Arthroscopic findings in patients with chronic ankle instability.
BACKGROUND
There are little objective data on structural changes of the chronically unstable ankle. Such knowledge could help with preoperative planning.


OBJECTIVE
Preoperative ankle arthroscopy provides important insights into the causes and mechanisms of ankle instability and the resulting disability.


METHODS
Case series.


METHODS
From 1993 to 1999, arthroscopic examination was performed in the ankles of 148 patients with symptomatic chronic ankle instability that had lasted 6 months or more. All structural changes were recorded and compared with the clinical diagnosis.


RESULTS
A rupture or elongation of the anterior talofibular ligament was noted in 86% of ankles, of the calcaneofibular ligament in 64%, and of the deltoid ligament in 40%. Cartilage damage was noted in 66% of ankles with lateral ligament injuries, whereas 98% of the ankles with deltoid ligament injuries had cartilage damage. Although lateral instability could be verified arthroscopically in 127 patients, medial instability was presumed clinically in 38 patients but was actually detected in 54 patients arthroscopically.


CONCLUSIONS
Preoperative ankle arthroscopy revealed an essential amount of information that would otherwise have been undetected. For instance, the ligaments showed typical abnormalities corresponding to different entities of ankle instability and different intraarticular pathologic conditions.
Hintermann
Beat
B
Clinic of Orthopaedic Surgery, University of Basel, Kantonsspital CH-4031 Basel, Switzerland.
Boss
Andreas
A
Schäfer
Dirk
D
D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis* / Q000601:surgery; D000843:Ankle Joint / Q000473:pathology / Q000601:surgery; D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000293:injuries; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D012008:Recurrence; D012421:Rupture; D013180:Sprains and Strains / Q000150:complications; D013628:Talus / Q000473:pathology; D013977:Tibia / Q000473:pathology