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关节镜下距腓前韧带修复联合全内缝合带增强治疗伴广义关节松弛的慢性外侧踝关节不稳定。

Arthroscopic Anterior Talofibular Ligament Repair Combined With All-Inside Suture Tape Augmentation for Treatment of Chronic Lateral Ankle Instability With Generalized Joint Laxity.

机构信息

Center of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Department of Orthopaedic Surgery, University of Colorado-Anschutz Medical Campus, Denver, CO, USA.

出版信息

Foot Ankle Int. 2024 Oct;45(10):1102-1110. doi: 10.1177/10711007241271247. Epub 2024 Aug 30.

Abstract

BACKGROUND

To analyze the feasibility and clinical results of the modified Broström operation (MBO) combined with suture tape augmentation under arthroscopy for chronic lateral ankle instability (CLAI) in patients with generalized joint laxity (GJL).

METHODS

From October 2019 to October 2021, a total of 111 patients (111 ankles) treated with MBO combined with suture tape augmentation under arthroscope were retrospectively divided into a GJL group (29 patients) and a control group (82 patients). Mechanical stability of the affected ankle joint was evaluated radiographically preoperatively, at 6 months postoperatively, and the last follow-up. Complications and surgical failures, as well as visual analog scale (VAS) score, the Foot and Ankle Ability Measure (FAAM), and the Karlsson score were also recorded. All statistical analyses were completed using SPSS 20.0.

RESULTS

The average follow-up time was 21.7 ± 5.2 months for the GJL group, and 20.9 ± 5.3 months for the control group. Pain and symptoms in both groups were effectively relieved by the procedure reflected by decreased VAS scores, improved FAAM and Karlsson scores at 6 months postoperatively, and the final follow-up ( < .05). Preoperative talar tilt angle and anterior talar translation were significantly greater in the GJL group than those in the control group ( < .05). Postoperatively, both talar tilt angle and anterior talar translation were reduced in both groups at 6 months postoperatively and the last follow-up ( < .05), and we found no significant difference between the two groups ( > .05). Furthermore, we found no significant difference in VAS, FAAM, and Karlsson scores between the 2 groups 6 months postoperatively and at the last follow-up.

CONCLUSION

Arthroscopic MBO combined with suture tape augmentation is a reliable procedure for treating CLAI with GJL. At short-term follow-up, we found that the GJL group achieved an equivalent level of stability compared with the control group.

摘要

背景

分析改良 Broström 手术(MBO)联合关节镜下缝线带增强在伴全身性关节松弛(GJL)的慢性外侧踝关节不稳定(CLAI)患者中的可行性和临床结果。

方法

回顾性分析 2019 年 10 月至 2021 年 10 月期间 111 例(111 足)接受 MBO 联合关节镜下缝线带增强治疗的患者资料,根据是否存在 GJL 将患者分为 GJL 组(29 例)和对照组(82 例)。术前、术后 6 个月及末次随访时均进行影像学评估,评估患踝的机械稳定性。记录并发症及手术失败情况,采用视觉模拟评分(VAS)、足踝能力测量(FAAM)及 Karlsson 评分评估疼痛和踝关节功能。所有统计分析均采用 SPSS 20.0 完成。

结果

GJL 组的平均随访时间为 21.7±5.2 个月,对照组为 20.9±5.3 个月。两组术后 VAS 评分降低,FAAM 及 Karlsson 评分升高,疼痛及症状均得到有效缓解( < .05)。GJL 组术前距骨倾斜角及距骨前移明显大于对照组( < .05)。术后两组距骨倾斜角及距骨前移均较术前减小( < .05),但组间比较差异无统计学意义( > .05)。术后 6 个月及末次随访时,两组间 VAS、FAAM 及 Karlsson 评分比较差异均无统计学意义( > .05)。

结论

关节镜下 MBO 联合缝线带增强是治疗伴 GJL 的 CLAI 的可靠方法。短期随访发现,GJL 组与对照组相比获得了同等水平的稳定性。

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