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年轻慢性踝关节不稳女性患者中使用缝线带增强外侧韧带与改良 Broström 修复术的随机对照比较。

A randomized comparison between lateral ligaments augmentation using suture-tape and modified Broström repair in young female patients with chronic ankle instability.

作者信息

Cho Byung-Ki, Park Ji-Kang, Choi Seung-Myung, SooHoo Nelson F

机构信息

Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.

Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.

出版信息

Foot Ankle Surg. 2019 Apr;25(2):137-142. doi: 10.1016/j.fas.2017.09.008. Epub 2017 Oct 18.

Abstract

BACKGROUND

Although various minimally invasive procedures for chronic ankle instability are increasingly being used, a question regarding whether these procedures can be a viable alternative of the modified Broström procedure remains controversial. This study was conducted to compare the intermediate-term clinical outcomes between lateral ligaments augmentation using suture-tape and modified Broström repair in a selected cohort of patients.

METHODS

Sixty female patients with chronic lateral ankle instability were randomly assigned and underwent surgical treatments by one surgeon. Twenty-eight patients with suture-tape augmentation and 27 modified Broström procedures were followed ≥2 years and analysed in this comparative study. The clinical evaluation included the Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), and stress radiographs. Medical expense related with operation was analysed to evaluate the cost-effectiveness.

RESULTS

There were no statistically significant differences in the clinical outcomes between two procedures based on FAOS, FAAM, recurrence rate of instability, and stress radiographs. Total medical expense was approximately 1.3 times more in the suture-tape group (P<0.001), despite shorter operation time.

CONCLUSIONS

Lateral ankle ligaments augmentation using suture-tape showed the similar clinical outcomes but low cost-effectiveness, as compared to modified Broström repair for young female patients with chronic ankle instability.

摘要

背景

尽管各种用于慢性踝关节不稳的微创手术越来越多地被采用,但这些手术能否成为改良 Broström 手术的可行替代方案仍存在争议。本研究旨在比较在一组选定患者中,使用缝线带进行外侧韧带增强术与改良 Broström 修复术的中期临床结果。

方法

60 名患有慢性外侧踝关节不稳的女性患者被随机分组,由一名外科医生进行手术治疗。本比较研究对 28 例行缝线带增强术的患者和 27 例行改良 Broström 手术的患者进行了≥2 年的随访并分析。临床评估包括足踝结果评分(FAOS)、足踝能力测量(FAAM)和应力 X 线片。分析与手术相关的医疗费用以评估成本效益。

结果

基于 FAOS、FAAM、不稳复发率和应力 X 线片,两种手术的临床结果在统计学上无显著差异。尽管手术时间较短,但缝线带组的总医疗费用约高出 1.3 倍(P<0.001)。

结论

对于患有慢性踝关节不稳的年轻女性患者,与改良 Broström 修复术相比,使用缝线带进行外侧踝关节韧带增强术显示出相似的临床结果,但成本效益较低。

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