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Arthroscopic anterior talofibular ligament repair for chronic ankle instability with concomitant lesions of the ankle
Arthrosc Orthop Sports Med 2020;7:1-7
Published online May 1, 2020;  https://doi.org/10.14517/aosm19008
© 2020 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Jin Su Kim1,2, Ki Won Young2, Hun Ki Cho2, Seung Min Lim2

1Sejong Sports Medicine & Performance Center, 2Nowon Eulji Medical Center, Surgery of Foot and Ankle, Seoul, Korea
Correspondence to: Jin Su Kim, https://orcid.org/0000-0002-3954-5302
Sejong Sports Medicine & Performance Center, Daeyang AI Center, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea. Tel: +82-2-2244-5161, Fax: +82-2-2244-6171, E-mail: jins33@hanmail.net
Received October 8, 2019; Revised April 22, 2020; Accepted April 28, 2020.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The authors evaluated the clinical results of arthroscopic anterior talofibular ligament (ATFL) repair in patients with chronic ankle instability (CAI) with concomitant injuries.
Methods: The authors conducted a retrospective review of the 25 patients who underwent arthroscopic ATFL repair. Of the 25 patients, 24 had synovitis, 17 had osteochondral lesions on the talar dome, two had os submalleolare, six had os subfibulare, and four had anterior tibial spur. The mean follow-up period in this study was 30 months. The preoperative and postoperative differences were measured using the American Orthopedic Foot and Ankle Society (AOFAS) ankle–hindfoot scale, Hannover score, anterior drawer test, talar tilt test, and satisfaction scale.
Results: The mean preoperative AOFAS ankle–hindfoot score was 62.2 (standard deviation [SD] 8.5) and significantly improved to 84.0 (SD 11.0) after the operation (P < 0.001). The mean preoperative Hannover score was 60.6 (SD 10.3) and significantly improved to 89.4 (SD 9.6) postoperatively (P < 0.001). Of the patients, 68.0% were satisfied with the arthroscopic ATFL repair with arthroscopic intra-articular procedures. The number of patients with grade 2 or above instability in the anterior drawer test has decreased from 21 preoperatively to two after the operation. The talar tilt angle improved significantly from 9.3° (SD 4.9°) preoperatively to 6.5° (SD 3.0°) at the final follow-up (P = 0.001). Complications occurred in three patients (12.0%), who had injuries of the superficial peroneal nerve.
Conclusion: The results of this study demonstrate that arthroscopic ATFL repair may be used effectively in patients with CAI combined with concomitant lesions.
Keywords : Ankle; Instability; Arthroscopy; Osteochondral lesion
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