Kanzaki Noriyuki, Chinzei Nobuaki, Yamashita Takahiro, Kumai Tsukasa, Kuroda Ryosuke
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Kobe, Japan.
Orthop J Sports Med. 2020 Nov 9;8(11):2325967120962079. doi: 10.1177/2325967120962079. eCollection 2020 Nov.
Although arthroscopic lateral ligament repair (ALLR) with suture anchors for chronic lateral ankle instability has become widely accepted, some complications have been reported as well. Establishment of a new technique is essential for better clinical outcomes after ALLR.
To report a novel technique and good clinical results of ALLR using a knotless suture anchor.
Case series; Level of evidence, 4.
We examined 30 patients (16 men and 14 women) who underwent ALLR. The mean age of the patients was 30.0 years, and the average period of postoperative monitoring was 21 months. The Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale was used for clinical evaluation postoperatively, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) for patient-reported results. Surgical complications were also examined.
The JSSF ankle-hindfoot scale showed a significant improvement from preoperatively to follow-up (from 72.1 to 96.1; < 0.001), and the SAFE-Q was significantly improved in all subscales (pain and pain-related, physical function and daily living, social function, shoe-related, and general health and well-being; < 0.004 for all). Complications included residual joint pain due to remaining osteophytes in 1 case, scar pain of the accessory anterolateral portal in 2 cases, and positive Tinel sign indicative of superficial peroneal nerve irritation at the anterolateral portal in 1 case.
The clinical results of the novel ALLR technique were overall satisfactory. Knot-related complications, one of the main reasons for postoperative complications, were reduced by using a knotless suture anchor.
尽管使用缝线锚钉进行关节镜下外侧韧带修复（ALLR）治疗慢性外侧踝关节不稳已被广泛接受，但也有一些并发症的报道。建立一种新技术对于ALLR术后获得更好的临床效果至关重要。
报告一种使用无结缝线锚钉进行ALLR的新技术及良好的临床结果。
病例系列；证据水平，4级。
我们检查了30例行ALLR的患者（16例男性和14例女性）。患者的平均年龄为30.0岁，术后平均随访时间为21个月。术后临床评估采用日本足外科学会（JSSF）踝后足评分量表，患者报告结果采用自我管理足部评估问卷（SAFE-Q）。还检查了手术并发症。
JSSF踝后足评分量表显示从术前到随访有显著改善（从72.1提高到96.1；<0.001），SAFE-Q的所有子量表均有显著改善（疼痛及与疼痛相关、身体功能及日常生活、社会功能、鞋相关以及总体健康和幸福感；所有均<0.004）。并发症包括1例因残留骨赘导致的残留关节疼痛、2例副前外侧入路的瘢痕疼痛以及1例在前外侧入路出现提示腓浅神经刺激的阳性Tinel征。
新型ALLR技术的临床结果总体令人满意。使用无结缝线锚钉减少了作为术后并发症主要原因之一的与结相关的并发症。
