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Arthroscopic ankle lateral ligament repair with biological augmentation gives excellent results in case of chronic ankle instability.

关节镜下生物强化踝关节外侧韧带修复在慢性踝关节不稳的情况下取得了极好的效果。

  • 影响因子:3.28
  • DOI:10.1007/s00167-019-05650-9
  • 作者列表:"Cordier G","Lebecque J","Vega J","Dalmau-Pastor M
  • 发表时间:2020-01-01
Abstract

PURPOSE:The open "Broström-Gould" procedure has become the gold standard technique for the treatment of chronic ankle instability. Although arthroscopic techniques treating ankle instability have significantly evolved in the last years, no all arthroscopic Broström-Gould has been described. The aim of the study was to describe the all-arthroscopic Broström-Gould technique [anterior talofibular ligament (ATFL) repair with biological augmentation using the inferior extensor retinaculum (IER)], and to evaluate the clinical results in a group of patients. METHODS:Fifty-five patients with isolated lateral ankle instability were arthroscopically treated. Arthroscopic ATFL repair with biological augmentation was performed through a two-step procedure. First, the ligament is reattached through an arthroscopic procedure. Next, the ligament is augmented with the IER that is endoscopically grasped. Both the ligament repair and its augmentation with IER were performed with the help of an automatic suture passer and two soft anchors. Characteristics of the patients, and pre- and postoperatively AOFAS and Karlsson scores were recorded. RESULTS:The median preoperative AOFAS score increased from 74 (range 48-84) to 90 (range 63-100). According to the Karlsson score, the median preoperative average increased from 65 (range 42-82) to 95 (range 65-100). No major complications were reported. Only one case (1.8%) required a revision surgery at 23 months of follow-up. CONCLUSION:The arthroscopic all-inside ATFL repair with biological augmentation using the IER is a reproducible technique. Excellent clinical results were obtained. The technique has the advantage of its minimally invasive approach and the potential to treat concomitant ankle intra-articular pathology. LEVEL OF EVIDENCE:Retrospective case series, Level IV.

摘要

目的: 开放式 “brostr ö m-Gould” 手术已成为治疗慢性踝关节不稳的金标准技术。尽管治疗踝关节不稳的关节镜技术在过去几年有了显著的发展,但没有描述所有的关节镜brostr ö m-Gould。本研究的目的是描述全关节镜下brostr ö m-Gould技术 [使用下伸肌支持带 (IER) 生物扩增的距腓前韧带 (ATFL) 修复],并对一组患者的临床结果进行评价。 方法: 对 5 5 例单纯踝关节外侧不稳患者行关节镜下治疗。通过两步手术进行关节镜下ATFL修复和生物增强。首先,通过关节镜手术重新连接韧带。接下来,韧带用内窥镜抓握的IER增强。韧带修复和IER隆突均在自动缝合器和两个软锚钉的帮助下进行。记录患者的特征,以及术前和术后AOFAS和Karlsson评分。 结果: 中位术前AOFAS评分从 74 (范围 48-84) 增加到 90 (范围 63-100)。根据Karlsson评分,术前平均中位数从 65 (范围 42-82) 增加到 95 (范围 65-100)。无重大并发症报告。在 23 个月的随访中,只有 1 例 (1.8%) 需要翻修手术。 结论: 关节镜下全内修复ATFL并使用IER进行生物强化是一种可重复的技术。获得了极好的临床结果。该技术具有微创性和治疗伴随踝关节内病变的潜力。 证据级别: 回顾性病例系列,IV级。

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DOI:10.1002/acr.23824
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