scholarly journals Functional Outcome of Modified Brostrom-Gould Procedure Using the PopLok Knotless Suture Anchor Technique in Lateral Ankle Instability

Cureus ◽  
2019 ◽  
Author(s):  
Mohd Yazid Bajuri ◽  
Edewet Daun ◽  
Muhammad H Abdul Raof ◽  
Mohd Rohaizat Hassan ◽  
Srijit Das
Keyword(s):  
Functional Outcome ◽  
Suture Anchor ◽  
Ankle Instability ◽  
Lateral Ankle ◽  
Lateral Ankle Instability ◽  
Knotless Suture Anchor

scholarly journals A new arthroscopic BrostrÖm procedure for chronic lateral ankle instability

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0051
Author(s):  
Hailin Xu
Keyword(s):  
Suture Anchor ◽  
Ankle Instability ◽  
Clinical Success Rate ◽  
Anterior Talofibular Ligament ◽  
Neurologic Symptom ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability ◽  
Anterolateral Portal

Category: Arthroscopy Introduction/Purpose: Chronic lateral ankle instability is usually progressed from previous lateral ankle sprain which is not treated properly. Although patients with acute lateral ankle ligament injury are often managed successfully with conservative treatment, approximately 20%-40% will go on developing symptomatic chronic recurrent lateral ankle instability. Several procedures have been introduced to address these patients including open or arthroscopic techniques, the most common of which is the BrostrÖm procedure. The aim of this study was to describe a new outside-in arthroscopic BrostrÖm procedure and its results for treating patients with chronic lateral ankle instability. Methods: Of the 32 patients that were treated, 18 males and 14 females, and aged from 15~57 years (mean 27.8 years). All patients were symptomatic with a combination of recurrent ankle sprains, giving way and avoidance of sports, as well as presented positive anterior drawer test in the physical examination. The history of all patients was over 6 months and conservative treatments were not enough to relieve the symptoms. Standard anteromedial and anterolateral portal was established. Using a suture anchor (2.9 mm Lupine BR, preloaded with double orthocord sutures, DePuy Synthes) and a cannulated needle as a suture passer, anterior talofibular ligament repair was achieved with an outside-in technique. Follow-up was 6~14 months (mean 8.7). Results: Subjective instability and mechanical instability were all significantly improved. No recurrences of ankle instability were reported. The mean AOFAS Ankle-Hindfoot score increased from 74 preoperatively to 95 at final follow-up. 2 patients reported superficial peroneal nerve (SPN) irritation symptom postoperatively but only 1 persisted. 2 patients complained mild pain anteroinferior to the lateral ankle. Conclusion: The arthroscopic outside-in BrostrÖm procedure with a single suture anchor was a safe, effective and reproducible technique for chronic lateral ankle instability. The ankle stability resumed with high clinical success rate. The main complication of this procedure was injury to SPN, which crossed the area of repair. The transient neurologic symptom may be related to stretch injury when establishing the anterolateral portal, while the persistent one may be due to nerve entrapment.

scholarly journals Stable ankle after modified brostrom technique using one anchor with double suture at Sanglah Hospital: a case report

2020 ◽  
Vol 8 (3) ◽  
pp. 1141
Author(s):  
I. Wayan Subawa ◽  
Dwiwahyonokusuma . ◽  
I. Gede Mahardika Putra
Keyword(s):  
Case Report ◽  
Suture Anchor ◽  
Ankle Instability ◽  
Suture Anchors ◽  
Lateral Ankle ◽  
Left Ankle ◽  
Resource Setting ◽  
Minimal Incision ◽  
Lateral Ankle Instability ◽  
Lateral Ankle Ligaments

Ankle sprains are commonly seen injuries among athletic and young population, and it is necessary to stabilize the patient ankle as soon as possible. Authors report the cost-effective option of using a modified Brostrom technique with one suture anchor in a limited resource setting. Case a 24- year-old male came to the orthopaedic clinic with chief complaint of left ankle pain for the past 2 weeks after jumping and landing in a twisted position. Patient also complained of unstable ankle after the fall. On physical examination, the ankle showed tenderness and instability when anterior drawer test was performed. The patient was diagnosed with lateral ankle instability. This case report describes a modification to the original Brostrom procedure using one suture anchor to anatomically reconstruct the lateral ankle ligaments in treating high demand patient who have lateral ankle instability. After six months follow up, the patient has shown significant improvement on his left ankle. Despite of all the modifications of Brostrom procedure, the use of more suture anchors or sophisticated technique such as arthroscopy might result in increasing cost. Reasonably good outcome can still be achieved with modified Brostrom procedure that utilizes minimal incision, simple steps, and single suture anchor. Due to its cost-effectiveness, authors believe that modified Brostrom technique with one suture anchor is an effective and practical treatment option for lateral ankle instability. Brostrom technique using suture anchors as shown here can provide similarly good outcomes compared with other more complex techniques.

All-Inside, Anatomical Lateral Ankle Stabilization for Revision and Complex Primary Lateral Ankle Stabilization

2014 ◽  
Vol 7 (6) ◽  
pp. 484-491 ◽  
Author(s):  
Mark A. Prissel ◽  
Thomas S. Roukis
Keyword(s):  
Suture Anchor ◽  
Ankle Instability ◽  
Surgical Approaches ◽  
Mechanical Problem ◽  
Arthroscopic Technique ◽  
Lateral Ankle ◽  
Arthroscopic Management ◽  
Ligament Augmentation ◽  
Lateral Ankle Instability ◽  
Primary Lateral

Lateral ankle instability is a common mechanical problem that often requires surgical management when conservative efforts fail. Historically, myriad open surgical approaches have been proposed. Recently, consideration for arthroscopic management of lateral ankle instability has become popular, with promising results. Unfortunately, recurrent inversion ankle injury following lateral ankle stabilization can occur and require revision surgery. To date, arthroscopic management for revision lateral ankle stabilization has not been described. We present a novel arthroscopic technique combining an arthroscopic lateral ankle stabilization kit with a suture anchor ligament augmentation system for revision as well as complex primary lateral ankle stabilization.

scholarly journals Consistency and Reliability of Ankle Stress Radiography in Patients With Chronic Lateral Ankle Instability

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110040
Author(s):  
Ji Hye Choi ◽  
Kug Jin Choi ◽  
Chin Youb Chung ◽  
Moon Seok Park ◽  
Ki Hyuk Sung ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Tilt Angle ◽  
Ankle Instability ◽  
Interobserver Reliability ◽  
Initial Presentation ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Stress Radiographs ◽  
Lateral Ankle Instability

Background: Ankle stress radiographs are important tools for evaluating chronic lateral ankle instability. The consistency of a patient’s ankle condition as it affects the reliability of ankle stress radiographs has never been evaluated. Purpose: To investigate the consistency and reliability of ankle stress radiographs in patients with chronic lateral ankle instability without an ankle injury during the study period. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Included were patients with chronic lateral ankle instability who underwent 2 repeated ankle stress radiographs between January 2014 and July 2019; those with an ankle injury during the study period were excluded. The tibiotalar tilt angle on varus stress radiographs and anterior translation of the talus on anterior drawer stress radiographs were measured at initial presentation and final follow-up examination. Interobserver reliability and consistency of ankle stress radiographs were analyzed using the intraclass correlation coefficient (ICC). Results: A total of 45 patients (mean ± standard deviation age, 36.4 ± 13.4 years; 18 men and 27 women; follow-up duration, 9.1 ± 3.2 months) were included. The mean ± standard deviation tibiotalar tilt angle and anterior talar translation at initial presentation were 10.8° ± 5.2° and 6.9 ± 2.7 mm, respectively. The interobserver reliabilities of the tibiotalar tilt angle and anterior talar translation were excellent (ICC = 0.926 [95% CI, 0.874-0.959] and 0.911 [95% CI, 0.766-0.961], respectively). The consistency between the initial and final radiographs was good for tibiotalar tilt angle (ICC = 0.763 [95% CI, 0.607-0.862]) and poor for anterior talar translation (ICC = 0.456 [95% CI, 0.187-0.660]). Conclusion: Although the interobserver reliability of the radiographic measurements was excellent, the consistency of the ankle stress radiographs was not as acceptable. Surgeons need to be cautious when deciding whether to operate on a patient with chronic lateral ankle instability based on a single ankle stress radiograph.

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.

Magnetic Resonance Imaging T2* Mapping of the Talar Dome and Subtalar Joint Cartilage 3 Years After Anterior Talofibular Ligament Repair or Reconstruction in Chronic Lateral Ankle Instability

2021 ◽  
Vol 49 (3) ◽  
pp. 737-746
Author(s):  
Yiwen Hu ◽  
Yuyang Zhang ◽  
Qianru Li ◽  
Yuxue Xie ◽  
Rong Lu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ankle Instability ◽  
Anterior Talofibular Ligament ◽  
Resonance Imaging ◽  
Talar Dome ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Lateral Ankle Instability

Background: Cartilage degeneration is a common issue in patients with chronic lateral ankle instability. However, there are limited studies regarding the effectiveness of lateral ligament surgery on preventing talar and subtalar joint cartilage from further degenerative changes. Purpose: To longitudinally evaluate talar and subtalar cartilage compositional changes using magnetic resonance imaging T2* mapping in anatomic anterior talofibular ligament (ATFL)–repaired and ATFL-reconstructed ankles and to compare them with measures in asymptomatic controls. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2015 and December 2016, patients with chronic lateral ankle instability who underwent anatomic ATFL repair (n = 19) and reconstruction (n = 20) were prospectively recruited. Patients underwent 3.0-T magnetic resonance imaging at baseline and 3-year follow-up. As asymptomatic controls, 21 healthy volunteers were recruited and underwent imaging at baseline. Talar dome cartilage was divided into (1) medial anterior, central, and posterior and (2) lateral anterior, central, and posterior. Posterior subtalar cartilage was divided into (1) central talus and calcaneus and (2) lateral talus and calcaneus. Ankle function was assessed using the American Orthopaedic Foot & Ankle Society scores. Results: There were significant increases in T2* values in medial and lateral posterior and central talus cartilage from baseline to 3-year follow-up in patients who underwent repair. T2* values were significantly higher in ATFL-repaired ankles at follow-up for all cartilage regions of interest, except medial and lateral anterior and lateral central, compared with those in healthy controls. From baseline to 3-year follow-up, ATFL-reconstructed ankles had a significant increase in T2* values in lateral central and posterior cartilage. T2* values in ATFL-reconstructed ankles at follow-up were elevated in all cartilage regions of interest, except medial and lateral anterior, compared with those in healthy controls. ATFL-repaired ankles showed a greater decrease of T2* values from baseline to follow-up in lateral calcaneus cartilage than did ATFL-reconstructed ankles ( P = .031). No significant differences in American Orthopaedic Foot & Ankle Society score were found between repair and reconstruction procedures (mean ± SD, 19.11 ± 7.45 vs 16.85 ± 6.24; P = .311). Conclusion: Neither anatomic ATFL repair nor reconstruction could prevent the progression of talar dome and posterior subtalar cartilage degeneration; however, ankle function and activity levels were not affected over a short period. Patients who underwent ATFL repair exhibited lower T2* values in the lateral calcaneus cartilage than did those who underwent reconstruction.

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