ABSTRACT
Long-term results of anatomic reconstruction for chronic ankle instability are good,
but no study has shown the results of fibular periosteum ligamentoplasty associated
with extensor retinaculum flap at long-term follow-up. To demonstrate the efficacy
of fibular periosteum ligamentoplasty and extensor retinaculum flap in chronic lateral
instability, 40 patients underwent surgery for ankle instability. Thirty-three (82.5%)
patients were reviewed, with a median follow-up duration of 8.2 (range 4 to 13) years.
Functional results were assessed using the Karlsson score. Static and dynamic x-ray
images were realized to measure varus tilt and anterior drawer, and osteoarthritis
was evaluated with the van Dijk classification. The median Karlsson score was 95 (range
80 to 100). The mean decrease in varus laxity was 11° (range 0 to 18) and in anterior
drawer was 1 (range –8 to 4) mm. At the last follow-up visit, 3 (7.5%) patients showed
an evidence of osteoarthritis according to the preoperative criteria of the van Dijk
classification (grade 2) and 6 (15%) patients had radiologic changes, without narrowing
of the joint space (grade 1). Studies that have a follow-up time >5 years are rare.
This study shows that despite the excellent control of ankle laxity, severe radiographic
changes (grade 2) continue to evolve in the long term. This study indicates a good
long-term outcome but suggests the need to monitor the occurrence of osteoarthritis
over the long term.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: April 06, 2019
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
