Chronic Lateral Ankle Instability: The Effect of Intra-Articular Lesions on Clinical Outcome

• Published in: The American journal of sports medicine 2008-11, Vol.36 (11), p.2167-2172
• Main Authors: Choi, Woo Jin, Lee, Jin Woo, Han, Seung Hwan, Kim, Bom Soo, Lee, Su Keon
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Ankle; Ankle Joint - physiopathology; Ankle Joint - surgery; Arthroscopy; Arthroscopy - methods; Biological and medical sciences; Chronic Disease; Clinical outcomes; Diseases of the osteoarticular system; Endoscopy; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Joint Instability - surgery; Knee; Lateral Ligament, Ankle - surgery; Ligaments; Male; Medical sciences; Middle Aged; Sports medicine; Treatment Outcome; Young Adult
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546508319050

Background There has been no attempt to correlate the type and number of intra-articular lesions with the results of ligament reconstruction for chronic lateral ankle instability. Hypothesis Certain intra-articular lesions affect the clinical outcome of ligament reconstruction. Study Design Case series; Level of evidence, 4. Methods Sixty-five ankles from 64 patients underwent a modified Broström operation for chronic lateral ankle instability with a mean follow-up of 28.7 months (range, 12–67). The results were assessed according to the Karlsson-Peterson Ankle Score. The type of intra-articular lesions and the association of clinical outcome were investigated using Pearson's correlation coefficient and multivariate logistic regression analysis. Results The average Karlsson-Peterson Ankle Score was improved from 53 ± 14.63 preoperatively to 85.21 ±11.97 at final follow-up (P < .001). Five different intra-articular lesions were described in 63 ankles (96.9%), and the ankle score negatively correlated with the number of lesions (r = −.604; P < .001). Multivariate logistic regression showed that syndesmosis widening (odds ratio, 11.1; 95% confidence interval: 2.2–55.4; P = .003), osteochondral lesions of the talus (odds ratio, 8.5; 95% confidence interval: 1.7–42.3; P = .008), and ossicles (odds ratio, 4.5; 95% confidence interval: 1.0–20.2; P = .046) are significant predictors of unsatisfactory results after ligament reconstruction. Conclusion Arthroscopic diagnosis and treatment of intra-articular lesions associated with chronic lateral ankle instability is a safe and effective method. The presence of any combination of associated intra-articular lesions can result in a poor outcome.