Department of Orthopedic Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Orthopaedic Foot and Ankle Center, Shiseikai Daini Hospital, Setagaya-ku, Tokyo, Japan.
Foot Ankle Int. 2023 Sep;44(9):872-878. doi: 10.1177/10711007231181123. Epub 2023 Jun 30.
Hindfoot varus deformity is a known risk factor for chronic lateral ankle instability (CLAI). The impact of this deformity on clinical results following arthroscopic lateral ankle ligament repair (ALLR) for CLAI has not been studied.
Sixty-three ankles from 62 patients who received ALLR for CLAI were retrospectively examined. Preoperative plain radiographs were used to measure tibial articular surface (TAS) angles, and long axial hindfoot alignment radiographs were used to measure tibiocalcaneal angles (TCAs) pre- and postoperatively. Results included ratings on the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) and recurrent ankle instability (respraining of the operated ankle following surgery).
Recurrent ankle instability, defined as incidence of any new ankle sprain after surgery reported in the follow-up period, occurred in 13 ankles. The TAS angles of these patients were significantly low, and their preoperative TCA was significantly high. Multivariate analysis showed that preoperative TCA was an independent risk factor for recurrent ankle instability. The threshold values for preoperative TCA for recurrent instability were determined via the receiver operating characteristic curve analysis to be 3.4 degrees. Patients were assigned to a low- or high-TCA group based on the reported average TCA (2.7 degrees) of healthy patients. In the high-TCA group, recurrent instability was significantly more frequent, and the scores on the pain subscale of the postoperative SAFE-Q were significantly lower.
Hindfoot varus alignment was associated with pooreroutcomes after ALLR.
Level III, retrospective comparative study.
后足内翻畸形是慢性外侧踝关节不稳定（CLAI）的已知危险因素。尚未研究这种畸形对 CLAI 关节镜下外侧踝关节韧带修复（ALLR）后临床结果的影响。
回顾性检查了 62 名患者的 63 例接受 ALLR 治疗 CLAI 的踝关节。使用术前普通 X 线片测量胫骨关节面（TAS）角，使用长轴向后足对线 X 线片测量术前和术后距骨跟骨角（TCAs）。结果包括自我管理足部评估问卷（SAFE-Q）评分和复发性踝关节不稳定（手术后手术踝关节扭伤复发）。
复发性踝关节不稳定定义为手术后随访期间报告的任何新踝关节扭伤的发生率，发生在 13 例踝关节中。这些患者的 TAS 角度明显较低，术前 TCA 明显较高。多变量分析表明，术前 TCA 是复发性踝关节不稳定的独立危险因素。通过受试者工作特征曲线分析确定术前 TCA 的临界值为 3.4 度。根据健康患者报告的平均 TCA（2.7 度），患者被分配到低 TCA 或高 TCA 组。在高 TCA 组中，复发性不稳定明显更为频繁，术后 SAFE-Q 疼痛子量表评分明显较低。
后足内翻对线与 ALLR 后结局较差相关。
III 级，回顾性比较研究。
