Alexandra J Brown1, Yoshiharu Shimozono1,2,3, Eoghan T Hurley1,4, John G Kennedy5. 1. Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA. 2. Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan. 3. Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. 4. Royal College of Surgeons in Ireland, Dublin, Ireland. 5. Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA. kennedyj@hss.edu.
Abstract
PURPOSE: The purpose of this meta-analysis was to analyze the current comparative studies of arthroscopic and open techniques for lateral ankle ligament repair to treat chronic lateral ankle instability. METHODS: A systematic search of MEDLINE, EMBASE and Cochrane Library databases was performed during February 2018. Included studies were evaluated with regard to level of evidence and quality of evidence using the Modified Coleman Methodology Score. Total number of patients, patient age, follow-up time, gender ratio, surgical technique, surgical complications, complication rate, recurrent instability or revision rate, clinical outcome measures and percentage of patients who returned to sport at previous level were also evaluated. Statistical analysis was performed using RevMan, and a p value of < 0.05 was considered to be statistically significant. RESULTS: Four comparative studies for a total of 207 ankles were included. There was a significant difference in favor of arthroscopic repair with regard to AOFAS score, and there was no significant difference with regard to Karlsson score. There was a statistically significant difference in AOFAS score in favor of the arthroscopic repair (MD; 1.41, 95% CI 0.29-2.52, I2 = 0%, p < 0.05). There was no statistically significant difference in Karlsson score (MD; 0.00, 95% CI - 3.51 to 3.51, I2 = 0%, n.s.). There was no statistically significant difference in total, nerve, or wound complications. CONCLUSIONS: The current meta-analysis found that short-term AOFAS functional outcome scores were significantly improved with arthroscopic lateral ankle repair compared to open repair. There was no significant difference between arthroscopic and open repair with regards to Karlsson functional outcome score, total complication rate, or the nerve and wound complication subsets with the included studies with at least 12 months of follow-up. However, the current evidence is still limited, and further prospective trials with longer follow-up are needed. LEVEL OF EVIDENCE: III.
PURPOSE: The purpose of this meta-analysis was to analyze the current comparative studies of arthroscopic and open techniques for lateral ankle ligament repair to treat chronic lateral ankle instability. METHODS: A systematic search of MEDLINE, EMBASE and Cochrane Library databases was performed during February 2018. Included studies were evaluated with regard to level of evidence and quality of evidence using the Modified Coleman Methodology Score. Total number of patients, patient age, follow-up time, gender ratio, surgical technique, surgical complications, complication rate, recurrent instability or revision rate, clinical outcome measures and percentage of patients who returned to sport at previous level were also evaluated. Statistical analysis was performed using RevMan, and a p value of < 0.05 was considered to be statistically significant. RESULTS: Four comparative studies for a total of 207 ankles were included. There was a significant difference in favor of arthroscopic repair with regard to AOFAS score, and there was no significant difference with regard to Karlsson score. There was a statistically significant difference in AOFAS score in favor of the arthroscopic repair (MD; 1.41, 95% CI 0.29-2.52, I2 = 0%, p < 0.05). There was no statistically significant difference in Karlsson score (MD; 0.00, 95% CI - 3.51 to 3.51, I2 = 0%, n.s.). There was no statistically significant difference in total, nerve, or wound complications. CONCLUSIONS: The current meta-analysis found that short-term AOFAS functional outcome scores were significantly improved with arthroscopic lateral ankle repair compared to open repair. There was no significant difference between arthroscopic and open repair with regards to Karlsson functional outcome score, total complication rate, or the nerve and wound complication subsets with the included studies with at least 12 months of follow-up. However, the current evidence is still limited, and further prospective trials with longer follow-up are needed. LEVEL OF EVIDENCE: III.
Authors: Laura Ramponi; Youichi Yasui; Christopher D Murawski; Richard D Ferkel; Christopher W DiGiovanni; Gino M M J Kerkhoffs; James D F Calder; Masato Takao; Francesca Vannini; Woo Jin Choi; Jin Woo Lee; James Stone; John G Kennedy Journal: Am J Sports Med Date: 2016-11-16 Impact factor: 6.202
Authors: Eric Giza; Edward C Shin; Stephanie E Wong; Jorge I Acevedo; Peter G Mangone; Kirstina Olson; Matthew J Anderson Journal: Am J Sports Med Date: 2013-08-27 Impact factor: 6.202
Authors: Nathaniel P Mercer; Mohammad T Azam; Nicholas Davalos; Daniel J Kaplan; Christopher A Colasanti; Jeffrey S Chen; Ajay C Kanakamedala; John F Dankert; James W Stone; John G Kennedy Journal: Arthrosc Tech Date: 2022-03-16