Arthroscopic All-Inside Anterior Talofibular Ligament Repair with and without Inferior Extensor Retinacular Reinforcement A Prospective Randomized Study
- Authors
- Jo, Joon; Lee, Jin Woo; Kim, Hak Jun; Suh, Dong Hun; Kim, Won Seok; Choi, Gi Won
- Issue Date
- Sep-2021
- Publisher
- Journal of Bone and Joint Surgery
- Citation
- Journal of Bone and Joint Surgery - Series A, v.103, no.17, pp 1578 - 1587
- Pages
- 10
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Bone and Joint Surgery - Series A
- Volume
- 103
- Number
- 17
- Start Page
- 1578
- End Page
- 1587
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54794
- DOI
- 10.2106/JBJS.20.01696
- ISSN
- 0021-9355
1535-1386
- Abstract
- Background
The utility of inferior extensor retinacular (IER) reinforcement for arthroscopic repair of a lateral ankle injury is debatable. We hypothesized that the outcomes would not differ significantly between arthroscopic all-inside anterior talofibular ligament (ATFL) repair with and without IER reinforcement.
Methods
We prospectively randomized 73 patients who had arthroscopic all-inside ATFL repair into 2 groups: those who had IER reinforcement (37 patients) and those who had no IER reinforcement (36 patients). The primary outcome was the Karlsson Ankle Functional Score (KAFS). The secondary outcomes included the Foot and Ankle Outcome Score (FAOS), Tegner activity score (TAS), ankle range of motion, and radiographic parameters. The functional outcomes were evaluated preoperatively and at 6 and 12 months postoperatively. Stress radiographs were obtained preoperatively and at 12 months postoperatively.
Results
The KAFS, all FAOS subscale scores, and TAS improved significantly at 1 year postoperatively in both groups, with no significant differences between the groups with respect to the preoperative and postoperative values. Significant differences were not observed between the ankle range of motion values recorded preoperatively and at 1 year postoperatively in both groups; the preoperative and postoperative range of motion values did not differ significantly between the groups. The mean talar tilt and talar anterior translation decreased significantly at 1 year postoperatively in both groups, with no significant differences between the groups preoperatively and postoperatively. One patient in each group had neuralgia of the superficial peroneal nerve; 2 patients in the IER reinforcement group had knot irritation causing mild discomfort.
Conclusions
Arthroscopic all-inside ATFL repair with and without IER reinforcement showed comparable functional and stress radiographic outcomes at 1 year. Performing IER reinforcement in addition to all-inside arthroscopic direct ATFL remnant repair is not necessary.
Level of Evidence
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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- Appears in
Collections - 2. Clinical Science > Department of Orthopedic Surgery > 1. Journal Articles
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