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Arthroscopic all-inside ATFL and CFL repair is feasible and provides excellent results in patients with chronic ankle instability.

关节镜下全内侧ATFL和CFL修复是可行的,在慢性踝关节不稳的患者中提供了极好的结果。

  • 影响因子:3.28
  • DOI:10.1007/s00167-019-05676-z
  • 作者列表:"Vega J","Malagelada F","Dalmau-Pastor M
  • 发表时间:2020-01-01
Abstract

PURPOSE:Chronic ankle instability has been described as presenting with complete tears of both the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in 20% of cases. Arthroscopic techniques to treat chronic ankle instability are increasingly being reported and in some instances they can be technically demanding. The aim of this study was to describe an arthroscopic all-inside repair of both the ATFL and CFL, and to report the outcomes of a group of patients with chronic ankle instability that underwent the technique. METHODS:Twenty-four patients [22 male and 2 female, median age 41 (range 22-56) years] with chronic ankle instability and torn ATFL and CFL were treated arthroscopically after failing non-operative management. Median follow-up was 35 (mean 34.7, and range 18-55) months. Through an arthroscopic all-inside technique, and using a suture passer and two knotless anchors, both fascicles of the ATFL and the CFL were repaired. RESULTS:Arthroscopic examination demonstrated ATFL and CFL injuries in all patients. Subjective improvement in their ankle instability was observed postoperatively. The anterior drawer and the talar tilt tests were negative at follow-up. The median AOFAS score increased from 65 (mean 65, range 52-85) preoperatively to 97 (mean 97, range 85-100) at final follow-up. CONCLUSION:Chronic ankle instability with concomitant injury of both the ATFL and CFL, can be successfully treated by an arthroscopic all-inside repair. The clinical relevance of the study is the description of the first arthroscopic all-inside ATFL and CFL anatomic repair technique, which offers excellent clinical results and the inherent benefits from minimally invasive surgery. LEVEL OF EVIDENCE:IV, retrospective case series.

摘要

目的: 慢性踝关节不稳在 20% 的病例中表现为距腓前韧带 (ATFL) 和跟腓韧带 (CFL) 完全撕裂。关节镜技术治疗慢性踝关节不稳的报道越来越多,在某些情况下,技术要求很高。本研究的目的是描述ATFL和CFL的关节镜下全内修复,并报告一组接受该技术的慢性踝关节不稳患者的结果。 方法: 24 例患者 [22 例男性和 2 例女性,中位年龄 41 (范围 22-56) 年] 慢性踝关节不稳,ATFL和CFL撕裂,非手术治疗失败后关节镜下治疗。中位随访时间为 35 (平均 34.7,范围 18-55) 个月。通过关节镜下全内侧技术,使用缝合器和两个无结锚,修复了ATFL和CFL的两个束。 结果: 所有患者关节镜检查均显示ATFL和CFL损伤。术后观察到踝关节不稳的主观改善。随访时前抽屉和距骨倾斜试验均为阴性。中位AOFAS评分从术前的 65 (平均 65,范围 52-85) 增加到最后随访时的 97 (平均 97,范围 85-100)。 结论: 关节镜下全内修复可成功治疗慢性踝关节不稳伴ATFL和CFL损伤。该研究的临床相关性是对首次关节镜下全内侧ATFL和CFL解剖修复技术的描述,该技术提供了极好的临床结果和微创手术的固有益处。 证据水平: IV,回顾性病例系列。

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DOI:10.1002/acr.23824
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