Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Department of Orthopedics, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China.
Knee Surg Sports Traumatol Arthrosc. 2018 Oct;26(10):3135-3139. doi: 10.1007/s00167-017-4813-2. Epub 2017 Nov 30.
This study aimed to investigate the results of arthroscopic treatment combined with ankle stabilization procedure for sinus tarsi syndrome (STS) in patients with chronic ankle instability (CAI).
A total of 57 patients (31 males and 26 females, average age 29.9 ± 8.4 years ranging from 15 to 52 years) with STS and CAI who accepted operation from 2013 to 2015 were included in this retrospective study. Surgical procedures included thorough tarsal sinus debridement and repair or reconstruction of lateral ankle ligaments according to the quality of ligaments. American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson score, and Tegner score were evaluated preoperatively and at final follow-up.
All the patients accepted thorough debridement of tarsal sinus. Of these, 53 patients (93.0%) had an arch structure between the posterior subtalar joint and the middle subtalar joint. Further, 54 patients accepted lateral ankle ligament repair, and 3 patients accepted ligament reconstruction. A total of 40 patients were followed up with an average time of 30.7 months. The modified AOFAS score increased from 62.5 (27-90) to 93 (67-100), the Karlsson score increased from 57 (30-82) to 90 (55-100), and the Tegner score increased from 1 (1-3) to 5 (1-8).
Arthroscopic treatment combined with the ankle stabilization procedure could get satisfactory results for STS in patients with CAI. The arch structure composed by medial calcaneal component of the medial root of the inferior extensor retinaculum (MCC) might contribute to the pathological mechanism of STS.
IV.
本研究旨在探讨关节镜下治疗联合跗骨窦稳定术治疗慢性踝关节不稳定（CAI）伴跗骨窦综合征（STS）的疗效。
回顾性分析 2013 年至 2015 年收治的 57 例（男 31 例，女 26 例；平均年龄 29.9±8.4 岁，15~52 岁）CAI 伴 STS 患者的临床资料。根据韧带质量，手术包括彻底清除跗骨窦、修复或重建外侧踝关节韧带。术前及末次随访时采用美国足踝外科协会（AOFAS）踝与后足评分、Karlsson 评分及 Tegner 评分评估疗效。
所有患者均行彻底跗骨窦清创术，其中 53 例（93.0%）后距下关节与中距下关节之间存在弓状结构。54 例患者行外侧踝关节韧带修复，3 例患者行韧带重建。40 例患者获得平均 30.7 个月的随访，改良 AOFAS 评分由术前的 62.5（2790）分提高至术后的 93 分（67100 分），Karlsson 评分由术前的 57 分（3082 分）提高至术后的 90 分（55100 分），Tegner 评分由术前的 1 分（13 分）提高至术后的 5 分（18 分）。
关节镜下治疗联合跗骨窦稳定术治疗 CAI 伴 STS 可获得满意疗效，可能与内侧跟骨部分构成的下伸肌支持带内侧根（MCC）弓状结构有关。
IV 级。
