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Timing of arthroscopy does not impact recurrence rate of ankle instability in patients undergoing lateral ligament repair surgery
Abstract   Open access   Peer reviewed

Timing of arthroscopy does not impact recurrence rate of ankle instability in patients undergoing lateral ligament repair surgery

Ashish Shah, Brent Cone, Cesar de Cesar Netto, Parke Hudson, Ibukunoluwa Araoye, Bahman Sahranavard, Zachariah Pinter, Sung Lee, Caleb Jones and Shelby Bergstresser
Foot & ankle orthopaedics, Vol.2(3), p.2473011417
09/11/2017
DOI: 10.1177/2473011417S000363
url
https://doi.org/10.1177/2473011417S000363View
Published (Version of record) Open Access

Abstract

Category: Ankle, Arthroscopy Introduction/Purpose: Ankle sprains are common orthopaedic injuries. Although the initial treatment is conservative, some patients may develop chronic instability requiring surgical repair. Arthroscopy is often performed prior to ligament reconstruction to evaluate concomitant intraarticular and cartilage injuries. Arthroscopic treatment may be performed immediately prior to ligament repair (single stage), or it may be scheduled days/weeks prior to ligament repair (double stage). Concerns of single stage arthroscopic treatment are related to the increased difficulty in dealing with ligaments and soft-tissue injuries hindered by fluid extravasation. Our study compares outcomes between single and double stage arthroscopy in patients undergoing lateral ligament repair surgery. Methods: In this retrospective study we reviewed charts of patients with chronic lateral ankle instability who underwent ankle arthroscopy followed by lateral ligament repair from 2011 to through 2015. A total of 102 patients were included in the study, 65 patients in the single stage group, and 37 in the double stage group. Surgical failure was defined as recurrence of ankle instability at any point in the follow up period after the procedure. Demographic data and recurrence rate of instability were compared between the groups using chi-squared test. Results: Women comprised 72% (73/102) percent of the total patient population. No significant differences in demographic data were found between the two groups. There was no difference in the recurrence rate of lateral ankle instability between patients who underwent 1-stage versus 2-stage arthroscopic treatment. The rate was similar between the groups: 10.8% (7/65) of patients with the single stage technique and 8.1% (3/37) of patients in the double stage group (p=0.6208). Conclusion: In the treatment of chronic lateral ankle instability, the use of single-stage arthroscopy and lateral ligament repair showed similar rates of surgical failure when compared to the double-stage procedure. A single stage approach may be a more efficient use of time and hospital resources, and avoids the need to place the patient under anesthesia multiple times. Arthroscopy may be performed immediately prior to lateral ligament repair without concern for increased risk of recurrence of instability.
Lateral Ankle Instability Brostrom-Gould outcomes ligament repair scope

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