The present study sought to assess the clinical and radiological results and long-term joint impact of different techniques of lateral ankle ligament reconstruction. A multicenter retrospective review was performed on 310 lateral ankle reconstructions, with a mean 13 years’ follow-up (minimum FU of 5 years with a maximum of 30). Male subjects (53%) and sports trauma (78%) predominated. Mean duration of instability was 92 months; mean age at surgery was 28 years. 28% of cases showed subtalar joint involvement. Four classes of surgical technique were distinguished: C1, direct capsulo-ligamentary repair; C2, augmented repair; C3, ligamentoplasty using part of the peroneus brevis tendon; and C4, ligamentoplasty using the whole peroneus brevis tendon. Clinical and functional assessment used Karlsson and Good-Jones-Livingstone scores; radiologic assessment combined centered AP and lateral views, hindfoot weight-bearing Méary views and dynamic views (manual technique, TelosR or self-imposed varus). The majority of results (92%) were satisfactory. The mean Karlsson score of 90 [19–100] (i.e., 87% good and very good results) correlated with the subjective assessment, and did not evolve over time. Postoperative complications (20%), particularly when neurologic, were associated with poorer results. Control X-ray confirmed the very minor progression in osteoarthritis (2 %), with improved stability (88%); there was, however, no correlation between functional result and residual laxity on X-ray. Unstable and painful ankles showed poorer clinical results and more secondary osteoarthritis. Analysis by class of technique found poorer results in C4-type plasties and poorer control of laxity on X-ray in C1-type tension restoration.Material and methods
Results
