Mercer Nathaniel P, Kanakamedala Ajay C, Azam Mohammad T, Hurley Eoghan T, Samsonov Alan P, Walls Raymond J, Kennedy John G
Department of Orthopaedic Surgery, NYU Langone Health, New York, New York, USA.
Royal College of Surgeons in Ireland, Dublin, Ireland.
Orthop J Sports Med. 2022 May 24;10(5):23259671221095791. doi: 10.1177/23259671221095791. eCollection 2022 May.
There is minimal literature on the use of suture tape augmentation in the treatment of chronic lateral ankle instability (CLAI), prompting an investigation on its use and effect during surgery of the lateral ankle.
To evaluate the evidence for the use of suture tape augmentation in the treatment of CLAI and the outcomes after this procedure.
Systematic review; Level of evidence, 4.
A literature search was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they evaluated the use of suture tape for CLAI. Outcome measures included the Foot and Ankle Ability Measure, American Orthopaedic Foot and Ankle Society (AOFAS) score, return to play, and radiological improvement in anterior talar translation and talar tilt angle. Quantitative and qualitative analyses were performed.
There were 11 studies (2 with level 2 evidence, 1 with level 3, and 8 with level 4) including 334 patients (334 ankles) that underwent suture-tape augmentation. The mean age was 27.3 years, 67.3% were women, and the mean follow-up was 27.6 months (range, 11.5-38.5 months). The mean weighted postoperative AOFAS score was 95, and 87.7% were able to return to sports. Overall, 9 recurrent instability events (4.1%) were reported. In 3 studies that compared Broström repair and suture tape augmentation, there were no significant differences between the procedures in recurrent instability (mean difference [MD], 0.81 [95% CI, 0.19 to 3.50]; = 0%; = .78), Foot and Ankle Ability Measure (MD, 1.24 [95% CI, -3.73 to 6.21]; = 66%; = .63), talar tilt angle improvement (MD, -0.07 [95% CI, -0.68 to 0.54]; = 0%; = .42), or anterior talar translation improvement (MD, -0.06 [95% CI, -0.69 to 0.56]; = 0%; = .77).
Suture tape augmentation did not significantly improve clinical or radiological outcomes in the setting of modified Broström repair for CLAI. There is currently insufficient evidence to recommend suture tape augmentation for all patients at this time.
关于使用缝线带增强术治疗慢性外侧踝关节不稳（CLAI）的文献极少，这促使我们对其在外侧踝关节手术中的应用及效果进行研究。
评估使用缝线带增强术治疗CLAI的证据以及该手术后的结果。
系统评价；证据等级为4级。
按照PRISMA（系统评价和Meta分析的首选报告项目）指南进行文献检索。纳入评估缝线带用于CLAI治疗的研究。观察指标包括足踝功能测量、美国矫形足踝协会（AOFAS）评分、恢复运动情况以及距骨前移和距骨倾斜角的影像学改善。进行了定量和定性分析。
有11项研究（2项为2级证据，1项为3级，8项为4级），共334例患者（334个踝关节）接受了缝线带增强术。平均年龄为27.3岁，67.3%为女性，平均随访时间为27.6个月（范围11.5 - 38.5个月）。术后AOFAS评分的平均加权值为95分，87.7%的患者能够恢复运动。总体上，报告了9例复发性不稳事件（4.1%）。在3项比较Broström修复术和缝线带增强术的研究中，两种手术在复发性不稳（平均差值[MD]，0.81[95%可信区间，0.19至3.50]；P = 0%；I² = 0%；P = 0.78）、足踝功能测量（MD，1.24[95%可信区间，-3.73至6.21]；P = 66%；I² = 0%；P = 0.63）、距骨倾斜角改善（MD，-0.07[95%可信区间，-0.68至0.54]；P = 0%；I² = 0%；P = 0.42）或距骨前移改善（MD，-0.06[95%可信区间，-0.69至0.56]；P = 0%；I² = 0%；P = 0.77）方面无显著差异。
在改良Broström修复术治疗CLAI的情况下，缝线带增强术并未显著改善临床或影像学结果。目前没有足够的证据推荐此时对所有患者使用缝线带增强术。
