Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Chronic Lateral Ankle Instability: Efficacy of Combination of Ankle Arthroscopic Exploration and Modified Brostrom Operation

족관절 외측 불안정성 재건 시 시행하는 탐험적 관절경의 유용성

  • Lee, Kyung-Tai (Department of Orthopedic Surgery of Foot and Ankle, Gangnam Eulji Hospital, Eulji University School of Medicine) ;
  • Kim, Jin-Su (Department of Orthopedic Surgery of Foot and Ankle, Gangnam Eulji Hospital, Eulji University School of Medicine) ;
  • Young, Ki-Won (Department of Orthopedic Surgery of Foot and Ankle, Gangnam Eulji Hospital, Eulji University School of Medicine) ;
  • Park, Young-Uk (Department of Orthopedic Surgery of Foot and Ankle, Gangnam Eulji Hospital, Eulji University School of Medicine) ;
  • Kim, Jun-Beom (Department of Orthopedic Surgery of Foot and Ankle, Gangnam Eulji Hospital, Eulji University School of Medicine) ;
  • Kim, Tae-Won (Department of Orthopedic Surgery of Foot and Ankle, Gangnam Eulji Hospital, Eulji University School of Medicine) ;
  • Jo, Jae-Ho (Department of Orthopedic Surgery, Military Capital Hospital)
  • 이경태 (을지대학교 의과대학 을지병원 정형외과) ;
  • 김진수 (을지대학교 의과대학 을지병원 정형외과) ;
  • 양기원 (을지대학교 의과대학 을지병원 정형외과) ;
  • 박영욱 (을지대학교 의과대학 을지병원 정형외과) ;
  • 김준범 (을지대학교 의과대학 을지병원 정형외과) ;
  • 김태원 (을지대학교 의과대학 을지병원 정형외과) ;
  • 조재호 (국군 수도병원 정형외과)
  • Received : 2010.10.17
  • Accepted : 2010.11.18
  • Published : 2010.12.15
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Abstract

Purpose: To evaluate the efficacy of the arthroscopic exploration combined with modified Brostrom operation (MBO) for the treatment of chronic lateral ankle instability (CAI). Materials and Methods: Sixty patients who diagnosed a CAI were performed MBO. We divided to 2 groups, whether simultaneously inspected by arthroscopy (group B) or not (group A). The both group's results were compared according to American Orthopedic Foot and Ankle Society Ankle-hindfoot score (AOFAS), functional ankle score and visual analog scale (VAS) at preoperative and final follow-up period. Results: There were no significant differences of AOFAS, functional ankle score and VAS between both groups at final follow-up. However, in group A, 2 cases associated with medial ankle instability and syndesmotic injuries were did not diagnosed preoperatively, showed poor prognosis. In group B, one case had a permanent peroneal nerve symptom. The match rate of intra-articular lesions between preoperative diagnosis and postoperative arthroscopic diagnosis was 30% in group B. Conclusion: Combination of arthroscopic exploration and MBO is effective strategy for intra-operatively discrimination of intra-articular associated lesions for CAI.

Keywords

References

  1. Balduini FC, Vegso JJ, Torg JS, Torg E. Management and rehabilitation of ligamentous injuries to the ankle. Sports Med. 1987;4:364-80. https://doi.org/10.2165/00007256-198704050-00004
  2. DiGiovanni CW, Brodsky A. Current concepts: lateral ankle instability. Foot Ankle Int. 2006;27:854-66.
  3. Kim JS, Lee, YS. Causal Relationship between Military Activities and Musculoskeletal Injuries. J Kor Mil Sci Tec. 2008;37:142-7.
  4. Choi WJ, Lee JW, Han SH, Kim BS, Lee SK. Chronic lateral ankle instability: the effect of intra-articular lesions on clinical outcome. Am J Sports Med. 2008;36:2167-72. https://doi.org/10.1177/0363546508319050
  5. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the anklehindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349-53. https://doi.org/10.1177/107110079401500701
  6. Povacz P, Unger S, Miller W, Tockner R, Resch H. A randomized, prospective study of operative and non-operative treatment of injuries of the fibular collateral ligaments of the ankle. J Bone Joint Surg Am. 1998;80:345-51. https://doi.org/10.1302/0301-620X.80B2.8032
  7. Garrick JG, Requa RK. The epidemiology of foot and ankle injuries in sports. Clin Podiatr Med Surg. 1989;6:629-37.
  8. Verhagen RA, de Keizer G, van Dijk CN. Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg. 1995;114:92-6. https://doi.org/10.1007/BF00422833
  9. Okuda R, Kinoshita M, Morikawa J, Yasuda T, Abe M. Arthroscopic findings in chronic lateral ankle instability: do focal chondral lesions influence the results of ligament reconstruction? Am J Sports Med. 2005;33:35-42. https://doi.org/10.1177/0363546504271058
  10. Taga I, Shino K, Inoue M, Nakata K, Maeda A. Articular cartilage lesions in ankles with lateral ligament injury. An arthroscopic study. Am J Sports Med. 1993;21:120-6; discussion 6-7. https://doi.org/10.1177/036354659302100120
  11. Lee SY, Kim GL, Park DY. Arthroscopic findings and treatment of chronic lateral ankle instability. J Korean Foot Ankle Soc. 2007;11:198-203.
  12. Ferkel RD, Chams RN. Chronic lateral instability: arthroscopic findings and long-term results. Foot Ankle Int. 2007;28:24-31. https://doi.org/10.3113/FAI.2007.0005
  13. Cannon LB, Hackney RG. Anterior tibiotalar impingement associated with chronic ankle instability. J Foot Ankle Surg. 2000;39:383-6. https://doi.org/10.1016/S1067-2516(00)80074-5
  14. Ogilvie-Harris DJ, Reed SC. Disruption of the ankle syndesmosis: diagnosis and treatment by arthroscopic surgery. Arthroscopy. 1994;10:561-8. https://doi.org/10.1016/S0749-8063(05)80015-5
  15. Han SH, Lee JW, Kim S, Suh JS, Choi YR. Chronic tibiofibular syndesmosis injury: the diagnostic efficiency of magnetic resonance imaging and comparative analysis of operative treatment. Foot Ankle Int. 2007;28:336-42. https://doi.org/10.3113/FAI.2007.0336
  16. Ferran NA, Oliva F, Maffulli N. Ankle instability. Sports Med Arthrosc. 2009;17:139-45. https://doi.org/10.1097/JSA.0b013e3181a3d790
  17. Valderrabano V, Wiewiorski M, Frigg A, Hintermann B, Leumann A. [Chronic ankle instability]. Unfallchirurg. 2007;110:691-9; quiz 700. https://doi.org/10.1007/s00113-007-1310-y
  18. Bell SJ, Mologne TS, Sitler DF, Cox JS. Twenty-six-year results after Brostrom procedure for chronic lateral ankle instability. Am J Sports Med. 2006;34:975-8. https://doi.org/10.1177/0363546505282616
  19. Saito A, Kikuchi S. Anatomic relations between ankle arthroscopic portal sites and the superficial peroneal and saphenous nerves. Foot Ankle Int. 1998;19:748-52. https://doi.org/10.1177/107110079801901107
  20. Ferkel RD, Heath DD, Guhl JF. Neurological complications of ankle arthroscopy. Arthroscopy. 1996;12:200-8. https://doi.org/10.1016/S0749-8063(96)90011-0
  21. Solomon LB, Ferris L, Henneberg M. Anatomical study of the ankle with view to the anterior arthroscopic portals. ANZ J Surg. 2006;76:932-6. https://doi.org/10.1111/j.1445-2197.2006.03909.x
  22. Takao M, Uchio Y, Shu N, Ochi M. Anatomic bases of ankle arthroscopy: study of superficial and deep peroneal nerves around anterolateral and anterocentral approach. Surg Radiol Anat. 1998;20:317-20. https://doi.org/10.1007/BF01630612
  23. Hintermann B, Boss A, Schafer D. Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med. 2002;30:402-9.