Sano Shohei, Kanzaki Noriyuki, Kataoka Kiminari, Nukuto Koji, Yamamoto Tetsuya, Nakanishi Yuta, Nishida Kyohei, Nagai Kanto, Hoshino Yuichi, Matsushita Takehiko, Kuroda Ryosuke
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2024 Nov 26;39:9-14. doi: 10.1016/j.asmart.2024.11.002. eCollection 2025 Jan.
There are reports indicating that between 10 and 38.5 % of patients with chronic lateral ankle instability (CLAI) have an os subfibulare. In cases where CLAI accompanied by os subfibulare is resistant to conservative treatment, surgery may be necessary; however, there is no consensus on the most appropriate surgical method. We report outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare at our hospital, followed for over 2 years post-operatively.
We reviewed 33 patients (39 ankles) whom underwent arthroscopic lateral ankle ligament repair (ALLR) for CLAI and followed for at least 2 years post-operatively between November 2015 and May 2020. Patients were classified into two groups: a group with os subfibulare (ossicle group) and a group without os subfibulare (non-ossicle group), based on the presence of an os subfibulare on pre-operative plain radiographs. ALLR surgeries were performed without resection of the os subfibulare in ossicle group. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot (JSSF) scale and the Self-administered Foot Evaluation Questionnaire (SAFE-Q). In addition, the bone-union rate was evaluated by using plain computer tomography in the ossicle group.
There were significant improvements in the mean total JSSF scale scores from pre-operative to post-operative measurements in both the ossicle and non-ossicle groups. The mean scores for pain and related symptoms, foot function and activities of daily living, social functioning, shoe-related, and general health and well-being subscales of the SAFE-Q also showed significant improvements in both groups. There were no significant differences between the post-operative ossicle and non-ossicle groups regarding the JSSF scale scores or the SAFE-Q subscale scores. In the ossicle group, the bone-union rate was 14.3 % (2 of 14 ankles), but no symptom recurrence was observed.
The 2 years outcomes of arthroscopic lateral ligament repair for chronic lateral ankle instability with os subfibulare revealed good results and no symptom recurrence.
有报告表明，在慢性外侧踝关节不稳（CLAI）患者中，10%至38.5%的患者存在腓骨下骨。在伴有腓骨下骨的CLAI病例中，如果保守治疗无效，则可能需要手术治疗；然而，对于最合适的手术方法尚无共识。我们报告了我院对伴有腓骨下骨的慢性外侧踝关节不稳进行关节镜下外侧韧带修复的结果，并在术后进行了超过2年的随访。
我们回顾了2015年11月至2020年5月期间接受关节镜下外侧踝关节韧带修复（ALLR）治疗CLAI且术后至少随访2年的33例患者（39个踝关节）。根据术前X线平片上是否存在腓骨下骨，将患者分为两组：有腓骨下骨的组（小骨组）和无腓骨下骨的组（无小骨组）。小骨组在ALLR手术中未切除腓骨下骨。使用日本足外科学会（JSSF）量表和自我足部评估问卷（SAFE-Q）评估临床结果。此外，在小骨组中使用普通计算机断层扫描评估骨愈合率。
小骨组和无小骨组术前至术后测量的JSSF量表总分平均均有显著改善。SAFE-Q的疼痛及相关症状、足部功能和日常生活活动、社会功能、鞋类相关以及总体健康和幸福感子量表的平均得分在两组中也均有显著改善。术后小骨组和无小骨组在JSSF量表得分或SAFE-Q子量表得分方面无显著差异。在小骨组中，骨愈合率为14.3%（14个踝关节中有2个），但未观察到症状复发。
对伴有腓骨下骨的慢性外侧踝关节不稳进行关节镜下外侧韧带修复的2年结果显示效果良好且无症状复发。
