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

Authors
 Woo Jin Choi  ;  Jin Woo Lee  ;  Seung Hwan Han  ;  Bom Soo Kim  ;  Su Keon Lee 
Citation
 AMERICAN JOURNAL OF SPORTS MEDICINE, Vol.36(11) : 2167-2172, 2008 
Journal Title
AMERICAN JOURNAL OF SPORTS MEDICINE
ISSN
 0363-5465 
Issue Date
2008
MeSH
Adolescent ; Adult ; Ankle Joint/physiopathology* ; Ankle Joint/surgery* ; Arthroscopy/methods* ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Joint Instability/surgery* ; Lateral Ligament, Ankle/surgery* ; Male ; Middle Aged ; Treatment Outcome ; Young Adult
Keywords
ankle ; arthroscopy ; instability ; intra-articular lesions
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.
Full Text
http://ajs.sagepub.com/content/36/11/2167.long
DOI
10.1177/0363546508319050
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bom Soo(김범수)
Lee, Jin Woo(이진우) ORCID logo https://orcid.org/0000-0002-0293-9017
Choi, Woo Jin(최우진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108624
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