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Updated: Jun 6, 2025
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Percutaneous inferior extensor retinaculum augmentation produces similar functional outcomes compared with modified
Shengxuan Cao1, Chen Wang2, Chao Zhang1
1Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Background:
In patients with lateral ankle instability (LAI) and attenuated ligament tissue quality, the stability of lateral ankle can be achieved through percutaneous inferior extensor retinaculum augmentation (PIERA). This study is aimed to compare the functional outcomes of PIERA with gold standard Modified Broström Procedure (MBP) for patients with LAI.
Methods:
Twenty participants were allocated to PIERA and MBP treatment group according to the intraoperative arthroscopic assessment of lateral ankle ligament, with each group comprises 10 participants. Patients were assessed using American Orthopaedic Foot and Ankle Society score, Cumberland ankle instability tool, Foot and Ankle Ability Measure, star excursion balance test (SEBT), and a stair descent gait analysis, a day prior to surgery and one year postoperatively. Operative outcomes and variables during stair descent were documented and compared between the preoperative and postoperative patients, and between treatment groups.
Results:
The PIERA procedure significantly promoted the clinical outcomes of the patients with LAI. The anterior reach of SEBT was increased from 79.1 ± 12.6 to 84.8 ± 12.9 (p = 0.034). The PIERA procedure significantly increased ankle flexion range of motion (p = 0.049), maximal ankle dorsiflexion (p = 0.009), and peroneal activation post-initial-contact (p = 0.002) and during the gait cycle (p = 0.015). The effects of PIERA and MBP on ankle function were not significantly different.
Conclusion:
PIERA produces similar functional outcomes compared with MBP in promoting clinical outcomes, dynamic postural stability, peroneal activation, and ankle sagittal range of motion for patients with LAI.
Level Of Evidence:
III, retrospective cohort study.
