Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine最新文献

{"title":"Donor site morbidity is higher when comparing bone–tendon–bone vs 4-strand semitendinosus/gracilis & all-inside 4-strand semitendinosus for anterior cruciate ligament reconstruction","authors":"Orlando Branco Simões ,&nbsp;João Pedro Oliveira ,&nbsp;Rui Lemos ,&nbsp;José Carlos Noronha","doi":"10.1016/j.jisako.2025.100394","DOIUrl":"10.1016/j.jisako.2025.100394","url":null,"abstract":"<div><h3>Objectives</h3><div>To study pain and sensory alterations of 75 (three cohorts of 25 patients) patients that underwent different anterior cruciate ligament reconstruction (ACLR) techniques. The cohorts were divided in the bone–patellar tendon–bone (BTB) autograft, the quadruple strand semitendinosus/gracilis (4ST/G) autograft and the all-inside quadruple strand semitendinosus autograft cohort.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study to evaluate pain and sensory alterations after surgery. All these patients followed a similar rehabilitation protocol, being 2 years the minimal follow-up time. Pain was characterized by duration and anatomical location and sensory deficits were evaluated concerning duration and affected area. Patients also scored on three different subjective tests: knee walking test (KWT); Lysholm knee scoring scale (LKSS), and International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and were divided according to its Tegner activity level scale (TALS).</div></div><div><h3>Results</h3><div>The mean anterior knee pain (AKP) duration amongst the three cohorts was 1.8 ​± ​4.5 months and was smaller in the 4ST/G cohort. The majority of patients of the BTB cohort located pain on the patellar tendon, while patients in the 4ST/G and all-inside cohorts referred that it was diffuse. At 15 days’ post-surgery, hypoesthesia was reported by 56 ​% patients and was higher on the BTB cohort and lower in the all-inside cohort. At 2-year follow-up, the all-inside cohort had no patients with hypoesthesia. In the BTB cohort, the sensitive alterations were only located on the area innervated by the infra-patellar branch of the saphenous nerve (IPBSN). The 4ST/G cohort located the hypoesthesia in the area innervated by the IPBSN and in the area of the lateral sural cutaneous nerve (LSCN). The all-inside group located the sensitive alterations mostly in the LSCN. The KWT was painful in BTB and 4ST/G patients and reported 0 ​% for the all-inside cohort. No statistic significant relevance was found for the IKDC-SKF and LKSS.</div></div><div><h3>Conclusions</h3><div>All cohorts referred pain and sensitive alterations. Using BTB autograft for ACLR seems to condition a higher number of anterior knee pain and hypoesthesia on medium postoperative follow-up and KWT was more often reported. The 4ST/G group had the smallest duration of AKP. The all-inside cohort showed, globally, a lower number of complaints and a shorter time of symptom persistence, namely in terms of sensory deficits.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100394"},"PeriodicalIF":2.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to ‘Letter to Editor’","authors":"K.N. Subramanian,&nbsp;Saseendar Shanmugasundaram,&nbsp;K.S. Jeash Narayan","doi":"10.1016/j.jisako.2025.100392","DOIUrl":"10.1016/j.jisako.2025.100392","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100392"},"PeriodicalIF":2.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile app-based monitoring of recovery after knee osteotomy: Patients take approximately five months to return to preoperative step counts despite limited app uptake","authors":"Takaaki Hiranaka ,&nbsp;Nicola D. Mackay ,&nbsp;Adit R. Maniar ,&nbsp;Dianne M. Bryant ,&nbsp;Alan M.J. Getgood","doi":"10.1016/j.jisako.2025.100391","DOIUrl":"10.1016/j.jisako.2025.100391","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to assess the feasibility of using mobile application (app) technology for monitoring recovery after knee osteotomy and to determine the time required for patients to return to their preoperative step counts.</div></div><div><h3>Methods</h3><div>This retrospective study included 329 patients who underwent coronal realignment surgery, including high tibial osteotomy (HTO) or distal femoral osteotomy (DFO) with a minimum follow-up of 1 year. The patients were grouped based on the type of osteotomy performed, i.e., HTO and DFO groups. Step count data were collected using the myrecovery app and analyzed preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. Statistical analyses included univariate linear regression models to assess the relationship between step counts at each time point and the duration required to return to their preoperative step counts.</div></div><div><h3>Results</h3><div>Of the 329 patients included in the study, a total of 62 patients (19%) downloaded the app and 24 patients (7%) had complete step count data. Of the 24 patients with complete data, 18 were included in the HTO group and 6 were included in the DFO group. It took patients an average of 153 ​± ​112 days to return to their preoperative step counts, with the patients in the HTO group taking 174 ​± ​121 days and those in the DFO group taking 113 ​± ​77 days. Step counts increased significantly over time, with percentages of preoperative step counts reaching 108% at 12 months postoperatively. A statistically significant correlation was found between step counts at 3 months postoperatively and the time to return to preoperative step counts (R² ​= ​0.240, <em>P</em> ​= ​0.015).</div></div><div><h3>Discussion</h3><div>This study found that patients took approximately 5 months to return to their preoperative step counts after knee osteotomy. However, the adoption of the app was limited, with only 19% of patients downloading the app and just 7% providing complete data, posing a significant barrier to the feasibility of mobile apps for tracking recovery.</div></div><div><h3>Conclusion</h3><div>The mobile app is effective for tracking recovery progress following knee osteotomy, but strategies to increase patient adoption are essential for enhancing its practical application.</div></div><div><h3>Level of evidence</h3><div>Level IV, Retrospective Case Series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100391"},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to sport after first metatarsophalangeal arthrodesis in elite athletes","authors":"Dror Maor ,&nbsp;Daniel Meyerkort ,&nbsp;Salar Sobhi ,&nbsp;James Calder","doi":"10.1016/j.jisako.2025.100390","DOIUrl":"10.1016/j.jisako.2025.100390","url":null,"abstract":"<div><h3>Introduction</h3><div>Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a reliable procedure in alleviating pain and restoring function. However, there is limited published literature of the outcomes of this procedure and the ability to return to sport in elite athletes. This study aims to assess the outcomes of first MTPJ arthrodesis in the elite athlete population and their ability to return to professional sport.</div></div><div><h3>Methods</h3><div>A single-center prospective case series of elite athletes undergoing first MTPJ arthrodesis between 2004 and 2016 was conducted. Patients were assessed a minimum of 2, 6, 12 weeks, and 1-year postoperation and at the final follow-up. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and visual analogue scale (VAS) scores and assessing satisfaction.</div></div><div><h3>Results</h3><div>Sixteen elite athletes with a mean age of 27 years (range 19–32, 81 ​%) and mean follow-up of 81 months (range 60–121 months) were included. At 1-year postoperation, 12 (75 ​%) athletes returned to their original level of sport. Of the four unable to return, two soccer players dropped a division, an ATP tennis player never regained his original ranking, and a badminton player was unable to return to the same level of competition. Mean VAS scores improved from preoperation to final follow-up (5.6–0.4, <em>p</em> ​&lt; ​0.001). All FAOS subscores showed significant improvement from preoperation to final follow-up (all <em>p</em> ​&lt; ​0.05). All (100 ​%) athletes were either very satisfied or satisfied at final follow-up.</div></div><div><h3>Conclusion</h3><div>To our knowledge, this is the first study investigating return to elite level sport post first MTPJ arthrodesis. Our results confirm that a significant majority will return to their elite level of sport post operatively. Improved clinical outcomes and pain reduction was achieved in all patients.</div></div><div><h3>Level of evidence</h3><div>V.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100390"},"PeriodicalIF":2.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixation for osteochondral lesions of the talus leads to successful clinical outcomes in 9 out of 10 patients: A systematic review","authors":"Quinten G.H. Rikken ,&nbsp;Jari Dahmen ,&nbsp;Sjoerd A.S. Stufkens ,&nbsp;Tomoyuki Nakasa ,&nbsp;Gino M.M.J. Kerkhoffs","doi":"10.1016/j.jisako.2025.100389","DOIUrl":"10.1016/j.jisako.2025.100389","url":null,"abstract":"<div><h3>Importance</h3><div>Osteochondral lesions of the talus (OLT) with an osteochondral fragment are amenable for fixation. Fixation aims to stabilize the osteochondral fragment while retaining the native cartilage. Though fixation for OLT is a promising treatment, no systematic overview of the literature on its efficacy and safety exists.</div></div><div><h3>Aim</h3><div>The primary aim of the present study is to assess the clinical success rate of fixation for OLT. The secondary outcomes concern the union rate and adverse events.</div></div><div><h3>Evidence review</h3><div>A systematic literature search of PubMed, Embase (Ovid), and Cochrane Library was performed up to December 2023. The methodological quality of the included studies was evaluated using the Methodological Index for Non-Randomized Studies (MINORS) tool. The primary outcome the clinical success rate following fixation was pooled using a random effects model with 95% confidence interval (95%-CI). Success was predefined based on cut-off values for commonly used patient- or physician-reported outcome measures. Secondary outcomes concerned the union rate, complication rate, and revision rate.</div></div><div><h3>Findings</h3><div>A total of 10 studies with 241 ankles were included at a mean follow-up of 40 months. 88% of lesions were chronic in nature, and 12% acute. In total, 9 non-comparative studies had a mean MINORS score of 10.3 (range: 6–14) out of 16 points and 1 comparative study had and a MINORS score of 20 of 24 points. The pooled clinical success rate was 91% [95%-CI: 81%–96%]. The pooled union rate was 91% [95%-CI: 87%–94%]. The addition of biological adjuncts in the form of autologous bone-grafting did not show a statistically superior success rate. The pooled complication and revision rate were 1% [95%-CI: 0–4] and 6% [95%-CI: 0%–4%], respectively.</div></div><div><h3>Conclusion and relevance</h3><div>Fixation for osteochondral lesions of the talus leads to successful clinical outcomes in 9 out of 10 patients. Moreover, fragment union is achieved in 9 out of 10 patients, with a low reported complication rate. These findings show that when a symptomatic OLT is fixable physicians should consider fixation.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100389"},"PeriodicalIF":2.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The coraco-gleno-scapular line and assessing glenoid bone defects","authors":"Amnuay Kleebayoon,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.jisako.2025.100388","DOIUrl":"10.1016/j.jisako.2025.100388","url":null,"abstract":"","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100388"},"PeriodicalIF":2.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inframalleolar harvest of the peroneus longus tendon graft: Surgical technique","authors":"Andre Giardino Moreira da Silva ,&nbsp;Rodrigo Sousa Macedo ,&nbsp;Gil Goulart Choi ,&nbsp;Pedro Nogueira Giglio ,&nbsp;Riccardo Gomes Gobbi ,&nbsp;Alexandre Leme Godoy-Santos ,&nbsp;Camilo Partezani Helito","doi":"10.1016/j.jisako.2025.100384","DOIUrl":"10.1016/j.jisako.2025.100384","url":null,"abstract":"<div><div>Peroneus longus tendon (PLT) graft has recently gained visibility in the literature as a promising option for knee ligament reconstructions. The most used harvesting technique is performed with a single incision posterior to the lateral malleolus, with large series reporting tendon lengths enough to prepare a double or triple anterior cruciate ligament (ACL) graft, resulting in mean diameters greater than 8.0 mm. However, as happens with the hamstrings, some patients may present PLT grafts with a 7-mm diameter, which is associated with higher failure rates and is the minimum acceptable diameter for ACL reconstructions. In turn, the 2-incision technique has longer graft lengths reported, enough to prepare 4-folded grafts, with mean diameters above 9.0 mm, ranging from 8.5 to 10 mm. Once the PLT graft diameter has a direct correlation with anthropometric measurements, as well as larger ACL graft diameters are associated with lower failure rates and revision surgeries, the inframalleolar harvesting seems to be a reasonable option, especially for short-stature patients with a greater risk of insufficient grafts. Additionally, patients who benefit from an extra-articular procedure can have a combined reconstruction of the ACL and anterolateral ligament using the PLT graft with the two-incision technique, with no need for another graft. Therefore, this article aims to describe the step-by-step technique for the inframalleolar PLT harvesting.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100384"},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sulcus-deepening trochleoplasty and medial patellofemoral ligament reconstruction provide good clinical outcomes in addressing patellar instability at mid-term follow-up: A retrospective case series","authors":"Thomas E. Moran,&nbsp;Brock J. Manley,&nbsp;Adam J. Tagliero,&nbsp;Elizabeth K. Driskill,&nbsp;David R. Diduch","doi":"10.1016/j.jisako.2025.100387","DOIUrl":"10.1016/j.jisako.2025.100387","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to update previously published clinical and radiographic outcomes of Dejour sulcus-deepening trochleoplasty and medial patellofemoral ligament reconstruction (MPFL-R) at mid-term follow-up and monitor trends in patient-reported outcome scores and satisfaction.</div></div><div><h3>Methods</h3><div>Using the same cohort of patients from our previously published short-term series of 2-year follow-up, an interval follow-up was performed on 67 patients (76 knees) with severe trochlear dysplasia and recurrent patellar instability who were prospectively enrolled and underwent Dejour sulcus-deepening trochleoplasty and MPFL-R combined with other patellar stabilization procedures. Patients with less than 2 years of follow-up were excluded. Evaluation involved radiographic analysis, physical examination, clinical follow-up, and patient-reported outcome scores.</div></div><div><h3>Results</h3><div>A total of 37 patients (45 knees) were included in the current study, with a mean follow-up of 6.1 years postoperatively (standard deviation: 2.7 years). Two interval reoperations were performed (arthroscopic lysis of adhesions; hardware removal and arthroscopic shaving chondroplasty). There remained no occurrences of reoperation for recurrent patellar instability. Patient-reported outcomes were largely stable from early (mean: 3.6 years) to mid-term (mean: 6.1 years) follow-up, with no statistically significant difference between early and mid-term International Knee Documentation Committee (IKDC) (P ​= ​0.75), Kujala (P ​= ​0.47), or visual analog scale (VAS) pain (P ​= ​0.06) scores. Compared to preoperative knee scores, there was a significant difference in IKDC (49.3 vs 82.0, P ​&lt; ​0.001, d ​= ​1.85), Kujala (56.5 vs 89.3, P ​&lt; ​0.001, d ​= ​2.03), and VAS pain (3.8 vs 1.9, P ​= ​0.003, d ​= ​0.33) scores at mid-term follow-up (mean: 6.1 years). Mean Kellgren-Lawrence grading of patellofemoral arthritis showed no statistically significant change from 0.56 to 0.52 (P ​= ​0.511) on sunrise radiographs at the most recent follow-up.</div></div><div><h3>Conclusions</h3><div>At the mid-term follow-up, Dejour sulcus-deepening trochleoplasty and MPFL-R, combined with other patellar stabilization procedures, achieves durable resolution of patellar instability with maintained patient-reported outcome scores and satisfaction rates and is without interval evidence of clinical or radiographic progression of patellofemoral arthritis.</div></div><div><h3>Level of evidence</h3><div>IV, Case Series.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100387"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suture anchor fixation of the pediatric posteromedial and posterolateral meniscotibial ligament complex matches or exceeds native tissue strength: A cadaveric study","authors":"Ian Hollyer ,&nbsp;Thomas M. Johnstone ,&nbsp;Amin Alayleh ,&nbsp;Willemijn H. van Deursen ,&nbsp;Kelly H. McFarlane ,&nbsp;David W. Baird Jr ,&nbsp;Calvin K. Chan ,&nbsp;Marc Tompkins ,&nbsp;Henry B. Ellis ,&nbsp;Theodore J. Ganley ,&nbsp;Yi-Meng Yen ,&nbsp;Seth L. Sherman ,&nbsp;Kevin G. Shea","doi":"10.1016/j.jisako.2025.100385","DOIUrl":"10.1016/j.jisako.2025.100385","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare the biomechanical strength and stiffness of the native posteromedial and posterolateral meniscotibial ligament complex (MTLC) to suture anchor repair of the MTLC.</div></div><div><h3>Methods</h3><div>Biomechanical testing was performed on 24 fresh-frozen pediatric human knees. Four conditions were tested: native posteromedial MTLC (n ​= ​14), native posterolateral MTLC (n ​= ​14), posteromedial MTLC repair (n ​= ​5), and posterolateral MTLC repair (n ​= ​5). Load to failure and stiffness were measured for all conditions.</div></div><div><h3>Results</h3><div>The load to failure for the posteromedial suture anchor construct was significantly higher than that for the native MTLC (p ​&lt; ​0.01). The posterolateral suture anchor construct had a significantly greater stiffness than the native MTLC (p ​= ​0.03). Posterolateral MTLC load to failure and posteromedial MTLC stiffness were similar between native tissue and suture-anchor repair. All native MTLCs failed at the meniscus-MTLC interface. The suture anchor groups had various failure modes, including suture pullout and breakage.</div></div><div><h3>Conclusion</h3><div>Suture anchor fixation can match or exceed the native tissue's load to failure. This study supports the viability of suture anchor–based posterior MTLC repairs of the medial and lateral meniscus in pediatric bone.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100385"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided repair of the anterior talofibular ligament with or without Gould augmentation is safe and improves clinical outcomes for chronic lateral ankle instability: A case series of 49 patients","authors":"Soichi Hattori ,&nbsp;Kentaro Onishi ,&nbsp;Takuya Okada ,&nbsp;Marfred M. Umanes ,&nbsp;Ken Ichikawa ,&nbsp;Shuzo Takazawa ,&nbsp;Shin Yamada ,&nbsp;Yuki Kato ,&nbsp;MaCalus V. Hogan ,&nbsp;Hiroshi Ohuchi","doi":"10.1016/j.jisako.2025.100386","DOIUrl":"10.1016/j.jisako.2025.100386","url":null,"abstract":"<div><h3>Objectives</h3><div>We have previously shown that ultrasound-guided repair results in an accurate anchor placement and restores ankle joint stability using cadaveric models. The objective of this study is to assess the safety and clinical outcomes of ultrasound-guided anterior talofibular ligament (ATFL) repair with or without augmentation.</div></div><div><h3>Methods</h3><div>Forty-nine patients with chronic lateral ankle instability underwent ultrasound-guided ATFL repair with or without augmentation. Following the procedure, patients completed a standardized postoperative rehabilitation protocol. The primary outcome was the complication rate in 49 patients. The clinical outcomes were analyzed as a secondary outcome for 28 patients (20 athletes and 8 nonathletes) after excluding 21 patients with such concomitant injuries that could affect clinical course. These included (1) the Numerical Rating Scale (NRS) for pain, (2) Foot and Ankle Outcome Score (FAOS), (3) Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale (a Japanese equivalent of the American Orthopedic Foot and Ankle Society Ankle-Hindfoot score), and (4) Self-Administered Foot Evaluation Questionnaire Sports (SAFE-Q Sports) score at baseline, 3 months, and 6 months.</div></div><div><h3>Results</h3><div>The overall complication rate was 2.0%, with one superficial peroneal nerve irritation out of 49 cases, which was improving at 6 months. All 4 clinical outcome scores resulted in statistically significant improvement at 6 months. NRS decreased from 3.6 ​± ​2.1 at the baseline to 1.3 ​± ​1.6 (p ​&lt; ​0.001, Student's t-test). FAOS increased from 74.7 ​± ​11.9 to 93.4 ​± ​8.1 (p ​&lt; ​0.001). JSSF scale increased from 56.9 ​± ​15.1 to 90.9 ​± ​10.2 (p ​&lt; ​0.001). All 20 athletes returned to sports at a preinjury level, and their SAFE-Q sports activity scores increased from 40.7 ​± ​17.6 to 90.6 ​± ​0.2 (p ​&lt; ​0.001).</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided ATFL repair with or without augmentation for chronic lateral ankle instability is safe and results in clinical improvement at 6 months.</div></div><div><h3>Evidence level</h3><div>IV.</div></div>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":"11 ","pages":"Article 100386"},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}