Lopes Ronny, Hong Choon Chiet, Calder James, Kerkhoffs Gino M M J
Department of Orthopaedic Surgery and Sports Medicine Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay- Generale de Sante, Hôpital Privé Jean Mermoz Lyon France.
Department of Orthopaedic Surgery National University Hospital Singapore.
J Exp Orthop. 2025 Mar 22;12(1):e70214. doi: 10.1002/jeo2.70214. eCollection 2025 Jan.
To identify, review and summarize risk factors for failure of lateral ankle ligament operative treatment for chronic lateral ankle instability (CLAI).
A Systematic review according to PRISMA guidelines was performed. In July 2023, a bibliographic search of the PubMed, Medline, CINAHL, Cochrane, and Embase databases was performed. Articles were included if they were quantitative studies published in English and reported risk factors for recurrence of instability.
A total of 496 articles were identified using the search strategy, and nine articles were included. All were low-quality cohort studies (level 3 or 4 evidence). These nine studies comprising 762 participants met the criteria for inclusion. Eighty-nine patients (11%) had treatment failure as defined by recurrence of instability, with rates ranging from 5.7% to 28.5%. Six risk factors were divided into three categories: patient demographics (generalized joint laxity [GJL], high-level sports activities and female sex), imaging features (varus hindfoot alignment), and surgical findings (poor quality of the remnant lateral ligaments, intraoperative syndesmosis widening).
The presence of risk factors such as GJL, high-level sports activities, female sex, varus hindfoot alignment, poor ligament quality, and intraoperative syndesmosis widening should guide surgical strategy to reduce the risk of treatment failure in lateral ankle ligament repair for CLAI.
Level IV, systematic review.
识别、回顾和总结慢性外侧踝关节不稳（CLAI）外侧踝关节韧带手术治疗失败的风险因素。
按照PRISMA指南进行系统评价。2023年7月，对PubMed、Medline、CINAHL、Cochrane和Embase数据库进行文献检索。纳入以英文发表的定量研究且报告了不稳定复发风险因素的文章。
使用检索策略共识别出496篇文章，纳入9篇。均为低质量队列研究（3级或4级证据）。这9项研究共762名参与者符合纳入标准。89例患者（11%）出现定义为不稳定复发的治疗失败，发生率为5.7%至28.5%。六个风险因素分为三类：患者人口统计学特征（全身性关节松弛[GJL]、高水平体育活动和女性）、影像学特征（后足内翻对线）和手术发现（残余外侧韧带质量差、术中下胫腓联合增宽）。
GJL、高水平体育活动、女性、后足内翻对线、韧带质量差和术中下胫腓联合增宽等风险因素的存在应指导手术策略，以降低CLAI外侧踝关节韧带修复治疗失败的风险。
IV级，系统评价。
