateral Ankle Instability

2020 ◽  
Vol 41 (12) ◽  
pp. 1546-1552
Author(s):  
Ernesto Pintore ◽  
Lucio Cipollaro ◽  
Raffaele Pintore ◽  
Francesco Oliva ◽  
Nicola Maffulli
Keyword(s):  
Ankle Instability ◽  
Case Series ◽  
High Rate ◽  
Anterior Talofibular Ligament ◽  
Low Grade ◽  
Reconstructive Procedures ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability

Background: The anterior talofibular ligament and the calcaneofibular ligament are 2 of the most frequently injured structures in sports, being damaged in 30% to 45% of all sports injuries. Most reconstructive procedures are successful but can deteriorate with time and can lead to low-grade radiographic degeneration. Methods: We operated on 26 consecutive patients from 2001 to 2008 who had failed previous surgical procedures for the lateral ligamentous complex of the ankle, with an average of 104 (range, 75-140) months. Results: The overall functional rating was excellent in 14 ankles, good in 10, fair in 1, and poor in 1. Twenty-four patients (92.3%) were satisfied with the procedure and 15 (57.7%) were able to return to their preinjury level of activity. Local complications were detected in 2 patients who presented with skin necrosis; 1 patient developed severe reflex sympathetic dystrophy. Conclusion: Revision surgery for the management of failure after surgical treatment of chronic lateral ankle instability is under debate, and the literature is devoid of clinical studies with long-term follow-up. The technique described offers a high rate of long-term excellent and good results, with a low rate of complications and a good rate of return to preinjury level. Level of Evidence: Level IV, retrospective case series.

scholarly journals Therapeutic potential of Brazilian fluoride varnishes: an in vivo study

2011 ◽  
Vol 22 (3) ◽  
pp. 193-197 ◽  
Author(s):  
Marcella Quirino de Almeida ◽  
Olívia Ximenes Izidro Costa ◽  
Jainara Maria Soares Ferreira ◽  
Valdenice Aparecida de Menezes ◽  
Rossana Barbosa Leal ◽  
...  
Keyword(s):  
Therapeutic Potential ◽  
Clinical Results ◽  
White Spot Lesions ◽  
Final Size ◽  
Chi Square ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Chi Square Test ◽  
Student’S T

The aim of this study was to assess in vivo the therapeutic effect of three fluoride varnishes available in the Brazilian market on the performance of white spot lesions (WSL). The sample included 36 children aged 7 to 13 years old, with a total of 67 active WSL in permanent anterior teeth. The children were randomly divided into 3 groups, according to fluoride varnish used: FL- Fluorniz (n=24), DUO - Duofluorid XII (n=22) and DF - Durafluor (n=21). Maximum WSL dimensions (mesiodistal and incisogingival) were measured in millimeters by a previously calibrated single examiner using a periodontal probe. WSL were also assessed regarding lesion activity. Initial and final S-OHI (Simplified Oral Hygiene Index) scores were recorded. Pearson's chi-square test revealed no statistically significant differences (p>0.05) in the performance of the varnishes. At the end of the 5th week, FL had 6 active and 18 inactive WSL; DUO had 7 active and 15 inactive WSL; and DL had 6 active and 15 inactive WSL. Taking into account all lesions, there was a 45.7% reduction in WSL dimensions. Paired Student's t-test revealed a statistically significant difference (p<0.05) between the initial size (1.88) and final size (1.02). After four applications, all varnishes obtained similar clinical results.

scholarly journals Clinical Evaluation of Resin-Based Composites in Posterior Restorations: 12-Month Results

2010 ◽  
Vol 04 (01) ◽  
pp. 057-065 ◽  
Author(s):  
Cigdem Celik ◽  
Neslihan Arhun ◽  
Kivanc Yamanel
Keyword(s):  
Clinical Performance ◽  
Clinical Results ◽  
Class Ii ◽  
Class I ◽  
Chi Square ◽  
Exact Test ◽  
Usphs Criteria ◽  
Nanohybrid Composite

ABSTRACTObjectives: The purpose of this study was to evaluate and compare the 12 month clinical performances of two different posterior composites in Class I and Class II restorations.Methods: Thirty-one patients (10 male, 21 female) were recruited into the study. A total of 82 Class I and Class II cavities were restored with either a nanohybrid composite (Grandio) or a low-shrinkage composite (Quixfil), using their self etch adhesives (Futura Bond and Xeno III) according to manufacturers’ instructions. The restorations were clinically evaluated 1 week after placement as baseline, and after 6 and 12 months post-operatively using modified USPHS criteria by two previously calibrated operators. Statistical analysis were performed using Pearson Chi-square and Fisher’s Exact Test (P<.05).Results: All patients attended the 12-month recall. Lack of retention was not observed in any of the restorations. With respect to color match, marginal adaptation, secondary caries and surface texture, no significant differences were found between two restorative materials tested after 12 months (P>.05). None of the restorations had marginal discoloration and anatomic form loss on the 12 month follow-up. Restorations did not exhibit post-operative sensitivity at any evaluation period.Conclusions: Clinical assessment of nanohybrid (Grandio) and low-shrinkage posterior composite (Quixfil) exhibited good clinical results with predominating alpha scores after 12 months. However; further evaluations are necessary for the long-term clinical performance of these materials. (Eur J Dent 2010;4:57-65)

scholarly journals Comparison of Long-Term Fertility and Bleeding Outcomes after Robotic-Assisted, Laparoscopic, and Abdominal Myomectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Rebecca Flyckt ◽  
Enrique Soto ◽  
Benjamin Nutter ◽  
Tommaso Falcone
Keyword(s):  
Chi Square ◽  
Robotic Assisted ◽  
Abdominal Myomectomy ◽  
Spontaneous Pregnancy ◽  
Current Bleeding ◽  
Significant Difference ◽  
Long Term Follow Up

Background/Aims. To compare long-term fertility and bleeding outcomes of women who underwent robotic-assisted, laparoscopic, and abdominal myomectomy at our institution over a 15-year period. Methods. This was a retrospective cohort study of myomectomy patients 18–39 years old that had surgery between January 1995 and December 2009 at our institution. Long-term follow-up on fertility and bleeding outcomes was collected from the patient directly. The uterine fibroid symptom and quality of life survey was also administered to assess current bleeding patterns. Baseline characteristics were compared across groups. Univariable comparisons of fertility and bleeding outcomes based on surgical approach were made using analysis of variance, Kruskal-Wallis analysis of ranks, and Chi-square tests as appropriate. Results. 134/374 (36%) subjects agreed to participate in the study. 81 subjects underwent an open procedure versus 28 and 25 subjects in the laparoscopic and robotic groups, respectively. Median follow-up after surgery was 8 years. 50% of patients desired pregnancy following surgery and, of those, 60% achieved spontaneous pregnancy; the spontaneous pregnancy rate did not differ between groups. Additionally, UFS-QOL scores and/or subscores did not differ between groups. Conclusion. There is no significant difference in long-term bleeding or fertility outcomes in robotic-assisted, laparoscopic, or abdominal myomectomy.

scholarly journals All-inside Arthroscopic Modified Broström Operation for Lateral Ankle Instability with Os Subfibulare

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Woo Jong Kim ◽  
Young Koo Lee
Keyword(s):  
Tilt Angle ◽  
Ankle Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Varus Stress ◽  
Accessory Ossicle ◽  
Vas Scores ◽  
Talar Tilt

Category: Sports Introduction/Purpose: Os Subfibulare(OSF) is an accessory ossicle that lies at the tip of the lateral malleolus of the ankle. Patients with chronic lateral ankle instability (CLAI) have a high incidence of OSF, and there relationship implies that there is a correlation between OSF and CLAI. The all-inside arthroscopic Modified Broström Operation (MBO) has been developed for the treatment of chronic lateral ankle instability (CLAI) and the outcome was reported as good or excellent. But there were no report about comparison of the outcome between OSF and non-OSF patients with chronic lateral ankle instability treated by all-inside arthroscopic MBO. The purpose of this study was to evaluate the clinical and radiologic outcomes of the arthroscopic MBO procedure for CLAI with or without OSF. Methods: From January 2013 to september 2016, arthroscopic MBO was performed on 133 patients with CLAI. Of these, 126 ankles were evaluated for this study. Patients were divided into two groups: the OSF group (26 patients), without OSF group (100 patients). Evaluation tools included the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot ankle score and pain Visual Analogue Scale (VAS) at preoperatively, 6 and 12 months postoperatively for clinical outcomes. And we also evaluated the talar tilt angle in the varus stress radiograph at preoperatively, 6 and 12 months postoperatively for radiologic outcomes. Results: There were no difference in age, sex, preoperative AOFAS hindfoot ankle scores and VAS scores and talar tilt angle between the two groups preoperatively(P >.05). And there also were no difference at the final follow-up (P >.05).The final follow-up AOFAS hindfoot ankle score and Vas in both group showed improvement compared with preoperaive values. Conclusion: There were no difference in both clinical and radiologic outcomes between OSF group and non-OSF group at a minimum 12 months follow-up. We achieved similar successful outcomes in both groups using All-inside arthroscopic MBO. Arthroscopic MBO should be considered as a reasonable alternative method in patients who have chronic lateral ankle instability regardless of the presence of OSF.

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