T Diermeier1, B Scheiderer1, L Lacheta1, A B Imhoff2. 1. Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland. 2. Abteilung für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland. imhoff@tum.de.
Abstract
OBJECTIVES: Anatomical reconstruction of the lateral ligament complex in the ankle. INDICATIONS: Chronic lateral ankle instability. CONTRAINDICATIONS: Severe osteoarthritis, obesity, hindfoot varus, general contraindications (infection, circulatory disorders, diabetic foot syndrome). SURGICAL TECHNIQUE: Anatomical V‑shaped reconstruction of the lateral ligament complex with half of the peroneus brevis tendon and additional retinaculum stabilization. POSTOPERATIVE MANAGEMENT: Lower leg orthesis (e. g. protect.CAT Walker, medi GmbH, Bayreuth, Germany) for 6 weeks. Week 1-2, no weight bearing, no active pro- and supination. Starting in week 3-4, begin with partial weight bearing, pain adapted. Starting in week 7, free range of motion, begin with progressive training. RESULTS: Between March 2014 and June 2016, 16 patients (6 female, 10 male) were treated with the above-named technique. Average age was 32.8 years (range 17.9-57.1 years). Ten patients completed the 6‑ and 12-month follow-ups. None of these 10 patients reported a feeling of instability. In the clinical examination, the lateral ligament complex was stable. Patients showed a free range of motion at the 12-month follow-up.
OBJECTIVES: Anatomical reconstruction of the lateral ligament complex in the ankle. INDICATIONS: Chronic lateral ankle instability. CONTRAINDICATIONS: Severe osteoarthritis, obesity, hindfoot varus, general contraindications (infection, circulatory disorders, diabetic foot syndrome). SURGICAL TECHNIQUE: Anatomical V‑shaped reconstruction of the lateral ligament complex with half of the peroneus brevis tendon and additional retinaculum stabilization. POSTOPERATIVE MANAGEMENT: Lower leg orthesis (e. g. protect.CAT Walker, medi GmbH, Bayreuth, Germany) for 6 weeks. Week 1-2, no weight bearing, no active pro- and supination. Starting in week 3-4, begin with partial weight bearing, pain adapted. Starting in week 7, free range of motion, begin with progressive training. RESULTS: Between March 2014 and June 2016, 16 patients (6 female, 10 male) were treated with the above-named technique. Average age was 32.8 years (range 17.9-57.1 years). Ten patients completed the 6‑ and 12-month follow-ups. None of these 10 patients reported a feeling of instability. In the clinical examination, the lateral ligament complex was stable. Patients showed a free range of motion at the 12-month follow-up.
Authors: Marco-Christopher Rupp; Hannes Degenhardt; Philipp W Winkler; Maximilian Hinz; Yannick J Ehmann; Andreas B Imhoff; Jonas Pogorzelski; Alexander Themessl Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-03-31 Impact factor: 4.114