Baray Anne-Laure, Philippot Rémi, Neri Thomas, Farizon Frédéric, Edouard Pascal
Department of Orthopaedic and Trauma Surgery, University Hospital Center of Saint-Etienne, Hôpital Nord Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France.
Laboratory of Exercise Physiology (LPE EA 4338), Lyon University, Saint-Étienne, France.
Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1108-15. doi: 10.1007/s00167-015-3793-3. Epub 2015 Sep 26.
The Hemi-Castaing ligamentoplasty uses a powerful dynamic stabilizer of the ankle which is the peroneus brevis tendon. To our knowledge, there is no study available evaluating the effects of this type of surgery on proprioceptive, muscular and posturographic parameters.
This case-control study included 39 subjects divided into two groups: the operated (n = 24) and the control group (n = 15). All subjects underwent a clinical, proprioceptive and isokinetic assessment using a CON-TREX dynamometer, and a postural evaluation using the Win-Posturo force platform.
At a mean period of 23 (SD 5.4) post-operative months, the Karlsson ankle functional score was 84.2 (SD 23.8) and the AOFAS score was 88.1 (SD 16.2). The mean ankle joint position error for operated ankles was from 1.9° (SD 0.9) at 10° of inversion range of motion to 2.5° (SD 1.7) at 20°. It was similar to that achieved in the control group ranging from 2.2° (SD 1) at 10° to 2.3° (SD 1.3) at 20°. No significant loss of ankle eversion strength could be observed after ligamentoplasty. Ankle eversion/inversion ratio when tested under all velocities and contraction modes failed to reveal any statistical difference between the operated and healthy ankles in the patient group, neither between the patient and control groups.
This surgical technique achieved excellent functional outcomes. It did not impair the agonist/antagonist balance of ankle muscles, and use of half the peroneus brevis tendon did not lessen the eversion strength.
Case-control study, Level III.
半腱肌韧带成形术使用踝关节强大的动态稳定器——腓骨短肌腱。据我们所知，尚无研究评估此类手术对本体感觉、肌肉和姿势描记参数的影响。
本病例对照研究纳入39名受试者，分为两组：手术组（n = 24）和对照组（n = 15）。所有受试者均使用CON-TREX测力计进行临床、本体感觉和等速评估，并使用Win-Posturo力平台进行姿势评估。
术后平均23（标准差5.4）个月时，卡尔森踝关节功能评分为84.2（标准差23.8），美国足踝外科协会（AOFAS）评分为88.1（标准差16.2）。手术侧踝关节在10°内翻活动范围时的平均关节位置误差为1.9°（标准差0.9），在20°时为2.5°（标准差1.7）。这与对照组在10°时为2.2°（标准差1）、20°时为2.3°（标准差1.3）的结果相似。韧带成形术后未观察到踝关节外翻力量有明显损失。在所有速度和收缩模式下测试时，患者组手术侧与健康侧踝关节的外翻/内翻比率以及患者组与对照组之间均未发现任何统计学差异。
该手术技术取得了优异的功能结果。它未损害踝关节肌肉的主动肌/拮抗肌平衡，且使用一半的腓骨短肌腱并未减弱外翻力量。
病例对照研究，III级。
