J Korean Foot Ankle Soc.  2019 Mar;23(1):1-5. 10.14193/jkfas.2019.23.1.1.

Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction

Affiliations
  • 1Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea. parkyounguk@gmail.com

Abstract

Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

Keyword

Ankle; Chronic ankle instability; Surgical treatment; Repair; Reconstruction

MeSH Terms

Allografts
Ankle*
Autografts
Body Mass Index
Collateral Ligaments
Follow-Up Studies
Hand
Humans
Ligaments
Tendons

Figure

  • Figure 1 Non-anatomic reconstruction of lateral ligaments. (A) Watson-Jones procedure. (B) Evans procedure. (C) Chrisman-Snook procedure.

  • Figure 2 Various kinds of anatomical reconstruction of lateral ligaments. Two hole techniques (A, B) and one hole technique (C).


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