Mosca Massimiliano, Caravelli Silvio, Massimi Simone, Fuiano Mario, Catanese Giuseppe, Barone Giuseppe, Bragonzoni Laura, Benedetti Maria Grazia
II Clinic of Orthopaedics and Traumatology.
Dipartimento delle Scienze Biomediche e Neuromotorie.
Medicine (Baltimore). 2020 Apr;99(17):e19862. doi: 10.1097/MD.0000000000019862.
Recovery of postural control and proprioception in patients affected by chronic ankle instability (CAI) and operated on capsulo-ligaments reconstructive surgery lacks of objective assessment. The aim of this study was to evaluate long-term post-surgical postural and proprioceptive control through the DPPS device in a cohort of patients operated on ligaments reconstruction through the modified Brostrom procedure at a minimum follow up of 12 months.Eleven patients with post-traumatic lateral CAI, operated of external capsulo-ligamentous complex repair according to Brostrom technique at a minimum follow-up of 1 year were enrolled. Physical examination and American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score. Proprioceptive and postural stability was assessed by DPPS - Delos Postural Proprioceptive System, linked to a computer with a specific software and including a flat table, an electronic unstable proprioceptive board, a Delos Vertical Controller, a monitor and a horizontal bar fitted with an infra-red sensor for hand support.Patients were 5 males and 6 females, mean age of 38.4 ± 12 years. Mean BMI of the patients was 26.8 ± 4.4. Mean follow up was 13.4 ± 2.1. The mean value of (AOFAS) clinical score was 90.3/100. Mean Static Stability Index (SSI) with open eyes was 87.7% (±7.6) in the operated leg and 90.4% (±6.1) in the contra-lateral. SSI with closed eyes was 64.5% (±11.2) in the operated leg and 61.6% (±16.8) in the contra-lateral. Mean Dynamic Stability Index (DSI) without restrictions was 56.2% (±14.6) in the operated leg and 56.8% (±10.6) in the contra-lateral. DSI with restricted upper limbs, had a mean value of 56.3% (±11.4) in the operated leg and 58.1% (±11.9) in the contra-lateral.Re-tensioning capsular-ligamentous surgery of the external compartment for CAI allow to recovery proprioceptive and postural control on the operated side, comparable with data from the contralateral limb and from the healthy population of the same age and sex.
慢性踝关节不稳（CAI）患者接受关节囊韧带重建手术后姿势控制和本体感觉的恢复缺乏客观评估。本研究的目的是通过DPPS设备对一组接受改良Brostrom手术进行韧带重建的患者进行至少12个月的随访，以评估术后长期的姿势和本体感觉控制。招募了11例创伤后外侧CAI患者，他们根据Brostrom技术接受了外侧关节囊韧带复合体修复手术，至少随访1年。进行体格检查和美国矫形足踝协会（AOFAS）踝后足评分。通过DPPS - Delos姿势本体感觉系统评估本体感觉和姿势稳定性，该系统与一台装有特定软件的计算机相连，包括一张平板桌、一个电子不稳定本体感觉板、一个Delos垂直控制器、一个显示器和一个装有用于手部支撑的红外传感器的单杠。患者中男性5例，女性6例，平均年龄38.4±12岁。患者的平均体重指数为26.8±4.4。平均随访时间为13.4±2.1。（AOFAS）临床评分的平均值为90.3/100。患侧睁眼时的平均静态稳定指数（SSI）为87.7%（±7.6），对侧为90.4%（±6.1）。患侧闭眼时的SSI为64.5%（±11.2），对侧为61.6%（±16.8）。患侧无限制时的平均动态稳定指数（DSI）为56.2%（±14.6），对侧为56.8%（±10.6）。患侧上肢受限情况下的DSI平均值为56.3%（±11.4），对侧为58.1%（±11.9）。CAI患者外侧间室的关节囊韧带再张紧手术可使患侧的本体感觉和姿势控制恢复，与对侧肢体以及同年龄、同性别的健康人群的数据相当。
