J Korean Orthop Assoc.  2022 Jun;57(3):240-248. 10.4055/jkoa.2022.57.3.240.

More than Five-Year Follow-Up Results of Nonoperative Treatment of Lateral Ankle Instability Patients Who Were Recommended Surgery

• Kim TH
• Choi YR
• Bak GG

• KMID: 2530670
• DOI: http://doi.org/10.4055/jkoa.2022.57.3.240

Abstract

Purpose
This study analyzed the follow-up results of lateral ankle instability patients without surgery that were recommended surgery from other hospitals.
Materials and Methods
From May 2009 to December 2016, a retrospective study was conducted on 55 chronic lateral ankle instability patients at least five years of follow-up and an average of seven years or more. Nonoperative treatment was performed after one time of rehabilitation exercise training at the authors’ hospital. At the final follow-up, a physical examination and sports activity survey were done. Visual analogue scale (VAS), Foot Function Index (FFI), and Foot and Ankle Ability Measure (FAAM) scale were measured, respectively. For 37 patients who revisited, an anterior drawer test was done. In addition, the progression of arthritis was confirmed by a weight-bearing radiographic examination and instability was checked in stress radiographic examination.
Results
The average follow-up period of the 55 patients was 88.78 (60–136) months. The average VAS was 0.98 (0–4). None of the patients had restrictions of activities of daily living. For 37 patients who revisited, at the final follow-up, the mean FFI score was 11.27 (1–45), and the FAAM subscale scores were 79.35 (activities of daily living subscale) and 27.08 (sports subscale), respectively. As a result of the physical examination, the mean grade of anterior drawer test decreased from 2.08 at the first visit to 2.02 at the final follow-up. At the final follow-up, radiological examination showed no case of progression of degenerative arthritis of the ankle joint. The average value of anterior drawer stress X-ray was measured from 5.64 mm at the first visit to 5.47 mm (contralateral side 4.99 mm) at the final follow-up, and the average value of varus stress X-ray was measured from 12.03° at the first visit to 13.62°(contralateral side 10.62°) at the final follow-up.
Conclusion
In lateral ankle instability patients with nonoperative treatment after an average follow-up of more than seven years, ankle functions were good. There were no cases of progression to degenerative arthritis on radiological examination.

Keyword

ankle lateral ligament; joint instability; conservative treatment; osteoarthritis