Chronic lateral ankle instability surgical repairs: the long term prospective

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanics

Background:

• Ankle instability is a common issue, often resulting from lateral ligament injuries.
• Surgical reconstruction aims to restore stability and prevent long-term degenerative changes.
• Various techniques exist, each with potential benefits and drawbacks.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of different lateral ankle ligament reconstruction techniques.
• To assess the long-term impact on joint health and function.
• To identify factors influencing surgical success.

Main Methods:

• A multicenter retrospective review of 310 lateral ankle ligament reconstructions.
• Mean follow-up of 13 years.
• Four surgical technique classes (C1-C4) were analyzed using clinical scores (Karlsson, Good-Jones-Livingstone) and radiological assessments.

Main Results:

• 92% of reconstructions yielded satisfactory results, with a mean Karlsson score of 90.
• Postoperative complications, especially neurological, correlated with poorer outcomes.
• While stability improved, there was no correlation between functional results and residual laxity; C4 plasties showed poorer results, and C1 techniques had less laxity control.

Conclusions:

• Lateral ankle ligamentoplasty is beneficial for managing instability and preventing secondary osteoarthritis.
• Accurate preoperative assessment (CT-scan/MRI) is crucial for tailoring surgical techniques to ligamentary and associated lesions.
• Long-term follow-up confirms the efficacy of these reconstructive procedures.