Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 Years
Background: Chronic ankle instability is a common condition that develops after lateral ankle sprains. Many surgical techniques have been described in case of failure of conservative treatment. The purpose of this paper is to present the results in terms of clinical outcomes, return to sport and rec...
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MDPI AG
2023-07-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/13/13/7923 |
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| author | Federico Giuseppe Usuelli Alice Montagna Rudy Sangaletti Cristian Indino Camilla Maccario Federico Alberto Grassi |
| author_facet | Federico Giuseppe Usuelli Alice Montagna Rudy Sangaletti Cristian Indino Camilla Maccario Federico Alberto Grassi |
| author_sort | Federico Giuseppe Usuelli |
| collection | DOAJ |
| description | Background: Chronic ankle instability is a common condition that develops after lateral ankle sprains. Many surgical techniques have been described in case of failure of conservative treatment. The purpose of this paper is to present the results in terms of clinical outcomes, return to sport and recurrence rate after reconstruction of the lateral ligament complex of the ankle with a minimally invasive approach at a minimum follow up of five years. Methods: This retrospective study involved forty-seven patients treated for chronic ankle instability from January 2013 to November 2017. The clinical outcomes were evaluated with the American Orthopedic Foot and Ankle Society ankle and hindfoot score (AOFAS score), the University of California–Los Angeles Rating Scale (UCLA Rating Scale), the Karlsson–Peterson ankle instability score and the Halasi scale at a mean follow up time of 80 months. Results: The mean age of the patients was 42 years (23–63). The mean VAS pain score decreased from 5.6 (2–9) pre-operatively to 0.7 (0–7) post-operatively. The mean UCLA Rating Scale score improved from 7.7 (4–8) before surgical treatment to 9.2 (6–10) afterwards. The AOFAS score increased from a pre-operative mean value of 66.5 (40–95) to a post-operative mean value of 94 (88–100) and the Halasi scale from a pre-injury mean value of 4.3 (2–8) to 4.5 post-operatively (2–8). The mean Karlsson–Peterson ankle instability score increased from 71 (40–90) pre-operatively to 87.9 (70–90) post-operatively. During this period of follow up, the procedure survival rate was 95.7%, with two cases of recurrence of ankle sprain post-operatively after twelve months in one case and forty months in the other case. Conclusions: The described technique of reconstruction of the anterior talofibular and calcaneofibular ligament with a minimally invasive approach with a semitendinosus autograft is a viable treatment option for chronic ankle instability and enables the majority of patients to regain their activity and sport level with a low recurrence rate at a mid-term follow up. |
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| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-11T01:46:22Z |
| publishDate | 2023-07-01 |
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| spelling | doaj.art-a2a575460f1545ce95511262c72dbe612023-11-18T16:13:23ZengMDPI AGApplied Sciences2076-34172023-07-011313792310.3390/app13137923Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 YearsFederico Giuseppe Usuelli0Alice Montagna1Rudy Sangaletti2Cristian Indino3Camilla Maccario4Federico Alberto Grassi5Ankle and Foot Unit, Humanitas San Pio X Hospital, 20159 Milan, ItalyOrthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, ItalySezione di Chirurgia Protesica ad Indirizzo Robotico-Unità di Traumatologia dello Sport, U.O.C Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, ItalyAnkle and Foot Unit, Humanitas San Pio X Hospital, 20159 Milan, ItalyAnkle and Foot Unit, Humanitas San Pio X Hospital, 20159 Milan, ItalyOrthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, ItalyBackground: Chronic ankle instability is a common condition that develops after lateral ankle sprains. Many surgical techniques have been described in case of failure of conservative treatment. The purpose of this paper is to present the results in terms of clinical outcomes, return to sport and recurrence rate after reconstruction of the lateral ligament complex of the ankle with a minimally invasive approach at a minimum follow up of five years. Methods: This retrospective study involved forty-seven patients treated for chronic ankle instability from January 2013 to November 2017. The clinical outcomes were evaluated with the American Orthopedic Foot and Ankle Society ankle and hindfoot score (AOFAS score), the University of California–Los Angeles Rating Scale (UCLA Rating Scale), the Karlsson–Peterson ankle instability score and the Halasi scale at a mean follow up time of 80 months. Results: The mean age of the patients was 42 years (23–63). The mean VAS pain score decreased from 5.6 (2–9) pre-operatively to 0.7 (0–7) post-operatively. The mean UCLA Rating Scale score improved from 7.7 (4–8) before surgical treatment to 9.2 (6–10) afterwards. The AOFAS score increased from a pre-operative mean value of 66.5 (40–95) to a post-operative mean value of 94 (88–100) and the Halasi scale from a pre-injury mean value of 4.3 (2–8) to 4.5 post-operatively (2–8). The mean Karlsson–Peterson ankle instability score increased from 71 (40–90) pre-operatively to 87.9 (70–90) post-operatively. During this period of follow up, the procedure survival rate was 95.7%, with two cases of recurrence of ankle sprain post-operatively after twelve months in one case and forty months in the other case. Conclusions: The described technique of reconstruction of the anterior talofibular and calcaneofibular ligament with a minimally invasive approach with a semitendinosus autograft is a viable treatment option for chronic ankle instability and enables the majority of patients to regain their activity and sport level with a low recurrence rate at a mid-term follow up.https://www.mdpi.com/2076-3417/13/13/7923ankle sprainsankle instabilityankle ligamentssurgical treatmentankle lateral ligament reconstructionsemitendinosus autograft |
| spellingShingle | Federico Giuseppe Usuelli Alice Montagna Rudy Sangaletti Cristian Indino Camilla Maccario Federico Alberto Grassi Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 Years Applied Sciences ankle sprains ankle instability ankle ligaments surgical treatment ankle lateral ligament reconstruction semitendinosus autograft |
| title | Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 Years |
| title_full | Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 Years |
| title_fullStr | Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 Years |
| title_full_unstemmed | Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 Years |
| title_short | Minimally Invasive Reconstruction of the Ankle Lateral Ligament Complex in Chronic Ankle Instability: Clinical Outcomes, Return to Sport and Recurrence Rate at Minimum Follow up of 5 Years |
| title_sort | minimally invasive reconstruction of the ankle lateral ligament complex in chronic ankle instability clinical outcomes return to sport and recurrence rate at minimum follow up of 5 years |
| topic | ankle sprains ankle instability ankle ligaments surgical treatment ankle lateral ligament reconstruction semitendinosus autograft |
| url | https://www.mdpi.com/2076-3417/13/13/7923 |
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