Anne-Laure Baray1, Rémi Philippot2,3, Thomas Neri2, Frédéric Farizon2,3, Pascal Edouard3,4. 1. Department of Orthopaedic and Trauma Surgery, University Hospital Center of Saint-Etienne, Hôpital Nord Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France. annelaurebaray@gmail.com. 2. Department of Orthopaedic and Trauma Surgery, University Hospital Center of Saint-Etienne, Hôpital Nord Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France. 3. Laboratory of Exercise Physiology (LPE EA 4338), Lyon University, Saint-Étienne, France. 4. Sports Medicine Unit, Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, 42055, Saint-Étienne, France.
Abstract
PURPOSE: The Hemi-Castaing ligamentoplasty uses a powerful dynamic stabilizer of the ankle which is the peroneus brevis tendon. To our knowledge, there is no study available evaluating the effects of this type of surgery on proprioceptive, muscular and posturographic parameters. METHODS: This case-control study included 39 subjects divided into two groups: the operated (n = 24) and the control group (n = 15). All subjects underwent a clinical, proprioceptive and isokinetic assessment using a CON-TREX dynamometer, and a postural evaluation using the Win-Posturo force platform. RESULTS: At a mean period of 23 (SD 5.4) post-operative months, the Karlsson ankle functional score was 84.2 (SD 23.8) and the AOFAS score was 88.1 (SD 16.2). The mean ankle joint position error for operated ankles was from 1.9° (SD 0.9) at 10° of inversion range of motion to 2.5° (SD 1.7) at 20°. It was similar to that achieved in the control group ranging from 2.2° (SD 1) at 10° to 2.3° (SD 1.3) at 20°. No significant loss of ankle eversion strength could be observed after ligamentoplasty. Ankle eversion/inversion ratio when tested under all velocities and contraction modes failed to reveal any statistical difference between the operated and healthy ankles in the patient group, neither between the patient and control groups. CONCLUSIONS: This surgical technique achieved excellent functional outcomes. It did not impair the agonist/antagonist balance of ankle muscles, and use of half the peroneus brevis tendon did not lessen the eversion strength. LEVEL OF EVIDENCE: Case-control study, Level III.
PURPOSE: The Hemi-Castaing ligamentoplasty uses a powerful dynamic stabilizer of the ankle which is the peroneus brevis tendon. To our knowledge, there is no study available evaluating the effects of this type of surgery on proprioceptive, muscular and posturographic parameters. METHODS: This case-control study included 39 subjects divided into two groups: the operated (n = 24) and the control group (n = 15). All subjects underwent a clinical, proprioceptive and isokinetic assessment using a CON-TREX dynamometer, and a postural evaluation using the Win-Posturo force platform. RESULTS: At a mean period of 23 (SD 5.4) post-operative months, the Karlsson ankle functional score was 84.2 (SD 23.8) and the AOFAS score was 88.1 (SD 16.2). The mean ankle joint position error for operated ankles was from 1.9° (SD 0.9) at 10° of inversion range of motion to 2.5° (SD 1.7) at 20°. It was similar to that achieved in the control group ranging from 2.2° (SD 1) at 10° to 2.3° (SD 1.3) at 20°. No significant loss of ankle eversion strength could be observed after ligamentoplasty. Ankle eversion/inversion ratio when tested under all velocities and contraction modes failed to reveal any statistical difference between the operated and healthy ankles in the patient group, neither between the patient and control groups. CONCLUSIONS: This surgical technique achieved excellent functional outcomes. It did not impair the agonist/antagonist balance of ankle muscles, and use of half the peroneus brevis tendon did not lessen the eversion strength. LEVEL OF EVIDENCE: Case-control study, Level III.
Entities:
Keywords:
Chronic ankle instability; Hemi-Castaing; Joint position sense; Muscle strength; Postural control
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