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Deltoid ligament (DL) repair produced better results than DL nonrepair for the treatment for rotational ankle instability

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare the clinical and magnetic resonance imaging (MRI) results after arthroscopic deltoid ligament (DL) repair versus DL nonrepair in patients with rotational ankle instability.

Methods

All patients with rotational ankle instability were enrolled in this retrospective cohort study. Clinical evaluation was performed by the American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), and Tegner activity score preoperatively and at a minimum follow-up of 2 years. MRI at follow-up was performed to evaluate the DL morphology.

Results

A total of 50 patients were enrolled in this study. Among them, 24 patients received DL repair (the repair group), whereas 26 patients did not (the nonrepair group). No significant difference was found in the AOFAS score (98 ± 4 vs. 97 ± 4; n.s.), KAFS (94 ± 7 vs. 93 ± 9; n.s.), or Tegner activity score (5 ± 2 vs. 5 ± 1; n.s.) between the repair group and the nonrepair group at the final follow-up. However, the repair group had a significantly shorter return-to-sport time than the nonrepair group (4.6 ± 1.6 mo vs. 6.0 ± 2.5 mo; p = 0.03). Comparison of the postoperative deltoid ligament showed that the repair group had a lower signal intensity than the nonrepair group.

Conclusion

Arthroscopic treatment of rotational ankle instability revealed good to excellent clinical results. However, patients who underwent DL repair had a significantly earlier return to sports as well as a lower signal intensity of DL than those who did not undergo DL repair.

Level of evidence

Level III.

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Funding

This study was supported by National Natural Science Foundation of China (No.81572209), Shanghai Excellent Talents Program (No.201609) and Shanghai Sports Science and Technology "Comprehensive Plan" Project (18Z004).

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Authors and Affiliations

  1. Department of Sports Medicine, Huashan Hospital, No 12, Wulumuqi Zhong Road, 200040, Shanghai, People’s Republic of China

    Hong Li, XiaoAo Xue, Jiahui Tong, Hongyun Li & Yinghui Hua

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  1. Hong Li
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  2. XiaoAo Xue
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  3. Jiahui Tong
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  4. Hongyun Li
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  5. Yinghui Hua
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Correspondence to Yinghui Hua.

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The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

The study was approved by the Health Sciences Institutional Review Board of Huashan Hospital. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Li, H., Xue, X., Tong, J. et al. Deltoid ligament (DL) repair produced better results than DL nonrepair for the treatment for rotational ankle instability. Knee Surg Sports Traumatol Arthrosc 31, 2015–2022 (2023). https://doi.org/10.1007/s00167-022-07169-y

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  • DOI: https://doi.org/10.1007/s00167-022-07169-y

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