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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2012, Number 2

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An Med Asoc Med Hosp ABC 2012; 57 (2)

Arthroscopic diagnosis of associated lesions of lateral ankle instability

Sánchez BM, González UH, Camacho GJ

Language: Spanish
References: 13
Page: 123-128
PDF size: 132.04 Kb.


ABSTRACT

Introduction: Chronic ankle instability is associated with multiple lesions such as osteochondral lesions of the talus, anterior impingement, loose bodies or peroneal tendon rupture. This type of injuries are associated with long term morbidity in patients with ligament reconstruction, magnetic resonance is important for diagnosis of this lesions. Method: We review 18 ankle lateral ligament reconstructions from 2007 to 2011, all of the patients had a magnetic resonance before underwent ankle arthroscopy, we identified 13 osteochondral lesions treated before the open reconstruction. AOFAS scale (American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale) were applied pre and postoperative. All the magnetic resonances were reviewed postoperative and by a second radiologist. Results: Only 9 of the 13 osteochondral lesions detected during the ankle arthroscopy were described in the magnetic resonance, 8 lesions were detected by the second radiologist. All the lesions were confirmed postoperative in the magnetic resonances. Improvement of 25 points in the AOFAS scales were obtained. Discussion: The impact in long term of the lesions have not been studied yet, we recommend to do an ankle arthroscopy in every ankle ligament reconstruction in patients with ankle instability pain and swelling after physical activity and normal or subchondral edema in the MRI.


REFERENCES

  1. O’Neil P. Is MRI adequate to detect lesions in patients with ankle instability? Clin Orthop Relat Res 2010; 468: 1115-1119.

  2. Garrick JG. The frequency of injury, mechanism of injury and epidemiology of ankle sprains. Am J Sports Med 1977; 5: 241-242.

  3. Hintermann B, Boss A, Schafer D. Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med 2002; 30: 402-409.

  4. Freeman MA. Instability of the foot after injuries to the lateral ligament of the ankle. J Bone Joint Surg Br 1965; 47: 669-677.

  5. Karlsson J. Bergsten T, Lansinger O, Peterson L. Lateral instability of the ankle treated by the Evans procedure: a Long-term clinical and radiological follow-up. J Bone Joint Surg Br 1988; 70: 476-480.

  6. DiGiovanni BF, Fraga CJ, Cohen BE, Shereff MJ. Associated injuries found in chronic lateral ankle instability. Foot Ankle Int 2000; 21: 809-815.

  7. Ferkel RD, Chams RN. Chronic lateral instability: arthroscopic findings and long-term results. Foot Ankle Int 2007; 28: 24-31.

  8. Komenda GA. Ferkel RD. Arthroscopic findings associated with the unstable ankle. Foot Ankle Int 1999; 20: 708-713.

  9. Sammarco GJ, DiRaimondo CV. Surgical treatment of lateral ankle instability syndrome. Am J Sports Med 1988; 16: 501-511.

  10. Taga I, Shino K, Inoue M, Nakata K, Maeda A. Articular cartilage lesions in ankles with lateral ligament injury: an arthroscopic study. Am J Sports Med 1993; 21: 120-126.

  11. Rolf CG, Barclay C, Riyami M, George J. The importance of early arthroscopy in athletes with painful cartilage lesions of the ankle: a prospective study of 61 consecutive cases. J Bone Joint Surg Br 1961; 43-B: 752-757.

  12. Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43: 752-757.

  13. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle hindfoot, mid-foot, hallux and lesser toes. Foot Ankle Int 1994; 15: 349-353.




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