Purpose
To compare the return to sports and short-term clinical outcomes between the arthroscopic
all-inside and the open anatomic reconstruction with gracilis tendon autograft for
chronic lateral ankle instability (CLAI) patients.
Methods
From March 2018 to January 2020, 57 CLAI patients were prospectively included with
arthroscopic all-inside anatomic reconstruction (n = 31) or open anatomic reconstruction
(n = 26) with gracilis tendon autograft. The patients were evaluated before operation
and at 3 months, 6 months, 12 months, and 24 months after surgery. The American Orthopaedic
Foot and Ankle Society score (AOFAS), visual analog scale (VAS), and Karlsson-Peterson
score were evaluated at each time point, and stress radiography with a Telos device
was performed before surgery and at final follow-up. The time to return to full weightbearing
walking, jogging, sports, and work, Tegner activity score, and complications were
recorded and compared.
Results
All the subjective scores significantly improved after surgery from the preoperative
level. Compared with the open group, the arthroscopic group demonstrated significantly
earlier return to full weightbearing walking (8.9 vs 11.7 weeks, P < .001), jogging (17.9 vs 20.9 weeks, P = .012), and recreational sports (22.4 vs 26.5 weeks, P = .001) with significantly better AOFAS score and Karlsson score at 3 to 6 months,
and better VAS score at 6 months after surgery. The 2 groups demonstrated no significant
difference in the surgical duration or surgical complications. No significant difference
was found in the clinical scores or stress radiographic measurements at 24 months
after surgery (P > .05).
Conclusion
Compared with the open procedure, the arthroscopic all-inside anatomic lateral ankle
ligament reconstruction with autologous gracilis tendon could achieve earlier return
to full weightbearing, jogging, and recreational sports with less pain and better
ankle functional scores at 3 to 6 months after surgery. Similar favorable short-term
clinical outcomes were achieved for both techniques at 2 years after surgery.
Study Design
Level I, randomized controlled trial.
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Suttmiller AMB, Cavallario JM, Baez SE, Martinez JC, McCann RS. Perceived instability, pain, and psychological factors predict function and disability in individuals with chronic ankle instability [published online March 10, 2022]. J Athl Train. doi: 10.4085/1062-6050-0605.21.
Article info
Publication history
Published online: December 07, 2022
Accepted:
November 27,
2022
Received:
July 25,
2022
Footnotes
T.S. and A.W. equally contributed to this work.
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
