Chronic lateral ankle instability: the effect of intra-articular lesions on clinical outcome.
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.
Choi
Woo Jin
WJ
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, South Korea.
Lee
Jin Woo
JW
Han
Seung Hwan
SH
Kim
Bom Soo
BS
Lee
Su Keon
SK
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