scholarly journals The Interosseous Talocalcaneal Ligament Injury Findings in Lateral Ankle Instability with Sinus Tarsi Pain

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Hong-Geun Jung ◽  
Jong-won Lee ◽  
Won Tae Song
Keyword(s):  
Pain Score ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Common Finding ◽  
Functional Score ◽  
Lateral Ankle ◽  
Sinus Tarsi ◽  
Arthroscopic Findings ◽  
Lateral Ankle Instability ◽  
Subtalar Instability

Category: Ankle, Arthroscopy, Sports Introduction/Purpose: Lateral ankle instability (LAI) with concomitant sinus tarsi pain is a quite common finding. However, there has been few studies evaluating the subtalar arthroscopic findings for LAI with sinus tarsi pain. The purpose of the study is to evaluate the ST arthroscopic findings of chronic ankle instability with sinus tarsi syndrome. We hypothesized that chronic ankle instability with sinus tarsi pain is highly associated with interosseous talocalcaneal ligament (ITCL) tear which may be the cause for subtalar instability (STI). Methods: The study is based on 104 LAI with sinus tarsi pain ankles who had performed lateral ankle ligament stabilization. i.e. Modified Brostrum procedure (MBP), lateral ankle reconstruction (LAR) or subtalar ligament reconstruction (STR) with subtalar arthroscopic (STA) examinations from 2007 to 2018. The STA has been mainly focused on the ITCL injury and debridement of the ITCL tears and synovitis were performed when present. VAS pain score, AOFAS, Karlsson-Peterson functional score were evaluated. Results: According to the ST arthrosopic findings, ITCL tears were present in 94% (98/104) of the ankles. Lateral ankle instability (LAI), subtalar instability (STI), and LAI and STI combined were 32%, 30% and 38% respectively. MBP, LAR and STR were performed in 23%, 22% and 56% respectively. VAS pain score was improved from 5.3 to 1.9 (p<0.05). AOFAS score was improved from 67 to 89 (p<0.05), while K-P score improved from 50 to 83 (p<0.05). Sinus tarsi pain was relieved in 65% of the patients. Conclusion: We found the high incidence of the ITCL tears (98%) in LAI with sinus tarsi pain, and also diagnosed the STI in 68% of the ankles. We believe that in case of LAI with sinus tarsi pain, ST arthroscopic evaluation for ITCL tears is necessary and the possibility

scholarly journals Radiological and clinical outcome of lateral ankle instability with medial compartment osteoarthritis

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Sungwook Kim ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Hwa Jun Kang ◽  
Mao Yuan Sun
Keyword(s):  
Clinical Outcome ◽  
Pain Score ◽  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Degenerative Change ◽  
Medial Compartment ◽  
Functional Score ◽  
Lateral Ankle ◽  
Lateral Ankle Instability

Category: Ankle, Ankle Arthritis, osteoarthritis, ankle instability Introduction/Purpose: When lateral ankle instability (LAI) is not treated for long period, unbalanced loading on medial ankle may proceed to osteoarthritis (OA). Outcome studies about osteoarthritis with lateral ankle instability after stabilization, however, have rarely been reported. The authors have investigated the radiological and clinical outcome of ligament stabilization for LAI with medial compartment OA. Methods: The study is based on 25 ankles of LAI with medial compartment ankle OA that underwent lateral ankle ligament reconstruction from 2007 to 2014 with at least 1 year follow-up. The medial ankle OA was diagnosed with degenerative change of medial ankle on plain X-ray or MRI or arthroscopic findings. The OA was classified using Takakura stage, and arthroscopic degenerative change was classified by modified Outerbridge grading. Ligament stabilization surgery was done using either modified Broström procedure or lateral ligament reconstruction using semitendinosus tendon allograft. Arthroscopic synovectomy, debridement, and microfracture for osteochondral lesion were performed when needed. Clinical outcomes were evaluated using visual analogue scale (VAS) pain score, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Karlsson- Peterson score, and subjective patient satisfaction. Statistical analysis were done using Wilcoxon signed rank test. Results: The average instability duration was 98 (range, 12-480) months and the average follow up period was 46 (range, 13-108) months. Preoperative Takakura stage was mostly I (n=19, 76%) and II (n=4, 17%), and was same postoperatively. MRI OA findings of 18 ankles were medial cartilage denudation (17%), cartilage thinning/erosion (44%), medial osteophyte (50%), and loose bodies (30%). Modified Outerbridge grade 2 and 4 were most common (both 41%). The VAS pain score decreased from 6.1 ± 1.6 preoperatively to 1.8 ± 1.6 postoperatively (P<0.05). The AOFAS score improved from 61.8 ± 14.7 preoperatively to 90.0 ± 6.3 postoperatively, and the Karlsson-Peterson score improved from 54.5 ±14.4 to 89.4 ± 8.4 (P<0.05). There were no significant complications. All patients were satisfied. Conclusion: Ligament stabilization accompanied with arthroscopic procedure could draw good outcome, even without structural bony deformity correction. Even with no improvement in plain radiograph, functional score could be improved.

scholarly journals Chronic Lateral Ankle Instability with Subtalar Instability: Does Lateral Ligaments Reconstruction Reliable?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Shi-Ming Feng
Keyword(s):  
Ankle Instability ◽  
Anatomical Reconstruction ◽  
Functional Score ◽  
Anterior Talofibular Ligament ◽  
Short Term ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Subtalar Instability

Category: Ankle; Arthroscopy; Sports Introduction/Purpose: To evaluate the functional outcomes of arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability with subtalar instability during short term follow-up Methods: We retrospectively analyzed data in 8 patients (5 males, 3 females; 2 left ankles, 6 right ankles) aged between 21 and 49 years, with an average age of 31.74 +- 8.48 years presenting with CLAI with subtalar instability from Auguse 2015 to October 2018. The duration of the symptoms lasted for 12 to 43 months, with an average of 24.26 +- 10.17 months. All patients underwent arthroscopic anatomical reconstruction of ATFL and CFL. Pre- and postoperative visual analogue scales (VAS), the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score (AOFAS) and the Karlsson Ankle Functional Score (KAFS) were compared to evaluate the curative effect of the operation Results: After surgery, all incisions healed in stage I and there were no complications. All patients were followed for 12 to 36 months, averaging 26.15 +- 9.34 months. At the final follow-up, the ankle varus stress test and ankle anterior drawer test were both negative. Range of joint motion was good. There was no lateral instability of the ankle and subtalar, and all patients returned to normal gait. The mean VAS score decreased to 1.06 +- 0.27, the AOFAS score increased to 93.16 +- 5.26 and the KAFS score increased to 92.01 +- 6.73. All the follow-up indexes were significantly different from those before surgery Conclusion: Arthroscopic anatomical reconstruction of ATFL and CFL in the treatment of chronic lateral ankle instability with subtalar instability is reliable in short term

scholarly journals A comparison between arthroscopic and open surgery for treatment outcomes of chronic lateral ankle instability accompanied by osteochondral lesions of the talus

2019 ◽  
Author(s):  
Can Xu ◽  
Mingqing Li ◽  
Chenggong Wang ◽  
Hua Liu
Keyword(s):  
Complication Rate ◽  
Ankle Instability ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Functional Score ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Arthroscopic Procedure ◽  
Lateral Ankle Instability

Abstract Background : The present study aimed to examine the efficacy and safety of concurrent arthroscopic treatment of osteochondral lesion of talus (OLT) and lateral ankle instability. It was hypothesized that the outcome of all arthroscopic surgery was no worse than that of the combined open and arthroscopic surgery for treating chronic lateral ankle instability accompanied by OLT. Methods : All the patients diagnosed of chronic lateral ankle instability accompanied by OLT who were surgically treated between May 2015 and May2017 were targeted for inclusion. A total of 32 patients received concurrent arthroscopic treatment of OLT and lateral ankle instability, and 35 patients received arthroscopic treatment of OLT and open lateral ankle stabilization. All these patients were followed up using Karlsson Ankle Functional Score, visual analog scale (VAS) scores, Tegner activity score, and American Orthopaedic Foot and Ankle Society Score (AOFAS). The satisfaction and complication rate was evaluated and compared. Results : At 24-month follow-up, the Karlsson score, VAS score, Tegner score and AOFAS score were significantly improved in both groups in relation to the pre-operative condition. The two groups did not differ significantly from each other in terms of functional outcomes, satisfaction and complication rate. Conclusion : In comparison with the open lateral ankle stabilization and arthroscopic treatment of OLT, the all arthroscopic procedure showed no difference in clinical outcome at 24-month follow-up for treating chronic lateral ankle instability accompanied by OLT. With the benefits of minimal invasive arthroscopic procedure and an aggressive rehabilitation protocol, the treatment efficacy for the patients with chronic lateral ankle instability accompanied by OLT was still inferior to that for the patients with chronic ankle instability. Trial registration : The present study was carried out with the retrospectively registered data starting from May 28, 2015

Chronic Lateral Ankle Instability: Results of Anatomic Repair with Polyester Tape Augmentation

2020 ◽  
Vol 22 (1) ◽  
pp. 27-33
Author(s):  
Islam Sarhan ◽  
Islam Mubark ◽  
Ahmed Waly
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
High Rate ◽  
Anatomic Reconstruction ◽  
Foot And Ankle ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Anatomic Repair ◽  
Lateral Ankle Instability

Background. Ankle sprains are one of the most common injuries in both athletes and the general population. A major problem accompanying ankle injury is the high rate of recurrence, with about 20% of acute ankle sprain patients developing chronic ankle instability. Unlike acute ankle sprain, chronic ankle instability usually needs surgical intervention. Various anatomic reconstruction techniques using the ruptured ends of the ligaments to restore stability have gained popularity. The purpose of this study was to evaluate the functional results of the treatment of chronic lateral ankle instability with anatomic repair of the injured ligaments and reinforcement with polyester tape. Material and methods. A prospective study of 30 consecutive patients who underwent anatomic reconstruction of the lateral ligaments using transosseous suturing and augmentation using a polyester tape done at a single centre by a single surgeon from 2016 to 2017. All patients were assessed preoperatively and postoperatively at 6 weeks, 3, 6 and 12 months. The American Orthopaedic Foot and Ankle Score (AOFAS) and Free Online Foot and Ankle Ability Measure (FAAM) were recorded and used for results analysis. Results. At 12 months’ follow-up, the AOFAS had improved from mean 52.47 ± 2.06 to 91.0 ± 6.03 (p< 0.001) .The FAAM mean score had improved from mean 55.21± 1.9 to 90.43 ± 4.02 Conclusion. The ankle ligament reconstruction with additional polyester tape augmentation is an effective technique in treating chronic ankle instability with a satisfactory surgical outcome.

Arthroscopic Findings in Chronic Lateral Ankle Instability

2005 ◽  
Vol 33 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Ryuzo Okuda ◽  
Mitsuo Kinoshita ◽  
Junichi Morikawa ◽  
Toshito Yasuda ◽  
Muneaki Abe
Keyword(s):  
Ankle Instability ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Arthroscopic Findings ◽  
Lateral Ankle Instability

scholarly journals Localizer-Assisted Arthroscopic Anterior Talofibular Ligament and Calcaneus Fibula Ligament Reconstruction for the Treatment of Chronic Lateral Ankle Instability

2021 ◽  
Author(s):  
Liangjun Zhao ◽  
Fang Xu ◽  
Shan Lao ◽  
Jingmin Zhao ◽  
Qingjun Wei
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Anatomical Reconstruction ◽  
Tilt Test ◽  
Anterior Talofibular Ligament ◽  
Adjacent Area ◽  
Test Results ◽  
Arthroscopic Reconstruction ◽  
Lateral Ankle ◽  
Lateral Ankle Instability

Abstract Background Anatomic reconstruction has become one of the standard techniques used for the treatment of chronic ankle instability. Although arthroscopic treatment of chronic ankle instability has made remarkable progress in recent years, no comprehensive description of arthroscopic reconstruction of the ankle ligament is available. The purpose of this study is to describe the surgical technique of localizer-assisted arthroscopic anatomical reconstruction of the anterior talofibular ligament and the calcaneus fibular ligament and to evaluate the clinical effect in patients. Method In total, 36 young adults with simple lateral ankle instability were treated with arthroscopic anatomical reconstruction of the anterior talofibular ligament and the calcaneus fibula ligament, including 20 males and 16 females with an average age of 27 years (17-35 years). All patients had more than three ankle sprains in the past two years. Physical examination revealed positive anterior drawer test results of the ankle and/or talus tilt test results. The operation was performed in two steps. First, we found the adjacent area center of the peroneal lateral stop of the talofibular ligament and the calcaneus fibular ligament on the surface of distal fibula, and the skin mark was made. The localizer guided the surgeon to the location, and then the fibula bone canal was created. Next, the residual end of the talofibular side stop of the anterior fibula ligament was located under the arthroscope, and the talofibular end bone canal was made after the localizer was accurately positioned. Then, the calcaneus lateral stop of calcaneus fibula ligament was located on the calcaneus body surface, and the skin mark was made. Furthermore, the calcaneus end bone canal was generated under guidance of the localizer. Finally, anatomical reconstruction of the anterior talofibular ligament and/or calcaneus fibula ligament was completed in a step-by-step manner. The clinical characteristics, preoperative and postoperative the American Orthopaedic Foot and Ankle Society (AOFAS) and Karlsson scores were recorded. Results The AOFAS score increased from 60 (45-70) to 92 (80-98), and the Karlsson score increased from 62 (40-72) to 95 (75-96) after the operation. During the follow-up period, no patients experienced postoperative complications, such as infection at the incision, nerve injury, skin necrosis and ankle stiffness. No cases of recurrence of ankle instability were found. Conclusion Arthroscopic reconstruction of the talofibular and calcaneus fibular ligaments can achieve satisfactory clinical results in the treatment of chronic ankle instability with lower recurrence rates and reduced complications compared with open surgery. Meanwhile, localizer-assisted reconstruction is a reliable and simple operation technology with high clinical success rates. In addition, increased understanding of anatomic markers is very important to avoid operation failure.

scholarly journals All-inside arthroscopic modified Broström-Gould procedure for chronic lateral ankle instability with and without anterior talofibular ligament remnant repair produced similar functional results

2020 ◽  
Author(s):  
Shi-Ming Feng ◽  
Nicola Maffulli ◽  
Chao Ma ◽  
Francesco Oliva
Keyword(s):  
Ankle Instability ◽  
Rate Of Return ◽  
Lateral Ligament ◽  
Functional Score ◽  
Anterior Talofibular Ligament ◽  
Return To Sports ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Functional Scores

Abstract Purpose The Broström-Gould procedure, with the repair of the anterior talofibular ligament (ATFL) combined with the transfer of the extensor retinaculum, is considered the gold standard procedure for the management of chronic lateral ankle instability (CLAI). Lateral ligament reconstruction is considered if the ATFL remnant quality is poor or the ATFL has been damaged beyond the ability to suture it. It remains unclear whether not repairing the ATFL remnant produces comparable functional outcomes to the classical Broström-Gould procedure. Methods This retrospective cohort study included 84 patients with CLAI undergoing either repair or non-repair of the ATFL remnant using an all-inside arthroscopic Broström-Gould procedure from 2015 to 2018. The Visual Analogue Scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, Karlsson Ankle Functional Score (KAFS), Anterior Talar Translation (ATT), Active Joint Position Sense (AJPS), and the rate of return to sports were compared in both groups. Results All the functional scores (VAS, AOFAS, KAFS, ATT, AJPS) significantly improved in both groups at 1 and 2 years after surgery. At all the follow-up time points, the VAS, AOFAS, KAFS, ATT, AJPS, and the rate of return to sport scores were comparable between the repair and non-repair group. Conclusion There are no statistically significant differences in postoperative outcomes between ATFL remnant repair and non-repair for the management of CLAI using the all-inside arthroscopic Broström-Gould procedure. From the clinical viewpoint, the present study shows that the potential differences in clinical outcomes between ATFL remnant repair and non-repair are likely not relevant when performing an all-inside arthroscopic Broström-Gould procedure for CLAI. Level of evidence III.

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