Medial and Lateral Combined Ligament Arthroscopic Repair for Multidirectional Ankle Instability: Case Series

Completed

• Conditions: Ligament Injury; Joint Instability; Talofibular Ligament Tear; Ankle Injuries; Deltoid Ligament; Sprain (Strain) (Ankle)
• Interventions: Procedure: Arthroscopic Brostrom combined with Arthroscopic Deltoid Repair

• Registration Number: NCT04459910
• Lead Sponsor: Federal University of São Paulo

Brief Summary

Abstract Introduction: The high prevalence of sprains in the population has provided a substantial number of patients with lateral instability of the ankle. The continuity of this condition can lead to the progressive loosening of the medial containment structures, generating a multidirectional rotational instability. The deltoid approach through the imbrication of its components has been proposed as a solution for these patients. The arthroscopic technique has been described as an alternative.

Methods: This is a retrospective study with patients diagnosed with multidirectional instability and submitted to an ankle arthroscopy with medial repair (arthroscopic tensioning) and lateral (arthroscopic Brostrom) between January 2018 and January 2020. All patients will fill an epidemiological questionnaire and will be evaluated for pain and function according to the Visual Analogue Scale (VAS) and the American Orthopaedic Foot and Ankle Society Score (AOFAS) at 12 months (6-24 months) average of follow-up.

Discussion: The combined medial and lateral arthroscopic repair may be an effective and safe alternative in the treatment of multidirectional instability. The inclusion of the deltoid complex and the low invasiveness of this technique can improve the clinical outcomes of these patients. Additional studies, with a prospective and comparative methodology are required to sustain this proposal.

Design: Level IV. Retrospective case series.

Keywords: ankle injuries; lateral ligament; collateral ligaments; joint instability

Detailed Description

Not available

Study Timeline

• Study Start: 2019-07-01
• Study First Submitted: 2020-07-02
• Study First Submitted QC: 2020-07-02
• Study First Posted: 2020-07-07
• Primary Completion: 2020-09-01
• Study Completion: 2021-01-01
• Status Verified: 2021-02
• Last Update Submitted: 2021-02-02
• Last Update Posted: 2021-02-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 29

Inclusion Criteria

• complaints about ankle loosening for the last six months
• clinical findings of lateral and medial instability

Exclusion Criteria

• existence of previous surgery
• autoimmune diseases
• neuropathy
• inflammatory disease
• isolated medial instability
• flatfoot
• previous ankle infiltration
• radiographic findings of ankle arthritis
• cavovarus deformity
• coagulopathies
• body mass index over 35
• associated injuries, such as osteochondral lesions
• syndesmosis instability
• tendon ruptures
• fractures

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Multidirectional	Arthroscopic Brostrom combined with Arthroscopic Deltoid Repair	Arthroscopic lateral ligament repair combined with deltoid arthroscopic ligament repair.

Primary Outcome Measures

Name	Time	Method
American Orthopedic Foot and Ankle Society - Hindfoot Score (AOFAS)	6th post-operataive month	Functional Score (0 to 100 \| 100 best score possible \| 0 worst score possible)

Secondary Outcome Measures

Name	Time	Method
Visual Analogue Scale (VAS)	6th post-operataive month	Pain Score (0 to 10 \| 10 worst score possible \| 0 best score possible)
Complications	6th post-operataive month	Surgical complications

Trial Locations

Locations (1)

Federal University of Sao Paulo; 🇧🇷 Sao Paulo, SP, Brazil