Augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instability
Abstract Background To compare the clinical outcomes of inferior extensor retinaculum (IER) augmentation following repair of the anterior talofibular ligament (ATFL) with isolated ATFL repair in patients with an arthroscopically confirmed grade 3 lesion of the ATFL. Methods We conducted a retrospect...
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BMC
2025-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-024-05437-w |
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| author | Xin Luo Chong Xue Yue Xue Kai Fehske Zi-He Zhang Nicola Maffulli Filippo Migliorini Shi-Ming Feng |
| author_facet | Xin Luo Chong Xue Yue Xue Kai Fehske Zi-He Zhang Nicola Maffulli Filippo Migliorini Shi-Ming Feng |
| author_sort | Xin Luo |
| collection | DOAJ |
| description | Abstract Background To compare the clinical outcomes of inferior extensor retinaculum (IER) augmentation following repair of the anterior talofibular ligament (ATFL) with isolated ATFL repair in patients with an arthroscopically confirmed grade 3 lesion of the ATFL. Methods We conducted a retrospective study of consecutive chronic lateral ankle instability (CLAI) patients who underwent arthroscopic ATFL repair between March 2018 and August 2022. The average age of the patients was 31.5 ± 7.4 years (range, 16–50 years). All patients underwent all-inside arthroscopic repair, and were divided into two groups based on the ligament repair method: the Broström-Gould group (n = 64) and the Broström group (n = 67). At 3, 6, 12 and 24 months after surgery, ankle inversion stress tests and anterior drawer tests were employed to assess the stability of the ankle joint. The American Orthopedic Foot and Ankle Society ankle hindfoot scale(AOFAS-AH) and Karlsson ankle function score (KAFS) were employed to assess ankle function; the Tegner score was employed to assess the patient’s level of exercise; the Foot and Ankle Outcome Score [FAOS, including score of symptoms-diseases, pain, function-daily living score, function in sports and recreational activities, and quality of life] was used to assess the patient’s daily activity ability. Results The Tegner score, FAOS-function-daily living score, and FAOS-function in sports and recreational activities in the Broström-Gould group consistently outperformed the Broström group at 3 months and 6 months post-surgery, with the differences being statistically significant (all P < 0.05). However, although the differences are statistically significant, the clinical relevance of this statistical significance remains uncertain. At 12 and 24 months, there were no statistically significant differences between the two groups. Conclusions For CLAI patients with arthroscopic grade 3 lesion of the ATFL, both the all-inside arthroscopic Broström-Gould procedure and the Broström procedure provide stability and enhance ankle joint function, resulting in similar functional outcomes at a 2-year follow-up. IER augmentation following ATFL repair may facilitate earlier recovery exercises compared to isolated all-inside ATFL repair. |
| format | Article |
| id | doaj-art-08344f8531c847899fb2eb495f9c580e |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-08344f8531c847899fb2eb495f9c580e2025-01-12T12:32:30ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111110.1186/s13018-024-05437-wAugmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instabilityXin Luo0Chong Xue1Yue Xue2Kai Fehske3Zi-He Zhang4Nicola Maffulli5Filippo Migliorini6Shi-Ming Feng7Sports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical UniversitySports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical UniversitySports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical UniversityDepartment of Trauma Surgery, University Hosptial WuerzburgSports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical UniversityDepartment of Orthopaedic Surgery, Sant’Andrea Hospital, University La SapienzaDepartment of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical CentreSports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical UniversityAbstract Background To compare the clinical outcomes of inferior extensor retinaculum (IER) augmentation following repair of the anterior talofibular ligament (ATFL) with isolated ATFL repair in patients with an arthroscopically confirmed grade 3 lesion of the ATFL. Methods We conducted a retrospective study of consecutive chronic lateral ankle instability (CLAI) patients who underwent arthroscopic ATFL repair between March 2018 and August 2022. The average age of the patients was 31.5 ± 7.4 years (range, 16–50 years). All patients underwent all-inside arthroscopic repair, and were divided into two groups based on the ligament repair method: the Broström-Gould group (n = 64) and the Broström group (n = 67). At 3, 6, 12 and 24 months after surgery, ankle inversion stress tests and anterior drawer tests were employed to assess the stability of the ankle joint. The American Orthopedic Foot and Ankle Society ankle hindfoot scale(AOFAS-AH) and Karlsson ankle function score (KAFS) were employed to assess ankle function; the Tegner score was employed to assess the patient’s level of exercise; the Foot and Ankle Outcome Score [FAOS, including score of symptoms-diseases, pain, function-daily living score, function in sports and recreational activities, and quality of life] was used to assess the patient’s daily activity ability. Results The Tegner score, FAOS-function-daily living score, and FAOS-function in sports and recreational activities in the Broström-Gould group consistently outperformed the Broström group at 3 months and 6 months post-surgery, with the differences being statistically significant (all P < 0.05). However, although the differences are statistically significant, the clinical relevance of this statistical significance remains uncertain. At 12 and 24 months, there were no statistically significant differences between the two groups. Conclusions For CLAI patients with arthroscopic grade 3 lesion of the ATFL, both the all-inside arthroscopic Broström-Gould procedure and the Broström procedure provide stability and enhance ankle joint function, resulting in similar functional outcomes at a 2-year follow-up. IER augmentation following ATFL repair may facilitate earlier recovery exercises compared to isolated all-inside ATFL repair.https://doi.org/10.1186/s13018-024-05437-wChronic lateral ankle instabilityAnterior talofibular ligamentInferior extensor retinaculumArthroscopy |
| spellingShingle | Xin Luo Chong Xue Yue Xue Kai Fehske Zi-He Zhang Nicola Maffulli Filippo Migliorini Shi-Ming Feng Augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instability Journal of Orthopaedic Surgery and Research Chronic lateral ankle instability Anterior talofibular ligament Inferior extensor retinaculum Arthroscopy |
| title | Augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instability |
| title_full | Augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instability |
| title_fullStr | Augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instability |
| title_full_unstemmed | Augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instability |
| title_short | Augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all-inside arthroscopic management of chronic lateral ankle instability |
| title_sort | augmentation with the inferior extensor retinaculum may facilitate earlier recovery in all inside arthroscopic management of chronic lateral ankle instability |
| topic | Chronic lateral ankle instability Anterior talofibular ligament Inferior extensor retinaculum Arthroscopy |
| url | https://doi.org/10.1186/s13018-024-05437-w |
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