Painful Chronic Lateral Instability of the Ankle: Benefits of Arthroscopy Combined with Hemi-Castaing Ligamentoplasty

¹Oxford University Clinical Academic Graduate School (OUCAGS), Medical Sciences Division, John Radcliffe Hospital, Oxford, OX3 9DU UK

²Department of Orthopaedic and Trauma Surgery , CHU de la Cavale Blanche , Boulevard Tanguy Prigent, 29609 Brest.

³University of Western Brittany , Faculty of Medicine, 22 Rue Camille Desmoulins, 29200 Brest.

Corresponding Author: Clavé Arnaud, Orthopaedic Surgery and Traumatology of the Cavale Blanche, Boulevard Tanguy Prigent 29609 Brest, UK. Tel: +33298347273; Email: [email protected]

Received Date: 12 Jan 2016   
Accepted Date:18 Feb 2016   
Published Date:07 Mar 2016

Copyright © 2016 Clavé A

Citation: Nagra NS, Poirier N, Marc-Pierre H, Clavé A, et al. (2016). Painful Chronic Lateral Instability of the Ankle: Benefits of Arthroscopy Combined with Hemi-Castaing Ligamentoplasty. M J Orth. 1(1): 005.

ABSTRACT

Background and Aims

This study aimed to compare outcomes of chronic lateral instability of the ankle in patients treated by hemi- Castaingligamentoplasty with either arthrotomy or arthroscopy.

Patients and Methods

Eighty patients with painful chronic lateral instability who received lateral ligament reconstruction using a hemi-Castaing technique over a six-year period were included in this retrospective, single-centre study, with a mean follow-up of 36months (range 18-56months). Patients were divided into two groups: arthrotomy (n=50) and arthroscopy, (n=30). Preoperative and postoperative evaluation according to laxity, instability, pain, Olerud and Molander Ankle Scores and complications were compared between the groups.

Results

No difference in the subjective assessment of outcome (91% were ‘very satisfied’ and‘satisfied’ in arthrotomy patients versus 90% in arthroscopy patients) was detected. However, significant differences regarding persistence of pain at review were noted (60% versus 30% - p=0.0126). Superiority in outcomes in the arthroscopy group were also observed in overall functional outcome and its assessment through the Olerud and Molander Ankle Score with a mean gain of 11 (range, 0 to 35) points for arthrotomy (87.5) versus 20.5 (range, -50 to 60) for arthroscopy (90.5) (p=0.021) patients.

Conclusion

Our study shows that, when compared with a simple arthrotomy, ankle arthroscopy in the context of the hemi-Castaing technique results in marked reduction of pain symptoms and improvement of ankle function without affecting morbidity.

KEYWORDS

Ankle; Painful chronic lateral instability; Arthroscopy; Ligamentoplasty; Chondral lesio