Percutaneous inferior extensor retinaculum augmentation produces similar functional outcomes compared with modified Broström procedure for lateral ankle instability.

IF 1.9 3区 医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2024-11-19 DOI:10.1016/j.fas.2024.11.007
Shengxuan Cao, Chen Wang, Chao Zhang, Xin Ma, Xu Wang
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Abstract

Background: In patients with lateral ankle instability (LAI) and attenuated ligament tissue quality, the stability of lateral ankle can be achieved through percutaneous inferior extensor retinaculum augmentation (PIERA). This study is aimed to compare the functional outcomes of PIERA with gold standard Modified Broström Procedure (MBP) for patients with LAI.

Methods: Twenty participants were allocated to PIERA and MBP treatment group according to the intraoperative arthroscopic assessment of lateral ankle ligament, with each group comprises 10 participants. Patients were assessed using American Orthopaedic Foot and Ankle Society score, Cumberland ankle instability tool, Foot and Ankle Ability Measure, star excursion balance test (SEBT), and a stair descent gait analysis, a day prior to surgery and one year postoperatively. Operative outcomes and variables during stair descent were documented and compared between the preoperative and postoperative patients, and between treatment groups.

Results: The PIERA procedure significantly promoted the clinical outcomes of the patients with LAI. The anterior reach of SEBT was increased from 79.1 ± 12.6 to 84.8 ± 12.9 (p = 0.034). The PIERA procedure significantly increased ankle flexion range of motion (p = 0.049), maximal ankle dorsiflexion (p = 0.009), and peroneal activation post-initial-contact (p = 0.002) and during the gait cycle (p = 0.015). The effects of PIERA and MBP on ankle function were not significantly different.

Conclusion: PIERA produces similar functional outcomes compared with MBP in promoting clinical outcomes, dynamic postural stability, peroneal activation, and ankle sagittal range of motion for patients with LAI.

Level of evidence: III, retrospective cohort study.

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经皮下伸肌缰网增强术与改良布罗斯特伦手术相比,在治疗外侧踝关节不稳方面具有相似的功能效果。
背景:对于外侧踝关节不稳定(LAI)且韧带组织质量下降的患者,可通过经皮下伸肌缰绳增强术(PIERA)实现外侧踝关节的稳定。本研究旨在比较 PIERA 与金标准改良布氏手术(MBP)对 LAI 患者的功能效果:根据术中对外侧踝关节韧带的关节镜评估结果,20 名参与者被分配到 PIERA 和 MBP 治疗组,每组 10 人。在手术前一天和术后一年,使用美国骨科足踝协会评分、坎伯兰踝关节不稳定性工具、足踝能力测量、星形偏移平衡测试(SEBT)和下楼梯步态分析对患者进行评估。对手术结果和下楼梯过程中的变量进行了记录,并对术前和术后患者以及治疗组之间进行了比较:结果:PIERA手术明显提高了LAI患者的临床疗效。SEBT 的前伸量从 79.1 ± 12.6 增加到 84.8 ± 12.9(p = 0.034)。PIERA 程序明显增加了踝关节的屈曲活动范围(p = 0.049)、最大踝关节背屈(p = 0.009)、初次接触后(p = 0.002)和步态周期中(p = 0.015)的腓肠肌激活。PIERA 和 MBP 对踝关节功能的影响没有显著差异:结论:与 MBP 相比,PIERA 在促进 LAI 患者的临床疗效、动态姿势稳定性、腓肠肌激活和踝关节矢状运动范围方面产生了相似的功能效果:III,回顾性队列研究。
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来源期刊
Foot and Ankle Surgery
Foot and Ankle Surgery ORTHOPEDICS-
CiteScore
4.60
自引率
16.00%
发文量
202
期刊介绍: Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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