Comparison of clinical efficacy between ankle arthroscopic enhanced repair and reconstruc-tion technique in the treatment of chronic ankle instability
Objective To compare the clinical efficacy of total endoscopic enhanced repair technique and reconstruction technique in the treatment of chronic ankle instability(CAI).Methods A retrospective analysis was conducted on 39 CAI patients at the General Hospital of Northern Theater Command from Apr.2020 to Jul.2022.All the CAI were caused by military training,with 13 due to armed running,9 to tactical training,11 to S-shaped run-ning and 6 to physical training.According to different surgical techniques,patients were divided into enhanced repair group(19 cases,11 affecting the left side and 8 the right)and reconstruction group(20 cases,9 affecting the left side and 11 the right).For the enhanced repair group,3 suture anchors were used to enhance the repair of the ligaments,with 18 males and 1 female aged 21-39(mean 29.4)years.For the reconstruction group,ligament ad-vanced reinforcement system was adopted to reconstruct the lateral collateral ligament of the ankle,with 19 males and 1 female aged 25-42(mean 26.5)years.VAS,American Orthopaedic Foot and Ankle Society(AOFAS)scores,limb symmetry index(LSI),anterior displacement distance and inclination angle of the talus were compared before and 12 months after surgery,as well as the proportions of patients returning to life/exercise at 6 and 12 months after surgery,and postoperative complications.Results Both groups were followed for 12-15(mean 14.7)months.At postoperative 12 months,all patients were significantly improved in pain,functional recovery and anatomic reduction:enhanced repair group VAS 0.7±0.4 vs.3.8±0.6,AOFAS total score 92.6±2.5 vs.53.6±4.5,LSI 84.3％±3.6％vs.70.4％±6.1％,talus anterior displacement distance(3.1±1.0)mm vs.(9.8±1.6)mm and talus inclination angle 3.3°±1.0° vs.9.5°±1.1°;reconstruction group:VAS 0.8±0.5 vs.4.0±0.5,AOFAS total score 85.8±4.1 vs.51.2±4.1,LSI 77.7％±5.3％vs.69.0％±6.0％,talus anterior displacement distance(3.1±0.8)mm vs.(10.2±2.2)mm and talus inclination angle 3.5°±0.8° vs.9.7°±1.5°(all P＜0.05 compared with that before sur-gery).Moreover,the enhanced repair group was superior in terms of AOFAS total score and LSI at 12 months(both P＜0.05).At 6 months,the proportion of patients returning to exercise was much higher in the enhanced repair group than in the reconstruction group(36.8％vs.5.0％,P＜0.05).Other observed variables revealed no statisti-cally significant differences between the two groups,including postoperative adverse reactions related to surgical techniques like infection,screw loosening and thrombus embolism(all P＞0.05).Conclusion Both enhanced re-pair and reconstruction techniques are effective for CAI treatment,and the former is better at the early stage,which is beneficial for early recovery and return to exercise.
Chronic ankle instabilityAnkle jointArthroscopyAnterior talofibular ligamentReconstruc-tion surgery
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