Static or dynamic repair of chronic lateral ankle instability. A prospective randomized study

Area of Science:

• Orthopedics
• Sports Medicine
• Surgical Techniques

Background:

• Chronic lateral ankle instability affects numerous patients, often requiring surgical intervention.
• Current surgical options include static and dynamic reconstruction techniques.
• Assessing the long-term efficacy of these methods is crucial for patient management.

Purpose of the Study:

• To compare the clinical and radiographic outcomes of static versus dynamic ankle reconstruction for chronic lateral instability.
• To evaluate the effectiveness of each method in stabilizing the ankle and subtalar joints.
• To identify the optimal surgical approach for this condition.

Main Methods:

• A prospective randomized study involving 82 patients with 89 chronic lateral unstable ankles.
• Patients were allocated to either static (Group S, n=56) or dynamic (Group D, n=26) reconstruction using peroneus brevis tendon.
• Standardized clinical and radiographic assessments were performed preoperatively and at 9 and 25 months postoperatively.

Main Results:

• Static reconstruction (Group S) demonstrated superior clinical results at 25 months compared to dynamic reconstruction (Group D).
• Group D experienced a higher rate of reinjuries and patient dropouts from sports.
• Both methods improved talar tilting, rotational displacement, and postural balance, with greater improvements noted in Group S.

Conclusions:

• Static ankle reconstruction is recommended for chronic lateral instability, particularly when associated with increased subtalar mobility.
• The static technique provides better long-term stability and reduces the risk of reinjury.
• While both methods offer stabilization, static reconstruction yields more favorable clinical outcomes.