title: Simultaneous surgery for chronic lateral ankle instability accompanied by only subchondral bone lesion of talus.
abstract: BACKGROUND
  Osteochondral lesion of the talus (OCT) frequently accompanies chronic lateral ankle instability (CLAI). However, it remains unclear whether concomitant OCT and CLAI should be treated surgically at the same time. The purpose was to evaluate the clinical outcome of simultaneous surgery involving stabilization of CLAI and retrograde drilling for only subchondral bone lesion of the talus.
  
  
  METHODS
  The study was a case series; level of evidence, 4.
  
  
  METHODS
  Between January 2006 and February 2010, 16 feet of 16 patients (5 men, 11 women; mean age 25 years; age range 14-49 years) with CLAI accompanied by only subchondral bone lesion of talus underwent surgical repair or reconstruction of the anterior talofibular ligament and retrograde drilling. Subchondral bone lesion of talus was diagnosed by preoperative magnetic resonance imaging (MRI) and intraoperative arthroscopic investigation. Clinical outcome was measured using the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) and a visual analog scale (VAS). Improvement in lesion area was evaluated by assessing the change between preoperative and postoperative MRI findings.
  
  
  RESULTS
  Preoperative to postoperative changes in all patients were as follows: mean AOFAS score improved from 73.4 points (range 62-87) to 91.2 points (range 85-100) (p < 0.001); mean VAS score improved from 55.0 points (range 40-80) to 6.5 points (range 0-20) (p < 0.001); and mean lesion area improved from 33.9 mm(2) (range 14.2-59.6) to 11.8 mm(2) (range 4.3-22.1) (p < 0.001).
  
  
  CONCLUSIONS
  Simultaneous surgery involving lateral ankle stabilization and retrograde drilling under arthroscopic and fluoroscopic guidance is a promising method for treating CLAI accompanied by only subchondral bone lesion of talus.
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan.
authors.forename: Youichi
authors.initials: Y
authors.lastname: Yasui
authors.forename: Masato
authors.initials: M
authors.lastname: Takao
authors.forename: Wataru
authors.initials: W
authors.lastname: Miyamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsushita
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods; D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D013628:Talus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult