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Ankle Arthroscopy, Lateral Ligament Repair and Peroneal Tendon Reefing for Chronic Lateral Ankle Instability: The Triad vs Arthroscopy with Ligament Repair

DOI: 10.4236/ss.2015.69058, PP. 403-411

Keywords: Brostr?m-Gould, Lateral Ankle Instability, Triad Procedure

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Abstract:

Peroneal tendon and retinacular pathology contributes to chronic lateral ankle instability. The “gold standard” surgical treatment for chronic lateral ankle instability has been the Brostrom-Gould procedure with its modifications. An ankle arthroscopy is an adjuvant procedure to address any intra-articular pathology. We review our results of two study groups. The first group underwent an ankle arthroscopy and a Brostrom-Gould procedure. The second group (triad) underwent an ankle arthroscopy, the Brostrom-Gould procedure and excision of low lying peroneal muscle belly with tightening of the inferior peroneal retinaculum. The triad technique was performed on 97 patients and results compared to 71 ankle arthroscopies with the Brostrom-Gould procedure. The patients were contacted at a mean follow-up time of 30 months for postoperative ACFAS scores, VAS scores, and overall satisfaction. Patients were also asked to report incidence of ankle sprain recurrence. The average postoperative ACFAS hindfoot and ankle score was 92 for the triad group and 89 for the arthroscopic debridement and Brostrom-Gould group. The average overall satisfaction was 98% in the triad group and 91% in the scope and Brostrom group. There were 4 (4.3%) recurrences in the triad group and 12 (17.6%) in the Brostrom-Gould with scope group. Each group had a similar incidence of wound healing complications. Peroneal tendon and retinacular pathology contributes to continued ankle instability and pain. We believe that the triad procedure is superior to the Brostrom-Gould procedure.

References

[1]  Karlsson, J. and Lansinger, O. (1992) Lateral Instability of the Ankle Joint. Clinical Orthopaedics, 276, 253-261.
http://dx.doi.org/10.1097/00003086-199203000-00035
[2]  Ferkel, R.D. and Chams, R.N. (2007) Chronic Lateral Instability: Arthroscopic Findings and Long Term Results. Foot & Ankle International, 28, 24-31.
http://dx.doi.org/10.3113/FAI.2007.0005
[3]  Baumhauer, J.F. and O’Brien, T. (2002) Surgical Considerations in the Treatment of Ankle Instability. Journal of Athletic Training, 37, 458-462.
[4]  Hua, Y., Chen, S. and Li, Y. (2010) Combination of Modified Brostrom Procedure with Ankle Arthroscopy for Chronic Ankle Instability Accompanied by Intra-Articular Symptoms. Arthroscopy, 26, 524-528.
http://dx.doi.org/10.1016/j.arthro.2010.02.002
[5]  Oloff, L.M., Bocko, A.P. and Fenton, G. (2000) Arthroscopic Monopolar Radiofrequency Thermal Stabilization for Chronic Lateral Ankle Instability: A Preliminary Report on 10 Cases. Journal of Foot and Ankle Surgery, 39, 144-153.
http://dx.doi.org/10.1016/S1067-2516(00)80015-0
[6]  Freccero, D.M. and Berkowitz, M.J. (2006) The Relationship between Tears of the Peroneus brevis Tendon and the Distal Extent of Its Muscle Belly: An MRI Study. Foot & Ankle International, 27, 236-239.
[7]  Heckman, D.S., Reddy, S., Pedowitz, D., Wapner, K.L. and Parekh, S.G. (2008) Current Concepts Review: Operative Treatment for Peroneal Tendon Disorders. Journal of Bone & Joint Surgery, 90-A, 404-418.
http://dx.doi.org/10.2106/JBJS.G.00965
[8]  Thomas, J.L., Christensen, J.C., Mendicino, R.W., Schuberth, J.M., Weil, L.S. and Zlotoff, H.J. (2005) ACFAS Scoring Scale User Guide. Journal of Foot and Ankle Surgery, 44, 316-335.
http://dx.doi.org/10.1053/j.jfas.2005.07.012
[9]  Karlsson, J. and Lansinger, O. (1992) Lateral Instability of the Ankle Joint. Clinical Orthopaedics, 276, 253-261.
http://dx.doi.org/10.1097/00003086-199203000-00035
[10]  Keller, M. and Grossman, J. (1996) Lateral Ankle Instability and the Brostrom-Gould Procedure. Journal of Foot and Ankle Surgery, 35, 513-520.
http://dx.doi.org/10.1016/S1067-2516(96)80123-2
[11]  Colville, M.R. (1994) Reconstruction of the Lateral Ankle Ligaments. Journal of Bone & Joint Surgery, 76-A, 1092-1102.
[12]  Domblek, M.F., Lamm, B.M., Saltrick, K., Mendicino, R.W. and Catanzariti, A.R. (2003) Peroneal Tendon Tears: A Retrospective Review. Journal of Foot and Ankle Surgery, 42, 250-258.
http://dx.doi.org/10.1016/S1067-2516(03)00314-4
[13]  Froom, P., Melamed, S., Nativ, T., Gofer, D. and Froom, J. (2001) Low Job Satisfaction Predicts Delayed Return to Work After Laparoscopic Cholecystectomy. Journal of Occupational and Environmental Medicine, 43, 657-662.
http://dx.doi.org/10.1097/00043764-200107000-00014

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