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IS RECONSTRUCTION ALWAYS NECESSARY IN CHRONIC LATERAL ANKLE INSTABILITY?



Abstract

Introduction and Aims: Lateral ligament complex injuries are a common cause of chronic ankle instability. It has been found that functional and mechanical instability of the ankle joint can respond to arthroscopic debridement of the ankle alone and that not all the structurally unstable joints require stabilisation.

Method: We retrospectively studied 43 patients with chronic lateral ankle instability who had failed to respond to a functional rehabilitation program. All patients underwent an examination under anaesthesia with or without stress views to determine instability and this was preceded by arthroscopic examination of the ankle.

Results: Intra-articular lesion was seen in 41.8% of cases. 79.1% had fibrosis in the anterolateral gutter, 27.9% had osteochondral defect, 30.2% had osteophytes causing impingement and 9.3% had loose bodies. Structural instability was confirmed in 53.4% and functional instability in 46.6%.

Arthroscopy demonstrated attenuation of the Anterior Talofibular ligament in 14%. Following arthroscopic debridement lateral reconstruction was required in only 14 (32.5%). Twenty-three patients (53.4%) went on to improve after arthroscopy alone and did not need lateral reconstruction. Three patients (6.9%) were lost to follow-up and three (6.9%) needed further procedures.

Conclusion: Arthroscopic assessment and treatment of intra-articular lesion in patients with chronic ankle instability can result in a stable ankle that does not necessitate a lateral ligament complex reconstruction.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

None of the authors is receiving any financial benefit or support from any source.