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Chronic lateral ankle instability: the effect of intra-articular lesions on clinical outcome.

Authors
Choi, WJ; Lee, JW; Han, SH; Kim, BS; Lee, SK
Citation
The American journal of sports medicine, 36(11):2167-2172, 2008
Journal Title
The American journal of sports medicine
ISSN
0363-54651552-3365
Abstract
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.
MeSH terms
AdolescentAdultAnkle Joint/physiopathology*Ankle Joint/surgery*Arthroscopy/methods*Chronic DiseaseFemaleFollow-Up StudiesHumansJoint Instability/surgery*Lateral Ligament, Ankle/surgery*MaleMiddle AgedTreatment Outcome
DOI
10.1177/0363546508319050
PMID
18669983
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Orthopedic Surgery
AJOU Authors
한승환
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