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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2020

05.10.2018 | KNEE

Anatomical reconstruction produced similarly favorable outcomes as repair procedures for the treatment of chronic lateral ankle instability at long-term follow-up

verfasst von: Hong Li, Yinghui Hua, Hongyun Li, Shiyi Chen

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2020

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Abstract

Purpose

The aim of this study was to compare long-term outcomes after anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) repair and reconstruction at 5–10 years after surgery.

Methods

Forty-five patients who underwent surgical repair or reconstruction of both ATFL and CFL were retrospectively investigated in this study. American Orthopedic Foot and Ankle Society (AOFAS), Karlsson Score, and Tegner activity scale were used to evaluate the ankle function at a follow-up of 5–10 years. Ultrasound examination was used to evaluate the ATFL and CFL, and MRI was used to evaluate the cartilage.

Results

At final follow-up, no patient had recurrent ankle instability. There were no significant differences in AOFAS (92.6 ± 6.5 vs 89.6 ± 3.4; n.s.) or Karlsson Score (93 ± 8.2 vs 90.6 ± 5.0; n.s.) between the reconstruction group (twenty patients) and the repair group (twenty-five patients) postoperatively. There were also no significant differences in activity level as measured by the Tegner activity score (6 (range 4 to 8) vs 6 (range 5 to 7); n.s.). Five patients in the reconstruction group complained of some tightness of the ankles. Ultrasound showed the reconstructed ligaments maintained good continuity and were thicker than the repaired ligaments.

Conclusion

Patients in both the repair and the reconstruction cohort had high patient satisfaction with the outcomes and high function and activity levels that indicated recreational sports participation over a long period.

Level of evidence

III.
Literatur
1.
Zurück zum Zitat Ahn HW, Lee KB (2016) Comparison of the modified Brostrom procedure for chronic lateral ankle instability with and without subfibular ossicle. Am J Sports Med 44(12):3158–3164CrossRef Ahn HW, Lee KB (2016) Comparison of the modified Brostrom procedure for chronic lateral ankle instability with and without subfibular ossicle. Am J Sports Med 44(12):3158–3164CrossRef
2.
Zurück zum Zitat Clifton DR, Koldenhoven RM, Hertel J, Onate JA, Dompier TP, Kerr ZY (2017) Epidemiological patterns of ankle sprains in youth, high school, and college football. Am J Sports Med 45(2):417–425CrossRef Clifton DR, Koldenhoven RM, Hertel J, Onate JA, Dompier TP, Kerr ZY (2017) Epidemiological patterns of ankle sprains in youth, high school, and college football. Am J Sports Med 45(2):417–425CrossRef
3.
Zurück zum Zitat Coughlin MJ, Schenck RC Jr, Grebing BR, Treme G (2004) Comprehensive reconstruction of the lateral ankle for chronic instability using a free gracilis graft. Foot Ankle Int 25(4):231–241CrossRef Coughlin MJ, Schenck RC Jr, Grebing BR, Treme G (2004) Comprehensive reconstruction of the lateral ankle for chronic instability using a free gracilis graft. Foot Ankle Int 25(4):231–241CrossRef
4.
Zurück zum Zitat Dierckman BD, Ferkel RD (2015) Anatomic reconstruction with a semitendinosus allograft for chronic lateral ankle instability. Am J Sports Med 43(8):1941–1950CrossRef Dierckman BD, Ferkel RD (2015) Anatomic reconstruction with a semitendinosus allograft for chronic lateral ankle instability. Am J Sports Med 43(8):1941–1950CrossRef
5.
Zurück zum Zitat Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E (2016) Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: a prospective cohort analysis. Am J Sports Med 44(4):995–1003CrossRef Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E (2016) Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: a prospective cohort analysis. Am J Sports Med 44(4):995–1003CrossRef
6.
Zurück zum Zitat Ellis SJ, Williams BR, Pavlov H, Deland J (2011) Results of anatomic lateral ankle ligament reconstruction with tendon allograft. HSS J 7(2):134–140CrossRef Ellis SJ, Williams BR, Pavlov H, Deland J (2011) Results of anatomic lateral ankle ligament reconstruction with tendon allograft. HSS J 7(2):134–140CrossRef
7.
Zurück zum Zitat Hua Y, Chen S, Jin Y, Zhang B, Li Y, Li H (2012) Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. Int Orthop 36(10):2027–2031CrossRef Hua Y, Chen S, Jin Y, Zhang B, Li Y, Li H (2012) Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. Int Orthop 36(10):2027–2031CrossRef
8.
Zurück zum Zitat Hua Y, Chen S, Li Y, Chen J, Li H (2010) Combination of modified Brostrom procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthroscopy 26(4):524–528CrossRef Hua Y, Chen S, Li Y, Chen J, Li H (2010) Combination of modified Brostrom procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthroscopy 26(4):524–528CrossRef
9.
Zurück zum Zitat Hua Y, Yang Y, Chen S, Cai Y (2012) Ultrasound examination for the diagnosis of chronic anterior talofibular ligament injury. Acta Radiol 53(10):1142–1145CrossRef Hua Y, Yang Y, Chen S, Cai Y (2012) Ultrasound examination for the diagnosis of chronic anterior talofibular ligament injury. Acta Radiol 53(10):1142–1145CrossRef
10.
Zurück zum Zitat Ibrahim SA, Hamido F, Al Misfer AK, Ghafar SA, Awad A, Salem H et al (2011) Anatomical reconstruction of the lateral ligaments using Gracillis tendon in chronic ankle instability; a new technique. Foot Ankle Surg 17(4):239–246CrossRef Ibrahim SA, Hamido F, Al Misfer AK, Ghafar SA, Awad A, Salem H et al (2011) Anatomical reconstruction of the lateral ligaments using Gracillis tendon in chronic ankle instability; a new technique. Foot Ankle Surg 17(4):239–246CrossRef
12.
Zurück zum Zitat Jung HG, Kim TH, Park JY, Bae EJ (2012) Anatomic reconstruction of the anterior talofibular and calcaneofibular ligaments using a semitendinosus tendon allograft and interference screws. Knee Surg Sports Traumatol Arthrosc 20(8):1432–1437CrossRef Jung HG, Kim TH, Park JY, Bae EJ (2012) Anatomic reconstruction of the anterior talofibular and calcaneofibular ligaments using a semitendinosus tendon allograft and interference screws. Knee Surg Sports Traumatol Arthrosc 20(8):1432–1437CrossRef
13.
Zurück zum Zitat Krips R, van Dijk CN, Halasi PT, Lehtonen H, Corradini C, Moyen B et al (2001) Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a multicenter study. Foot Ankle Int 22(5):415–421CrossRef Krips R, van Dijk CN, Halasi PT, Lehtonen H, Corradini C, Moyen B et al (2001) Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a multicenter study. Foot Ankle Int 22(5):415–421CrossRef
14.
Zurück zum Zitat Krips R, van Dijk CN, Lehtonen H, Halasi T, Moyen B, Karlsson J (2002) Sports activity level after surgical treatment for chronic anterolateral ankle instability. A multicenter study. Am J Sports Med 30(1):13–19CrossRef Krips R, van Dijk CN, Lehtonen H, Halasi T, Moyen B, Karlsson J (2002) Sports activity level after surgical treatment for chronic anterolateral ankle instability. A multicenter study. Am J Sports Med 30(1):13–19CrossRef
15.
Zurück zum Zitat Li H, Hua Y, Li H, Ma K, Li S, Chen S (2017) Activity level and function 2 years after anterior talofibular ligament repair: a comparison between arthroscopic repair and open repair procedures. Am J Sports Med 45(9):2044–2051CrossRef Li H, Hua Y, Li H, Ma K, Li S, Chen S (2017) Activity level and function 2 years after anterior talofibular ligament repair: a comparison between arthroscopic repair and open repair procedures. Am J Sports Med 45(9):2044–2051CrossRef
16.
Zurück zum Zitat Li Q, Ma K, Tao H, Hua Y, Chen S, Chen S et al (2018) Clinical and magnetic resonance imaging assessment of anatomical lateral ankle ligament reconstruction: comparison of tendon allograft and autograft. Int Orthop 42(3):551–557CrossRef Li Q, Ma K, Tao H, Hua Y, Chen S, Chen S et al (2018) Clinical and magnetic resonance imaging assessment of anatomical lateral ankle ligament reconstruction: comparison of tendon allograft and autograft. Int Orthop 42(3):551–557CrossRef
17.
Zurück zum Zitat Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G et al (2013) Isolated anterior talofibular ligament Brostrom repair for chronic lateral ankle instability: 9-year follow-up. Am J Sports Med 41(4):858–864CrossRef Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G et al (2013) Isolated anterior talofibular ligament Brostrom repair for chronic lateral ankle instability: 9-year follow-up. Am J Sports Med 41(4):858–864CrossRef
18.
Zurück zum Zitat Matheny LM, Johnson NS, Liechti DJ, Clanton TO (2016) Activity level and function after lateral ankle ligament repair versus reconstruction. Am J Sports Med 44(5):1301–1308CrossRef Matheny LM, Johnson NS, Liechti DJ, Clanton TO (2016) Activity level and function after lateral ankle ligament repair versus reconstruction. Am J Sports Med 44(5):1301–1308CrossRef
19.
Zurück zum Zitat Matsui K, Takao M, Tochigi Y, Ozeki S, Glazebrook M (2017) Anatomy of anterior talofibular ligament and calcaneofibular ligament for minimally invasive surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc 25(6):1892–1902CrossRef Matsui K, Takao M, Tochigi Y, Ozeki S, Glazebrook M (2017) Anatomy of anterior talofibular ligament and calcaneofibular ligament for minimally invasive surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc 25(6):1892–1902CrossRef
20.
Zurück zum Zitat Mauntel TC, Wikstrom EA, Roos KG, Djoko A, Dompier TP, Kerr ZY (2017) The epidemiology of high ankle sprains in national collegiate athletic association sports. Am J Sports Med 45(9):2156–2163CrossRef Mauntel TC, Wikstrom EA, Roos KG, Djoko A, Dompier TP, Kerr ZY (2017) The epidemiology of high ankle sprains in national collegiate athletic association sports. Am J Sports Med 45(9):2156–2163CrossRef
21.
Zurück zum Zitat Miklovic TM, Donovan L, Protzuk OA, Kang MS, Feger MA (2018) Acute lateral ankle sprain to chronic ankle instability: a pathway of dysfunction. Phys Sportsmed 46(1):116–122CrossRef Miklovic TM, Donovan L, Protzuk OA, Kang MS, Feger MA (2018) Acute lateral ankle sprain to chronic ankle instability: a pathway of dysfunction. Phys Sportsmed 46(1):116–122CrossRef
22.
Zurück zum Zitat Park CH, Lee WC (2017) Donor site morbidity after lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon autograft. Am J Sports Med 45(4):922–928CrossRef Park CH, Lee WC (2017) Donor site morbidity after lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon autograft. Am J Sports Med 45(4):922–928CrossRef
23.
Zurück zum Zitat Park KH, Lee JW, Suh JW, Shin MH, Choi WJ (2016) Generalized ligamentous laxity is an independent predictor of poor outcomes after the modified Brostrom procedure for chronic lateral ankle instability. Am J Sports Med 44(11):2975–2983CrossRef Park KH, Lee JW, Suh JW, Shin MH, Choi WJ (2016) Generalized ligamentous laxity is an independent predictor of poor outcomes after the modified Brostrom procedure for chronic lateral ankle instability. Am J Sports Med 44(11):2975–2983CrossRef
24.
Zurück zum Zitat Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA (2017) The epidemiology of lateral ligament complex ankle sprains in national collegiate athletic association sports. Am J Sports Med 45(1):201–209CrossRef Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA (2017) The epidemiology of lateral ligament complex ankle sprains in national collegiate athletic association sports. Am J Sports Med 45(1):201–209CrossRef
25.
Zurück zum Zitat Song B, Li C, Chen N, Chen Z, Zhang Y, Zhou Y et al (2017) All-arthroscopic anatomical reconstruction of anterior talofibular ligament using semitendinosus autografts. Int Orthop 41(5):975–982CrossRef Song B, Li C, Chen N, Chen Z, Zhang Y, Zhou Y et al (2017) All-arthroscopic anatomical reconstruction of anterior talofibular ligament using semitendinosus autografts. Int Orthop 41(5):975–982CrossRef
26.
Zurück zum Zitat Ventura A, Terzaghi C, Legnani C, Borgo E (2014) Lateral ligament reconstruction with allograft in patients with severe chronic ankle instability. Arch Orthop Trauma Surg 134(2):263–268CrossRef Ventura A, Terzaghi C, Legnani C, Borgo E (2014) Lateral ligament reconstruction with allograft in patients with severe chronic ankle instability. Arch Orthop Trauma Surg 134(2):263–268CrossRef
27.
Zurück zum Zitat Vuurberg G, Pereira H, Blankevoort L, van Dijk CN (2018) Anatomic stabilization techniques provide superior results in terms of functional outcome in patients suffering from chronic ankle instability compared to non-anatomic techniques. Knee Surg Sports Traumatol Arthrosc 26(7):2183–2195CrossRef Vuurberg G, Pereira H, Blankevoort L, van Dijk CN (2018) Anatomic stabilization techniques provide superior results in terms of functional outcome in patients suffering from chronic ankle instability compared to non-anatomic techniques. Knee Surg Sports Traumatol Arthrosc 26(7):2183–2195CrossRef
28.
Zurück zum Zitat Wang W, Xu GH (2017) Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability. BMC Musculoskelet Disord 18(1):150CrossRef Wang W, Xu GH (2017) Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability. BMC Musculoskelet Disord 18(1):150CrossRef
29.
Zurück zum Zitat Xu HX, Lee KB (2016) Modified brostrom procedure for chronic lateral ankle instability in patients with generalized joint laxity. Am J Sports Med 44(12):3152–3157CrossRef Xu HX, Lee KB (2016) Modified brostrom procedure for chronic lateral ankle instability in patients with generalized joint laxity. Am J Sports Med 44(12):3152–3157CrossRef
30.
Zurück zum Zitat Yasui Y, Shimozono Y, Kennedy JG (2018) Surgical procedures for chronic lateral ankle instability. J Am Acad Orthop Surg 26(7):223–230CrossRef Yasui Y, Shimozono Y, Kennedy JG (2018) Surgical procedures for chronic lateral ankle instability. J Am Acad Orthop Surg 26(7):223–230CrossRef
Metadaten
Titel
Anatomical reconstruction produced similarly favorable outcomes as repair procedures for the treatment of chronic lateral ankle instability at long-term follow-up
verfasst von
Hong Li
Yinghui Hua
Hongyun Li
Shiyi Chen
Publikationsdatum
05.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2020
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5176-z

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