Medial and Lateral Combined Ligament Arthroscopic Repair for Multidirectional Ankle Instability: Case Series

Federal University of São Paulo

Status: Completed

Conditions: Talofibular Ligament Tear; Deltoid Ligament; Sprain (Strain) (Ankle); Joint Instability; Ligament Injury; Ankle Injuries

Treatments: Procedure: Arthroscopic Brostrom combined with Arthroscopic Deltoid Repair

Study type: Observational

Funder types: Other

Identifiers

NCT04459910

Multi_EPM

Details and patient eligibility

About

Abstract Introduction: The high prevalence of sprains in the population has provided a substantial number of patients with lateral instability of the ankle. The continuity of this condition can lead to the progressive loosening of the medial containment structures, generating a multidirectional rotational instability. The deltoid approach through the imbrication of its components has been proposed as a solution for these patients. The arthroscopic technique has been described as an alternative.

Methods: This is a retrospective study with patients diagnosed with multidirectional instability and submitted to an ankle arthroscopy with medial repair (arthroscopic tensioning) and lateral (arthroscopic Brostrom) between January 2018 and January 2020. All patients will fill an epidemiological questionnaire and will be evaluated for pain and function according to the Visual Analogue Scale (VAS) and the American Orthopaedic Foot and Ankle Society Score (AOFAS) at 12 months (6-24 months) average of follow-up.

Discussion: The combined medial and lateral arthroscopic repair may be an effective and safe alternative in the treatment of multidirectional instability. The inclusion of the deltoid complex and the low invasiveness of this technique can improve the clinical outcomes of these patients. Additional studies, with a prospective and comparative methodology are required to sustain this proposal.

Design: Level IV. Retrospective case series.

Keywords: ankle injuries; lateral ligament; collateral ligaments; joint instability

Enrollment: 29 patients

Sex: All

Ages: 15 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• complaints about ankle loosening for the last six months
• clinical findings of lateral and medial instability

Exclusion criteria

• existence of previous surgery
• autoimmune diseases
• neuropathy
• inflammatory disease
• isolated medial instability
• flatfoot
• previous ankle infiltration
• radiographic findings of ankle arthritis
• cavovarus deformity
• coagulopathies
• body mass index over 35
• associated injuries, such as osteochondral lesions
• syndesmosis instability
• tendon ruptures
• fractures

Trial design

29 participants in 1 patient group

Multidirectional

Description:

Arthroscopic lateral ligament repair combined with deltoid arthroscopic ligament repair.

Treatment:

Procedure: Arthroscopic Brostrom combined with Arthroscopic Deltoid Repair