Evolution in Surgical Management of Ankle Instability in Athletes
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Evolution in Surgical Management of Ankle Instability in Athletes. / Lau, Brian C; Barg, Alexej; Haytmanek, C Thomas; McCullough, Kirk; Amendola, Annunziato.
In: J AM ACAD ORTHOP SUR, Vol. 29, No. 1, 01.01.2021, p. e5-e13.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Evolution in Surgical Management of Ankle Instability in Athletes
AU - Lau, Brian C
AU - Barg, Alexej
AU - Haytmanek, C Thomas
AU - McCullough, Kirk
AU - Amendola, Annunziato
N1 - Copyright © 2020 by the American Academy of Orthopaedic Surgeons.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Recent concepts are changing the management of ankle instability. These include concurrent medial and lateral instabilities, use of ankle arthroscopy, use of suture anchors, all-arthroscopic stabilization, synthetic augmentation, and early postoperative rehabilitation. Medial sided injuries occur in up to 72% of the lateral ankle sprains, and concomitant repair may provide greater stability. Suture anchors are equally as strong as transosseous tunnels, and the technique is simple, reproducible, and may decrease complications, but anchors do increase costs. Synthetic augmentation demonstrates greater strength than Broström alone in cadaver-based biomechanical testing. Although clinical studies of synthetic augmentation have demonstrated equivocal stability and pain compared with Broström alone, synthetic augmentation may expedite rehabilitation. All-arthroscopic ankle stabilization is gaining popularity with increasing publications. Early findings demonstrate comparable biomechanical and clinical data compared with open techniques. Early postoperative weight-bearing within 2 weeks seems to be safe and may shorten time to return to play. Surgeons may consider using these novel techniques in the management of lateral ankle instability.
AB - Recent concepts are changing the management of ankle instability. These include concurrent medial and lateral instabilities, use of ankle arthroscopy, use of suture anchors, all-arthroscopic stabilization, synthetic augmentation, and early postoperative rehabilitation. Medial sided injuries occur in up to 72% of the lateral ankle sprains, and concomitant repair may provide greater stability. Suture anchors are equally as strong as transosseous tunnels, and the technique is simple, reproducible, and may decrease complications, but anchors do increase costs. Synthetic augmentation demonstrates greater strength than Broström alone in cadaver-based biomechanical testing. Although clinical studies of synthetic augmentation have demonstrated equivocal stability and pain compared with Broström alone, synthetic augmentation may expedite rehabilitation. All-arthroscopic ankle stabilization is gaining popularity with increasing publications. Early findings demonstrate comparable biomechanical and clinical data compared with open techniques. Early postoperative weight-bearing within 2 weeks seems to be safe and may shorten time to return to play. Surgeons may consider using these novel techniques in the management of lateral ankle instability.
U2 - 10.5435/JAAOS-D-20-00176
DO - 10.5435/JAAOS-D-20-00176
M3 - SCORING: Review article
C2 - 33306560
VL - 29
SP - e5-e13
JO - J AM ACAD ORTHOP SUR
JF - J AM ACAD ORTHOP SUR
SN - 1067-151X
IS - 1
ER -