ADVANCES IN ANATOMICAL REPAIR OF CHRONIC LATERAL ANKLE INSTABILITY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANGYan ¹ ,  LIANGXiaojun ²

1. Xi'an Medical University, Xi'an Shaanxi, 710068, P. R. China;
2. Department of Foot and Ankle Surgery, Honghui Hospital, Xi'an Jiaotong University School of Medicine, Xi'an Shaanxi, 710068, P. R. China;

Corresponding author：

LIANGXiaojun, Email: lingjun33369@163.com

Keywords：

Chronic lateral ankle instability; Ligament injury; Anatomical repair; Research progress

DOI：

10.7507/1002-1892.20160319

Video：

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Objective To summarize the current status and progress of the treatment of chronic lateral ankle instability (CLAI). Methods The literature about the anatomical repair of CLAI at home and abroad was reviewed and summarized. Results Broström and its modified operations are the most common surgical treatment of CLAI. The operations showed satisfactory clinical outcomes in the short-, medium-, and long-term follow-up and low complication rate. Suture anchor technique and arthroscopic techniques are gradually used in Broström and its modified operations with satisfactory short-term effectiveness, but long-term effectiveness needs further observation because of the limitation of the short clinical application time. Conclusion Broström and its modified operations are effective, convenient, and safe to treat CLAI. Based on the researches of biomechanics and dynamic anatomy, the more personalized design of the rehabilitation program is the further research direction.

Citation： ZHANGYan, LIANGXiaojun. ADVANCES IN ANATOMICAL REPAIR OF CHRONIC LATERAL ANKLE INSTABILITY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(12): 1551-1555. doi: 10.7507/1002-1892.20160319 Copy

1.	Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg (Am), 2010, 92(13):2279-2284.
2.	Maffulli N, Ferran NA. Management of acute and chronic ankle instability. J Am Acad Orthop Surg, 2008, 16(10):608-615.
3.	Ajis A, Younger AS, Maffulli N. Anatomic repair for chronic lateral ankle instability. Foot Ankle Clin, 2006, 11(3):539-545.
4.	de Vries JS, Krips R, Sierevelt IN, et al. Interventions for treating chronic ankle instability. Cochrane Database Syst Rev, 2006, (4):CD004124.
5.	Buerer Y, Winkler M, Burn A, et al. Evaluation of a modified Broström-Gould procedure for treatment of chronic lateral ankle instability:A retrospective study with critical analysis of outcome scoring. Foot Ankle Surg, 2013, 19(1):36-41.
6.	Marx RC, Mizel MS. What's New in Foot and Ankle Surgery. J Bone Joint Surg (Am), 2015, 97(10):862-868.
7.	Michael J Coughlin, Charles L Saltzman, Robert B Anderson.曼氏足踝外科学.唐康来, 徐林, 主译.北京:人民卫生出版社, 2015:1473-1476.
8.	丁晶, 徐达传.踝关节外侧韧带和距下关节韧带修复重建的应用解剖.中国临床解剖学杂志, 2002, 20(5):366-368.
9.	van den Bekerom MP, Oostra RJ, Golanó P, et al. The anatomy in relation to injury of the lateral collateral ligaments of the ankle:a current concepts review. Clin Anat, 2008, 21(7):619-626.
10.	Khawaji B, Soames R. The anterior talofibular ligament:A detailed morphological study. Foot (Edinb), 2015, 25(3):141-147.
11.	Broström L. Sprained ankles.3.Clinical observations in recent ligament ruptures. Acta Chir Scand, 1965, 130(6):560-569.
12.	Ferran NA, Maffulli N. Epidemiology of sprains of the lateral ankle ligament complex. Foot Ankle Clin, 2006, 11(3):659-662.
13.	Huang B, Kim YT, Kim JU, et al. Modified Broström procedure for chronic ankle instability with generalized joint hypermobility. Am J Sports Med, 2016, 44(4):1011-1016.
14.	Cho BK, Kim YM, Kim DS, et al. Outcomes of the modified Broström procedure using suture anchors for chronic lateral ankle instability-a prospective, randomized comparison between single and double suture anchors. J Foot Ankle Surg, 2013, 52(1):9-15.
15.	Burrus MT, Werner BC, Hadeed MM, et al. Predictors of peroneal pathology in Broström-Gould ankle ligament reconstruction for lateral ankle instability. Foot Ankle Int, 2015, 36(3):268-276.
16.	Xu HX, Lee KB. Modified Broström procedure for chronic lateral ankle instability in patients with generalized joint laxity. Am J Sports Med, 2016, 44(8):173-179.
17.	Baumhauer JF, O'Brien T. Surgical considerations in the treatment of ankle instability. J Athl Training, 2002, 37(4):458-462.
18.	Broström L. Sprained ankles. Ⅵ. Surgical treatment of "chronic" ligament ruptures. Acta Chir Scand, 1966, 132(5):551-556.
19.	Lee KT, Park YU, Kim JS, et al. Long-term results after modified Broström procedure without calcaneofibular ligament reconstruction. Foot Ankle Int, 2011, 32(2):153-157.
20.	Karlsson J, Bergsten T, Lansinger O, et al. Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J Bone Joint Surg (Am), 1988, 70(4):581-588.
21.	Gould N, Seligson D, Gassman J. Early and late repair of lateral ligament of the ankle. Foot Ankle, 1980, 1(2):84-89.
22.	Sjølin SU, Dons-Jensen H, Simonsen O. Reinforced anatomical reconstruction of the anterior talofibular ligament in chronic anterolateral instability using a periosteal flap. Foot Ankle, 1991, 12(1):15-18.
23.	Hess A, Caborn D, Rehak D, et al. Surgical treatment of chronic lateral ankle instability using the Mitek suture anchor system. Pittsburgh Orthop J, 1991, 27(2):54-59.
24.	Messer TM, Cummins CA, Ahn J, et al. Outcome of the modified Broström procedure for chronic lateral ankle instability using suture anchors. Foot Ankle Int, 2000, 21(12):996-1003.
25.	Li X, Killie H, Guerrero P, et al. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete:functional outcomes after the modified Broström repair using suture anchors. Am J Sports Med, 2009, 37(3):488-494.
26.	Brown CA, Hurwit D, Behn A, et al. Biomechanical comparison of an all soft suture anchor with a modified Broström-Gould suture repair for lateral ligament reconstruction. Am J Sports Med, 2014, 42(2):417-422.
27.	Waldrop NE 3rd, Wijdicks CA, Jansson KS, et al. Anatomic suture anchor versus the Broström technique for anterior talofibular ligament repair:a biomechanical comparison. Am J Sports Med, 2012, 40(11):2590-2596.
28.	Hu CY, Lee KB, Song EK, et al. Comparison of bone tunnel and suture anchor techniques in the modified Broström procedure for chronic lateral ankle instability. Am J Sports Med, 2013, 41(8):1877-1884.
29.	Cho BK, Kim YM, Kim DS, et al. Comparison between suture anchor and transosseous suture for the modified-Broström procedure. Foot Ankle Int, 2012, 33(6):462-468.
30.	Hawkins RB. Arthroscopic stapling repair for chronic lateral instability. Clin Podiatr Med Surg, 1987, 4(4):875-883.
31.	Cottom JM, Baker JS, Richardson PE. The "All-Inside" arthroscopic Broström procedure wth additional suture anchor augmentation:a prospective study of 45 consecutive patients. J Foot Ankle Surg, 2016, 55(6):1223-1228.
32.	Giza E, Whitlow SR, Williams BT, et al. Biomechanical analysis of an arthroscopic Broström ankle ligament repair and a suture anchor-augmented repair. Foot Ankle Int, 2015, 36(7):836-841.
33.	Bell SJ, Mologne TS, Sitler DF, et al. Twenty-six-year results after Broström procedure for chronic lateral ankle instability. Am J Sports Med, 2006, 34(6):975-978.
34.	Wainright WB, Spritzer CE, Lee JY, et al. The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics. Am J Sports Med, 2012, 40(9):2099-2104.
35.	Brodsky AR, O'Malley MJ, Bohne WH, et al. An analysis of outcome measures following the Broström-Gould procedure for chronic lateral ankle instability. Foot Ankle Int, 2005, 26(10):816-819.
36.	Baumhauer JF, O'Brien T. Surgical considerations in the treatment of ankle instability. J Athl Train, 2002, 37(4):458-462.
37.	Krips R, van Dijk CN, Halasi PT, et al. Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint:a multicenter study. Foot Ankle Int, 2001, 22(5):415-421.
38.	Hennrikus WL, Mapes RC, Lyons PM, et al. Outcomes of the Chrismann-Snook and modified Brostrom procedures for chronic lateral ankle instability. A prospective, randomized comparison. Am J Sports Med, 1996, 24(4):400-404.
39.	Mabit C, Chaudruc JM, Fiorenza F, et al. Lateral ligament reconstruction of the ankle:comparative study of peroneus brevis tenodesis versus periosteal ligamentoplasty. Foot Ankle Surg, 1998, 4(2):71-76.
40.	Liu SH, Baker CL. Comparison of lateral ankle ligamentous reconstruction procedures. Am J Sports Med, 1994, 22(3):313-317.
41.	Yasui Y, Takao M, Miyamoto W, et al. Simultaneous surgery for chronic lateral ankle instability accompanied by only subchondral bone lesion of talus. Arch Orthop Trauma Surg, 2014, 134(6):821-827.
42.	Yeo ED, Lee KT, Sung IH, et al. Comparison of all-inside arthroscopic and open techniques for the modified Broström procedure for ankle instability. Foot Ankle Int, 2016, 37(10):1037-1045.

1. Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg (Am), 2010, 92(13):2279-2284.
2. Maffulli N, Ferran NA. Management of acute and chronic ankle instability. J Am Acad Orthop Surg, 2008, 16(10):608-615.
3. Ajis A, Younger AS, Maffulli N. Anatomic repair for chronic lateral ankle instability. Foot Ankle Clin, 2006, 11(3):539-545.
4. de Vries JS, Krips R, Sierevelt IN, et al. Interventions for treating chronic ankle instability. Cochrane Database Syst Rev, 2006, (4):CD004124.
5. Buerer Y, Winkler M, Burn A, et al. Evaluation of a modified Broström-Gould procedure for treatment of chronic lateral ankle instability:A retrospective study with critical analysis of outcome scoring. Foot Ankle Surg, 2013, 19(1):36-41.
6. Marx RC, Mizel MS. What's New in Foot and Ankle Surgery. J Bone Joint Surg (Am), 2015, 97(10):862-868.
7. Michael J Coughlin, Charles L Saltzman, Robert B Anderson.曼氏足踝外科学.唐康来, 徐林, 主译.北京:人民卫生出版社, 2015:1473-1476.
8. 丁晶, 徐达传.踝关节外侧韧带和距下关节韧带修复重建的应用解剖.中国临床解剖学杂志, 2002, 20(5):366-368.
9. van den Bekerom MP, Oostra RJ, Golanó P, et al. The anatomy in relation to injury of the lateral collateral ligaments of the ankle:a current concepts review. Clin Anat, 2008, 21(7):619-626.
10. Khawaji B, Soames R. The anterior talofibular ligament:A detailed morphological study. Foot (Edinb), 2015, 25(3):141-147.
11. Broström L. Sprained ankles.3.Clinical observations in recent ligament ruptures. Acta Chir Scand, 1965, 130(6):560-569.
12. Ferran NA, Maffulli N. Epidemiology of sprains of the lateral ankle ligament complex. Foot Ankle Clin, 2006, 11(3):659-662.
13. Huang B, Kim YT, Kim JU, et al. Modified Broström procedure for chronic ankle instability with generalized joint hypermobility. Am J Sports Med, 2016, 44(4):1011-1016.
14. Cho BK, Kim YM, Kim DS, et al. Outcomes of the modified Broström procedure using suture anchors for chronic lateral ankle instability-a prospective, randomized comparison between single and double suture anchors. J Foot Ankle Surg, 2013, 52(1):9-15.
15. Burrus MT, Werner BC, Hadeed MM, et al. Predictors of peroneal pathology in Broström-Gould ankle ligament reconstruction for lateral ankle instability. Foot Ankle Int, 2015, 36(3):268-276.
16. Xu HX, Lee KB. Modified Broström procedure for chronic lateral ankle instability in patients with generalized joint laxity. Am J Sports Med, 2016, 44(8):173-179.
17. Baumhauer JF, O'Brien T. Surgical considerations in the treatment of ankle instability. J Athl Training, 2002, 37(4):458-462.
18. Broström L. Sprained ankles. Ⅵ. Surgical treatment of "chronic" ligament ruptures. Acta Chir Scand, 1966, 132(5):551-556.
19. Lee KT, Park YU, Kim JS, et al. Long-term results after modified Broström procedure without calcaneofibular ligament reconstruction. Foot Ankle Int, 2011, 32(2):153-157.
20. Karlsson J, Bergsten T, Lansinger O, et al. Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J Bone Joint Surg (Am), 1988, 70(4):581-588.
21. Gould N, Seligson D, Gassman J. Early and late repair of lateral ligament of the ankle. Foot Ankle, 1980, 1(2):84-89.
22. Sjølin SU, Dons-Jensen H, Simonsen O. Reinforced anatomical reconstruction of the anterior talofibular ligament in chronic anterolateral instability using a periosteal flap. Foot Ankle, 1991, 12(1):15-18.
23. Hess A, Caborn D, Rehak D, et al. Surgical treatment of chronic lateral ankle instability using the Mitek suture anchor system. Pittsburgh Orthop J, 1991, 27(2):54-59.
24. Messer TM, Cummins CA, Ahn J, et al. Outcome of the modified Broström procedure for chronic lateral ankle instability using suture anchors. Foot Ankle Int, 2000, 21(12):996-1003.
25. Li X, Killie H, Guerrero P, et al. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete:functional outcomes after the modified Broström repair using suture anchors. Am J Sports Med, 2009, 37(3):488-494.
26. Brown CA, Hurwit D, Behn A, et al. Biomechanical comparison of an all soft suture anchor with a modified Broström-Gould suture repair for lateral ligament reconstruction. Am J Sports Med, 2014, 42(2):417-422.
27. Waldrop NE 3rd, Wijdicks CA, Jansson KS, et al. Anatomic suture anchor versus the Broström technique for anterior talofibular ligament repair:a biomechanical comparison. Am J Sports Med, 2012, 40(11):2590-2596.
28. Hu CY, Lee KB, Song EK, et al. Comparison of bone tunnel and suture anchor techniques in the modified Broström procedure for chronic lateral ankle instability. Am J Sports Med, 2013, 41(8):1877-1884.
29. Cho BK, Kim YM, Kim DS, et al. Comparison between suture anchor and transosseous suture for the modified-Broström procedure. Foot Ankle Int, 2012, 33(6):462-468.
30. Hawkins RB. Arthroscopic stapling repair for chronic lateral instability. Clin Podiatr Med Surg, 1987, 4(4):875-883.
31. Cottom JM, Baker JS, Richardson PE. The "All-Inside" arthroscopic Broström procedure wth additional suture anchor augmentation:a prospective study of 45 consecutive patients. J Foot Ankle Surg, 2016, 55(6):1223-1228.
32. Giza E, Whitlow SR, Williams BT, et al. Biomechanical analysis of an arthroscopic Broström ankle ligament repair and a suture anchor-augmented repair. Foot Ankle Int, 2015, 36(7):836-841.
33. Bell SJ, Mologne TS, Sitler DF, et al. Twenty-six-year results after Broström procedure for chronic lateral ankle instability. Am J Sports Med, 2006, 34(6):975-978.
34. Wainright WB, Spritzer CE, Lee JY, et al. The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics. Am J Sports Med, 2012, 40(9):2099-2104.
35. Brodsky AR, O'Malley MJ, Bohne WH, et al. An analysis of outcome measures following the Broström-Gould procedure for chronic lateral ankle instability. Foot Ankle Int, 2005, 26(10):816-819.
36. Baumhauer JF, O'Brien T. Surgical considerations in the treatment of ankle instability. J Athl Train, 2002, 37(4):458-462.
37. Krips R, van Dijk CN, Halasi PT, et al. Long-term outcome of anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint:a multicenter study. Foot Ankle Int, 2001, 22(5):415-421.
38. Hennrikus WL, Mapes RC, Lyons PM, et al. Outcomes of the Chrismann-Snook and modified Brostrom procedures for chronic lateral ankle instability. A prospective, randomized comparison. Am J Sports Med, 1996, 24(4):400-404.
39. Mabit C, Chaudruc JM, Fiorenza F, et al. Lateral ligament reconstruction of the ankle:comparative study of peroneus brevis tenodesis versus periosteal ligamentoplasty. Foot Ankle Surg, 1998, 4(2):71-76.
40. Liu SH, Baker CL. Comparison of lateral ankle ligamentous reconstruction procedures. Am J Sports Med, 1994, 22(3):313-317.
41. Yasui Y, Takao M, Miyamoto W, et al. Simultaneous surgery for chronic lateral ankle instability accompanied by only subchondral bone lesion of talus. Arch Orthop Trauma Surg, 2014, 134(6):821-827.
42. Yeo ED, Lee KT, Sung IH, et al. Comparison of all-inside arthroscopic and open techniques for the modified Broström procedure for ankle instability. Foot Ankle Int, 2016, 37(10):1037-1045.

Chinese Journal of Reparative and Reconstructive Surgery

ADVANCES IN ANATOMICAL REPAIR OF CHRONIC LATERAL ANKLE INSTABILITY

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