title: Chronic lateral ankle instability: the effect of intra-articular lesions on clinical outcome.
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.
  
  
  OBJECTIVE
  Certain intra-articular lesions affect the clinical outcome of ligament reconstruction.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, South Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Choi
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.forename: Bom Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: Su Keon
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology* / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult