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Comparative analyses of arthroscopic and open repairs of lateral ligament complex injuries of the ankle: a systematic review and meta-analysis of the medium-term outcomes

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Abstract

Purpose

Little is known regarding the comparative analyses of the medium-term outcomes (with a mean minimum follow-up period of 24 months), between arthroscopic and open repairs of lateral ligament complex (LLC) injuries of the ankle. Thus, in this study, we aimed to explore the comparative analyses regarding the medium-term follow-up outcomes of these repairs, by conducting a systematic review and meta-analysis.

Methods

The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines; data were extracted from the PubMed and Google Scholar databases. From an initial search, a total of 1182 abstracts (280 and 902 abstracts, from PubMed and Google Scholar, respectively) were found and screened in accordance with the eligibility criteria. Subsequently, six articles were found to be eligible for further review.

Results

A total of 419 patients underwent surgical repairs; 205 and 214 patients underwent arthroscopic and open repairs, respectively. The mean minimum follow-up period was 29.2 months. The medium-term follow-up for arthroscopic LLC repairs was found to be superior to that of open LLC repairs, with more favorable outcomes; as evidenced by better clinical scores, lower pooled complication rates, earlier return times to pre-injury sport, and higher early sport ratios.

Conclusions

The findings of this systematic review and meta-analysis support near-future developments validating arthroscopic repair as the new gold standard for LLC repairs, similarly to arthroscopic ligament and tendon repairs, as well as arthroscopic reconstruction surgeries, of the knee and shoulder.

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Acknowledgements

All authors declare that they have not received sponsorship or funding for the study design, collection, analysis and interpretation of the data, writing of the manuscript, or submission for publication.

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Authors and Affiliations

  1. Foot and Ankle surgery unit, Department of Orthopedic Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

    Sora Tonsuthanluck

  2. Faculty of Medicine Widya Mandala Catholic University, Surabaya, Indonesia

    Henry Ricardo Handoyo

  3. Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang (KMITL), Bangkok, Thailand

    Ramita Tharincharoen

  4. Division of Digital and Innovative Medicine, Faculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang (KMITL), Bangkok, Thailand

    Chayanin Angthong

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  1. Sora Tonsuthanluck
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  2. Henry Ricardo Handoyo
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Contributions

ST helped in literature search and data analysis and drafting of the work; HRH helped in literature search and data analysis; RT done literature search; CA done the study conception and design, literature search, research supervision, and drafting of the work. ST and CA wrote the draft of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Chayanin Angthong.

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Tonsuthanluck, S., Handoyo, H.R., Tharincharoen, R. et al. Comparative analyses of arthroscopic and open repairs of lateral ligament complex injuries of the ankle: a systematic review and meta-analysis of the medium-term outcomes. Eur J Orthop Surg Traumatol 34, 1487–1495 (2024). https://doi.org/10.1007/s00590-023-03825-2

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