Preoperative predictors of arthroscopically confirmed lateral ankle micro-instability and two-year outcomes after arthroscopic repair of the ATFL superior fascicle.

IF 2.4 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2026-07-15 DOI:10.1016/j.fas.2026.07.009

Shi-Ming Feng, Chong Xue, Chang-Qing Shao, Chao-Fan Su, Shun-Hong Gao

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引用次数: 0

Abstract

Background: Lateral ankle microinstability (LAM) caused by anterior talofibular ligament (ATFL) superior fascicle injury is difficult to diagnose preoperatively.

Methods: Sixty-seven patients with suspected LAM underwent arthroscopy. Preoperative anterior talar translation (ATT), active joint position sense (AJPS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Karlsson Ankle Functional Score (KAFS) were compared between LAM and non-LAM groups. Logistic regression and Receiver operating characteristic analysis identified predictors. Confirmed LAM cases underwent arthroscopic superior fascicle repair and were followed for 2 years.

Results: Forty-five patients had confirmed LAM. ATT and AJPS errors were significantly greater in the LAM group. ATT and AJPS error at 10° plantar flexion were independent predictors. The combined model showed excellent discrimination (AUC, 0.90). At 2 years, ATT, AJPS, AOFAS, and KAFS improved significantly after arthroscopic repair procedure.

Conclusions: Combined assessment of ATT and AJPS improves preoperative prediction of LAM. Arthroscopic ATFL superior fascicle repair was associated with improved stability, proprioception, and function.

Level of evidence: Level III.

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关节镜下确认的外侧踝关节微不稳定的术前预测因素和关节镜下ATFL上肌束修复后的两年预后。

背景：距腓骨前韧带（ATFL）上肌束损伤引起的外侧踝关节微不稳定（LAM）术前诊断困难。方法：67例疑似LAM患者行关节镜检查。LAM组与非LAM组术前距前平移（ATT）、主动关节位置感（AJPS）、美国矫形足踝协会（AOFAS）评分、Karlsson踝关节功能评分（KAFS）进行比较。逻辑回归和接受者工作特征分析确定了预测因子。确诊的LAM病例接受关节镜下上筋束修复，随访2年。结果：45例患者确诊LAM。LAM组ATT和AJPS误差明显大于LAM组。脚底屈曲10°时的ATT和AJPS误差是独立的预测因子。组合模型具有良好的判别性（AUC为0.90）。术后2年，关节镜修复术后ATT、AJPS、AOFAS和KAFS均有显著改善。结论：ATT和AJPS联合评估可提高LAM的术前预测。关节镜下ATFL上肌束修复与稳定性、本体感觉和功能的改善相关。证据等级：三级。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.