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A long-term review of a modified Evans procedure
G A Nimon1, P J Dobson, K R Angel
1Wakefield Orthopaedic Clinic, Adelaide, Australia.
The Journal of Bone and Joint Surgery. British Volume
|March 14, 2001
Summary
The modified Evans procedure for ankle ligament reconstruction yielded mixed clinical outcomes, with 65% experiencing mild pain and instability. However, patient satisfaction remained high, with nearly all willing to repeat the ankle surgery.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Ankle ligament injuries are common, often leading to chronic instability.
- Surgical reconstruction aims to restore ankle stability and function.
- The modified Evans procedure is a technique for primary ankle ligament arthroplasty.
Purpose of the Study:
- To evaluate the long-term clinical outcomes of the modified Evans procedure.
- To assess patient satisfaction and functional results after ankle ligament reconstruction.
- To identify potential complications and degenerative changes following the procedure.
Main Methods:
- Retrospective review of 111 primary ankle ligament arthroplasties (modified Evans procedure).
- Follow-up conducted on 89 patients (94 ankles), with 86 undergoing clinical and radiological assessment.
- Data collected on pain, instability, range of motion, and early degenerative changes.
Main Results:
- 65% of ankles reported mild pain and minimal instability.
- 17 ankles showed increased inversion, and 21 had limited inversion.
- Early degenerative changes were observed in 11 ankles, with four showing subtalar changes.
Conclusions:
- The modified Evans procedure does not guarantee universally excellent clinical results.
- Despite functional limitations, patient satisfaction with the ankle surgery was exceptionally high.
- Further research is needed to optimize surgical techniques for ankle ligament reconstruction.