Yang Xu, Yong-Xing Cao, Xing-Chen Li, Xiang-Yang Xu
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The operation was performed through minimally invasive incisions. Functional assessment was performed using the Karlsson-Peterson ankle scoring system (KP) and the Visual Analogue Scale (VAS). The questionnaires of KP and VAS were completed before surgery and at the last follow-up. Patients' subjective satisfaction level was graded as excellent, good, fair, and poor. Preoperative and postoperative anterior talar displacement and varus talus tilt angle in stress radiographs were recorded.</p><p><strong>Results: </strong>The average age at the revision surgery time was 39.6years. The mean follow-up was 39.2months. The VAS score improved from 4.1 ± 1.5 preoperatively to 1.3 ± 1.3 at the final follow-up (<i>p</i> < .05). The KP score improved from 59.0 ± 20.2 preoperatively to 88.2 ± 9.6 at the last follow-up (<i>p</i> < .05). The mean varus talar tilt angle was 14.1 ± 3.9 mm preoperatively versus 4.9 ± 4.7 mm at the final follow-up (<i>p</i> < .05). The mean anterior talar displacement was 12.8 ± 2.2 mm versus 5.6 ± 3.7 mm at the last follow-up (<i>p</i> < .05).</p><p><strong>Conclusions: </strong>The revision anatomic reconstruction of the lateral ligaments of the ankle is effective for patients with recurrent instability after a failed modified Broström procedure.</p>","PeriodicalId":520682,"journal":{"name":"Journal of orthopaedic surgery (Hong Kong)","volume":" ","pages":"10225536221125948"},"PeriodicalIF":1.6000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Revision lateral ankle ligament reconstruction for patients with a failed modified Brostrom procedure.\",\"authors\":\"Yang Xu, Yong-Xing Cao, Xing-Chen Li, Xiang-Yang Xu\",\"doi\":\"10.1177/10225536221125948\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The Brostrom-Gould procedure has been considered as a gold standard operative technique for chronic lateral ankle instability. Despite the popularity and excellent outcomes of the modified Brostrom procedure, some patients still experience recurrence of ankle instability. Few studies reported outcomes of revision reconstruction for patients with a failed modified Brostrom procedure. This study aimed to evaluate the outcomes of a percutaneous anatomic revision lateral ankle ligament reconstruction for patients with a failed modified Brostrom procedure.</p><p><strong>Methods: </strong>From March 2017 to April 2020, 21 patients with persistent ankle instability after a modified Brostrom procedure underwent revision lateral ankle ligament reconstruction. The operation was performed through minimally invasive incisions. Functional assessment was performed using the Karlsson-Peterson ankle scoring system (KP) and the Visual Analogue Scale (VAS). The questionnaires of KP and VAS were completed before surgery and at the last follow-up. Patients' subjective satisfaction level was graded as excellent, good, fair, and poor. Preoperative and postoperative anterior talar displacement and varus talus tilt angle in stress radiographs were recorded.</p><p><strong>Results: </strong>The average age at the revision surgery time was 39.6years. The mean follow-up was 39.2months. The VAS score improved from 4.1 ± 1.5 preoperatively to 1.3 ± 1.3 at the final follow-up (<i>p</i> < .05). The KP score improved from 59.0 ± 20.2 preoperatively to 88.2 ± 9.6 at the last follow-up (<i>p</i> < .05). The mean varus talar tilt angle was 14.1 ± 3.9 mm preoperatively versus 4.9 ± 4.7 mm at the final follow-up (<i>p</i> < .05). The mean anterior talar displacement was 12.8 ± 2.2 mm versus 5.6 ± 3.7 mm at the last follow-up (<i>p</i> < .05).</p><p><strong>Conclusions: </strong>The revision anatomic reconstruction of the lateral ligaments of the ankle is effective for patients with recurrent instability after a failed modified Broström procedure.</p>\",\"PeriodicalId\":520682,\"journal\":{\"name\":\"Journal of orthopaedic surgery (Hong Kong)\",\"volume\":\" \",\"pages\":\"10225536221125948\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2022-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of orthopaedic surgery (Hong Kong)\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10225536221125948\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedic surgery (Hong Kong)","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10225536221125948","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的:Brostrom-Gould手术被认为是治疗慢性外侧踝关节不稳的金标准手术技术。尽管改良的Brostrom手术很受欢迎，效果也很好，但一些患者仍然会出现踝关节不稳定的复发。很少有研究报道改良Brostrom手术失败患者翻修重建的结果。本研究旨在评估改良Brostrom手术失败患者经皮解剖翻修踝关节外侧韧带重建的结果。方法:2017年3月至2020年4月，21例改良Brostrom手术后持续踝关节不稳定的患者进行了翻修踝关节外侧韧带重建。手术通过微创切口进行。采用Karlsson-Peterson踝关节评分系统(KP)和视觉模拟量表(VAS)进行功能评估。术前和末次随访时分别完成KP和VAS问卷。患者主观满意度分为优、良、一般、差四个等级。术前和术后分别记录距前移位和距内翻角度。结果:翻修手术时平均年龄39.6岁。平均随访39.2个月。VAS评分由术前4.1±1.5分改善至终期随访时的1.3±1.3分(p < 0.05)。KP评分由术前59.0±20.2分提高至末次随访时的88.2±9.6分(p < 0.05)。术前距内翻倾斜角均值为14.1±3.9 mm，最终随访时为4.9±4.7 mm (p < 0.05)。最后一次随访时距前距位移平均为12.8±2.2 mm，而上一次随访时为5.6±3.7 mm (p < 0.05)。结论:踝关节外侧韧带的翻修解剖重建对于改良Broström手术失败后复发性不稳定的患者是有效的。
Revision lateral ankle ligament reconstruction for patients with a failed modified Brostrom procedure.
Purpose: The Brostrom-Gould procedure has been considered as a gold standard operative technique for chronic lateral ankle instability. Despite the popularity and excellent outcomes of the modified Brostrom procedure, some patients still experience recurrence of ankle instability. Few studies reported outcomes of revision reconstruction for patients with a failed modified Brostrom procedure. This study aimed to evaluate the outcomes of a percutaneous anatomic revision lateral ankle ligament reconstruction for patients with a failed modified Brostrom procedure.
Methods: From March 2017 to April 2020, 21 patients with persistent ankle instability after a modified Brostrom procedure underwent revision lateral ankle ligament reconstruction. The operation was performed through minimally invasive incisions. Functional assessment was performed using the Karlsson-Peterson ankle scoring system (KP) and the Visual Analogue Scale (VAS). The questionnaires of KP and VAS were completed before surgery and at the last follow-up. Patients' subjective satisfaction level was graded as excellent, good, fair, and poor. Preoperative and postoperative anterior talar displacement and varus talus tilt angle in stress radiographs were recorded.
Results: The average age at the revision surgery time was 39.6years. The mean follow-up was 39.2months. The VAS score improved from 4.1 ± 1.5 preoperatively to 1.3 ± 1.3 at the final follow-up (p < .05). The KP score improved from 59.0 ± 20.2 preoperatively to 88.2 ± 9.6 at the last follow-up (p < .05). The mean varus talar tilt angle was 14.1 ± 3.9 mm preoperatively versus 4.9 ± 4.7 mm at the final follow-up (p < .05). The mean anterior talar displacement was 12.8 ± 2.2 mm versus 5.6 ± 3.7 mm at the last follow-up (p < .05).
Conclusions: The revision anatomic reconstruction of the lateral ligaments of the ankle is effective for patients with recurrent instability after a failed modified Broström procedure.
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