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Concurrent arthroscopic osteochondral lesion treatment and lateral ankle ligament repair has no substantial effect on the outcome of chronic lateral ankle instability

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of the study was to evaluate the effect of concurrent arthroscopic osteochondral lesion (OCL) treatment and lateral ankle ligament repair on the outcome of chronic lateral ankle instability. It was hypothesized that the arthroscopic OCL treatment might have some negative effect on the outcome of chronic lateral ankle instability (CLAI) by compromising the rehabilitation program.

Methods

Ankle arthroscopy and anatomic lateral ankle ligament repair with suture anchors were performed for 70 patients with CLAI between 2010 and 2012. Thirty-four patients (group A), 20 males and 14 females with a median age of 30(14–54) years, received arthroscopic abrasion, curettage, drilling, or microfracture for OCLs. The splint was removed daily for joint motion exercises beginning at post-operative 2 weeks and full weight bearing was allowed between post-operative week 8 and 12. The other 36 patients (group B) with no combined OCL were followed up as controls. Pre-operative and post-operative visual analog scale (VAS) scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, Tegner scores, sprain recurrence, ankle stability, and range of motion (ROM) were evaluated and compared.

Results

The median follow-up was 46.5 (38–55) months and 44.5 (38–56) months for group A and group B, respectively. The median post-operative VAS score, AOFAS score, and Tegner score were improved from the pre-operative level for both groups with good-to-excellent results for more than 90% patients. No significant difference was found between the two groups for the subjective scores and satisfaction rate (n.s.). Recurrent sprain was found among nine patients(26.5%) of the group A and five patients (13.9%) of the group B (n.s.). The incidence of the ROM restriction of group A was significantly higher than in group B (23.5 vs 5.6%, P = 0.043).

Conclusions

The concurrent arthroscopic treatment of OCL with lateral ankle ligament repair demonstrated no substantial negative effect on the overall mid-term outcome of the patients with CLAI except for a potential risk of ROM restriction.

Level of evidence

III.

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Abbreviations

CLAI:

Chronic lateral ankle instability

ATFL:

Anterior talofibular ligament

CFL:

calcaneofibular ligament

OCL:

Osteochondral lesions

ROM:

Range of motion

BMI:

Body mass index

CPM:

Continuous passive motion

VAS:

Visual analog score

AOFAS:

American Orthopaedic Foot and Ankle Society

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Acknowledgements

The study was funded by the National Natural Science Foundation of China (31670982, 81672153, Z161100000116072). We thank Joshua N. Tennant, MD from University Of North Carolina Healthcare Orthopaedics for his valuable assistance in reviewing and editing the manuscript. We also thank Miss Yanfang Jiang for her assistance in statistics and language modification.

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Authors and Affiliations

  1. Institute of Sports Medicine of Peking University Third Hospital, No. 49 North Garden Road, Haidian, 100191, Beijing, China

    Dong Jiang, Yin-fang Ao, Chen Jiao, Xing Xie, Lin-xin Chen, Qin-wei Guo & Yue-lin Hu

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  1. Dong Jiang
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  2. Yin-fang Ao
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  3. Chen Jiao
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  4. Xing Xie
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  5. Lin-xin Chen
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  6. Qin-wei Guo
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  7. Yue-lin Hu
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Corresponding authors

Correspondence to Qin-wei Guo or Yue-lin Hu.

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Conflict of interest

Authors declare that there is no competing interest.

Ethical standards

This study was approved by the board of research ethics of our hospital (IRB00006761-2016011).

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Jiang, D., Ao, Yf., Jiao, C. et al. Concurrent arthroscopic osteochondral lesion treatment and lateral ankle ligament repair has no substantial effect on the outcome of chronic lateral ankle instability. Knee Surg Sports Traumatol Arthrosc 26, 3129–3134 (2018). https://doi.org/10.1007/s00167-017-4774-5

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