Torn ligaments that led to ankle instability responded well to arthroscopic treatment
LISBON, Portugal — Two techniques studied by investigators to repair the lateral ligaments of the ankle both effectively restored ankle stability, an orthopedic surgeon from Portugal said.
To compare the clinical outcomes of two different arthroscopic techniques that used all-suture anchors with either a knot-tie or knotless surgical approach, Hélder M.D. Pereira, MD, and his colleagues included 54 patients who met the study inclusion criteria.
Forty-seven women were included in the study.
There were 26 patients who underwent arthroscopic all-inside lateral ligament repair and 28 patients who underwent what Pereira described as the anti-roll technique, which was a ligament reconstruction that used gracilis tendon autograft. Surgeons made the decision of which technique to use for both the anterior talofibular ligament and calcaneal fibular ligament intraoperatively after they determined the status of the ligaments and the presence or lack thereof of a sufficiently sized remnant.
“There was a significant improvement of both clinical scores,” he said.
The American Orthopaedic Foot & Ankle Society and VAS scores were used to assess the results.
“The median of postoperative VAS ranged from 0 to 1 with the ligament repair and it was from 0 to 4 in the reconstruction group,” said Pereira, who said the difference between the groups was not significant.
The postoperative median AOFAS scores were 96 and 92, respectively, for the repair and reconstruction groups, and these were also not significantly different.
Both groups of patients followed the same postoperative management protocol of 7 days of non-weight-bearing followed by partial weight-bearing. Patients then wore a compression bandage and a halter boot. The boot could be removed after 2 weeks so patients could perform range of motion exercises.
“There was no recurrence of the instability in either of the groups,” Pereira said. “So, both techniques were capable to restore the instability in these patients.”
One infection occurred in the repair group and two infections occurred in the reconstruction group, he said. – by Susan M. Rapp
Batista J, et al. Abstract 1306. Presented at: EFORT Annual Congress; June 5-7, 2019; Lisbon, Portugal.
Disclosure: Pereira reports no relevant financial disclosures.