scholarly journals Residual Pain after Operative Treatment for Chronic Ankle Instability

2021 ◽  
Vol 25 (1) ◽  
pp. 32-37
Author(s):  
Byung-Ki Cho ◽  
Byung-Hyun Ahn
Keyword(s):  
Operative Treatment ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Residual Pain

The Arterial Anatomy of the Deltoid Ligament: A Cadaveric Study

2017 ◽  
Vol 38 (7) ◽  
pp. 785-790 ◽  
Author(s):  
Jacob A. Haynes ◽  
Michelle Gosselin ◽  
Brian Cusworth ◽  
Jeremy McCormick ◽  
Jeffrey Johnson ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Tibialis Anterior ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Vascular Supply ◽  
Tibialis Posterior ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Ankle Sprains ◽  
India Ink

Background: There is an increasing interest in the operative treatment of deltoid ligament disruption in the setting of chronic ankle instability. Understanding the vascular anatomy of the deltoid complex is beneficial when considering operative procedures on the medial ankle and may provide insight into factors that lead to chronic deltoid insufficiency and ankle instability. Methods: Thirty-two pairs of cadaveric specimens (64 total legs) were amputated below the knee, and the tibialis anterior, tibialis posterior, and peroneal arteries were injected with India ink and Ward’s blue latex. Specimens then underwent chemical debridement to identify the vascular supply to the deltoid ligament. A subset of specimens also underwent intraosseous debridement using the modified Spalteholz technique. Results: The vascular supply to the deltoid ligament was clearly visualized in 60 (93.8%) specimens. Fifty-eight specimens (96.7%) had arterial supply with an origin from the medial tarsal artery, 57 specimens (95%) had supply from the tibialis posterior artery, and 23 (38.3%) specimens had supply from the tibialis anterior artery. All specimens had at least 1 location of intraosseous vascular supply, either at the medial malleolus or medial talus. Conclusion: There were 3 separate extraosseous sources and 2 intraosseous sources of vascular supply to the deltoid ligament. Clinical Relevance: Knowledge of the vascular supply may aid in identifying factors that predispose a subset of patients with medial ankle sprains to failure of conservative treatment, as well as provide useful anatomic information when considering operative treatment for chronic ankle instability.

Outcome Following a Modified Broström Procedure and Arthroscopic Debridement of Medial Gutter Osteoarthritis Combined With Chronic Ankle Instability

2018 ◽  
Vol 39 (12) ◽  
pp. 1473-1480 ◽  
Author(s):  
Byung-Ki Cho ◽  
Young-Duck Shin ◽  
Hyun-Woo Park
Keyword(s):  
Operative Treatment ◽  
Ankle Instability ◽  
Case Series ◽  
Chronic Ankle Instability ◽  
Arthroscopic Debridement ◽  
Limited Information ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Aged Patients ◽  
Modified Broström Procedure

Background: There is limited information regarding the outcomes of operative treatment for ankle instability with coexisting arthritic changes in the medial gutter. This study was performed to evaluate the intermediate-term clinical and radiological outcomes following a modified Broström procedure and arthroscopic debridement in middle-aged patients with combined medial gutter osteoarthritis and chronic ankle instability. Methods: Twenty-two patients with medial gutter osteoarthritis related to chronic lateral ankle instability were followed for more than 3 years after operative treatment. All patients showed medial joint space narrowing of Takakura stage II at the time of surgery. The clinical evaluation consisted of the American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) for medial ankle pain during walking, and Foot and Ankle Ability Measure (FAAM). Results: Mean AOFAS and FAAM scores significantly improved from 51.2 and 45.7 points preoperatively to 80.3 and 78.4 points at final follow-up, respectively ( P < .001). Although mean pain-VAS significantly improved from 6.8 points to 3.5 points ( P < .001), 8 patients (36.4%) complained of gait discomfort with considerable pain of 4 or more points. There was only 1 patient (4.5%) with recurrent ankle instability, while 6 patients (27.3%) showed a progression of arthritis stage. Conclusions: Modified Broström procedure combined with arthroscopic debridement appears to be an effective operative option for medial gutter osteoarthritis secondary to chronic ankle instability. Despite the onset of arthritis, most patients were able to achieve significant improvement in reducing pain while eliminating instability. Level of Evidence: Level IV, retrospective case series.

scholarly journals Open operative treatment of chronic ankle instability

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0039
Author(s):  
Chad Purcell ◽  
Kentaro Matsui ◽  
Mark Glazebrook
Keyword(s):  
Literature Review ◽  
Operative Treatment ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Good Evidence ◽  
Operative Intervention ◽  
Anatomic Reconstruction ◽  
Evidence Based ◽  
Anatomic Repair ◽  
Evidence Grade

Category: Ankle Introduction/Purpose: Ankle sprains are one of the most common musculoskeletal injuries. Though most patients recover fully without intervention, 10-30% will develop chronic ankle instability and require conservative or surgical management. The aim of this article is to provide an evidence-based literature review and assessment of the quality of literature regarding open operative interventions for chronic ankle instability. Methods: A comprehensive evidence-based literature review of Pubmed, Embase, Cochrane and Web of Science databases, conducted March 9, 2016; and updated February 22, 2017 identified 1635 articles, of which, 71 were relevant in assessing the efficacy of common open operative interventions for treatment of chronic ankle instability. The open operative procedures described in included articles were classified into the following four main categories: Anatomic repair, Non-anatomic repair, Anatomic reconstruction and Non-anatomic reconstruction. The 71 studies were then assigned a level of evidence (I-V) to denote quality. They were then reviewed to provide a grade of recommendation (A-C, I) in support of or against the operative intervention in treatment of chronic ankle instability. Results: Among the open operative treatment options available for chronic ankle instability, there is good evidence (Grade A) in support of anatomic reconstructive procedures. There is fair evidence (Grade B) from level II and III studies in support of anatomic repair and non-anatomic reconstruction procedures. Insufficient evidence was available to grade internal brace and non-anatomic repair procedures. Conclusion: Good quality evidence exists in support of open operative treatment of chronic ankle instability. Future studies should aim to elucidate roles for each of the classifications of open operative intervention in specific circumstances and patient populations. Furthermore, with good evidence to support more traditional techniques for repair of chronic ankle instability, high quality studies should be conducted on more novel minimally invasive and arthroscopic operative techniques to assure equal efficacy and safety to open techniques summarized here.

Association between corticospinal inhibition and active dorsiflexion range of motion in patients with chronic ankle instability

2021 ◽  
Author(s):  
Kyle B. Kosik ◽  
Masafumi Terada ◽  
Ryan S. McCann ◽  
Colin P. Drinkard ◽  
Phillip A. Gribble
Keyword(s):  
Range Of Motion ◽  
Ankle Instability ◽  
Chronic Ankle Instability

scholarly journals Arthroscopic Internal Brace Augmentation With Arthroscopic Modified Broström Operation for Chronic Ankle Instability

2021 ◽  
Author(s):  
Akinobu Nishimura ◽  
Shigeto Nakazora ◽  
Yoshiyuki Senga ◽  
Yukie Kitaura ◽  
Aki Fukuda ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Internal Brace
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