Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction

Keun Soo Kim; Young Uk Park

doi:10.14193/jkfas.2019.23.1.1

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Kim and Park: Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction

Review Article

Journal of Korean Foot and Ankle Society 2019; 23(1): 1-5.

Published online: 18 March 2019

DOI: https://doi.org/10.14193/jkfas.2019.23.1.1

Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction

Keun Soo Kim, Young Uk Park

Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea.

Corresponding Author: Young Uk Park. Department of Orthopedic Surgery, Ajou University Hospital, 164 WorldCup-ro, Yeongtong-gu, Suwon 16499, Korea. Tel: 82-31-219-5220, Fax: 82-31-219-5229, parkyounguk@gmail.com

Received 16 January 2019 Revised 23 February 2019 Accepted 23 February 2019

Korean Foot and Ankle Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

Keywords: Ankle, Chronic ankle instability, Surgical treatment, Repair, Reconstruction

Figures and Tables

Figure 1

Non-anatomic reconstruction of lateral ligaments. (A) Watson-Jones procedure. (B) Evans procedure. (C) Chrisman-Snook procedure.

Figure 2

Various kinds of anatomical reconstruction of lateral ligaments. Two hole techniques (A, B) and one hole technique (C).

Notes

The point of this article was presented by the 62nd Spring Congress of the Korean Orthopaedic Association.

^{Financial support} None.

^{Conflict of interest} None.

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ORCID iDs: Young Uk Park
https://orcid.org/0000-0002-3400-497X
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