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All-inside endoscopic anatomic reconstruction leads to satisfactory functional outcomes in patients with chronic ankle instability

Abstract

Purpose

Ankle sprain is a common injury that can be treated conservatively, though many injured patients do not seek treatment or are not adequately managed, both of which can lead to subsequent chronic ankle instability (CAI). The purpose of this study was to evaluate the functional scores and complication rates of an all-inside anatomic reconstruction technique to treat CAI at a minimum follow-up of 24 months.

Methods

The authors retrospectively collected the records of 41 patients that underwent all-inside endoscopic anatomic reconstruction of the ATFL and CFL including demographics, complications, satisfaction, American Orthopaedic Foot and Ankle Society (AOFAS) score, Karlsson score, and ankle activity score (AAS), at a minimum follow-up of 24 months.

Results

The study cohort, comprised 34 patients aged 35.6 ± 10.8 years, were assessed at 48.7 ± 19.0 months. AOFAS scores improved from 60.3 ± 11.9 to 94.3 ± 6.2 postoperatively. Karlsson scores improved from 49.0 ± 10.9 to 87.2 ± 10.1 postoperatively. Thirty-three (97%) patients returned to the same AAS (5.6 ± 3.1) and rated their overall satisfaction ≥ 7. One patient (3%) was reoperated to treat a hematoma, while five patients (15%) were reoperated to remove the cortical fixation device that caused discomfort.

Conclusion

The novel all-inside endoscopic technique for anatomic reconstruction of the ATFL and CFL grants satisfactory functional outcomes at a minimum of 24 months, and the improvements in AOFAS and Karlsson scores compared favourably to those reported for other techniques in the literature.

Level of evidence

IV.

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Funding

Ramsay Santé funded statistical analysis and manuscript preparation.

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Correspondence to Floris van Rooij.

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Conflict of interest

Dr. Bauer is a consultant for Arthrex.

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This study was approved by the institutional review board of Ramsay Santé (COS-RGDS-2020-02-001-HARDY-A).

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Guillo, S., Odagiri, H., van Rooij, F. et al. All-inside endoscopic anatomic reconstruction leads to satisfactory functional outcomes in patients with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 29, 1318–1324 (2021). https://doi.org/10.1007/s00167-020-06130-1

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  • DOI: https://doi.org/10.1007/s00167-020-06130-1

Keywords

  • Ankle
  • Arthroscopy
  • Reconstruction
  • CAI
  • Ligament