Purpose
To determine whether concomitant chronic syndesmotic injury or chronic medial ankle
instability is associated with unsatisfactory outcomes in patients with chronic lateral
ankle instability (CAI).
Methods
We conducted a retrospective review of prospectively collected data from 276 male
military patients with CAI who had undergone a modified Broström procedure between
May 2007 and March 2010 and had been followed up for a mean of 26.7 months (range,
22 to 41 months). We evaluated clinical outcomes using American Orthopaedic Foot &
Ankle Society ankle-hindfoot, visual analog scale, and ankle functional satisfactory
scale scores. Possible associations with concomitant instability were reconstructed
and investigated using the Pearson correlation coefficient and multivariate logistic
regression analysis.
Results
Of the 236 patients with satisfactory outcomes, 19 (8%) had medial ankle instability
and 13 (6%) had syndesmotic instability; in contrast, of the 40 patients with unsatisfactory
outcomes, 14 (35%) had medial ankle instability and 12 (30%) had syndesmotic instability.
The mean American Orthopaedic Foot & Ankle Society scores for patients with satisfactory
and unsatisfactory outcomes increased from 68.1 to 92.8 (P < .001) and from 65.9 to 76.8 (P < .001), respectively. The mean visual analog scale scores for the groups with satisfactory
and unsatisfactory outcomes decreased from 5.8 to 2.1 (P < .001) and from 6.2 to 4.8 (P < .001), respectively. The mean ankle satisfaction score was 27.8 for patients with
satisfactory outcomes and 18.7 for those with unsatisfactory outcomes (P < .001). Multivariate logistic regression analysis showed a 4-fold higher risk of
dissatisfaction (95% confidence interval [CI], 0.81 to 20.07; P = .0880) with CAI and syndesmotic instability, a 3.8-fold higher risk (95% CI, 0.96
to 15.07; P = .0576) with CAI and medial ankle instability, and an 11.7-fold higher risk (95%
CI, 2.60 to 52.70; P = .0014) with CAI and both syndesmotic and medial ankle instability.
Conclusions
Chronic syndesmotic instability and chronic medial ankle instability are significantly
associated with unsatisfactory outcomes in patients with CAI.
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Published online: April 13, 2015
Accepted:
February 19,
2015
Received:
August 16,
2014
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
