Clinical Effect Of Lateral Collateral Ligament Repair Combined With Arthroscopic Ankle Joint Debridement In The Treatment Of Chronic Ankle Instability

Background Ankle sprain is a common disease in the orthopedic emergency department,about 90% patients will injury the lateral collateral ligament,70%-85%of patients with ankle sprain can have a good effect after conservative treatment.Because lack of knowledge of acute ankle sprain and improper treatment,it can developed into chronic ankle instability after repeated ankle sprain,and further resulting in ankle dysfunction.There are about 20% of acute ankle sprain will develop into chronic ankle instability and often associated with various lesions within the joint,Such as intra-articular cartilage injury,bone impact and articular free body.The etiology of chronic ankle lateral instability often have repeated ankle sprain,intra-articular lesions and foot deformity.The clinical manifestations are mainly joint instability and chronic pain.Chronic lateral ankle instability is divided into mechanical instability and functional instability,the functional instability mainly choose conservative treatment and mechanical instability sometimes choose surgical treatment.The surgical treatments can divided into three categories:the anatomical repair:mainly including Brostrom method and improved Brostrom method;anatomical reconstruction:use the autologous or allogeneic tendon to reconstruction the lateral collateral ligament;nonanatomical reconstruction: mainly including Watson-Jones surgery,Evans and Chrisman-Snook surgery.The improved Brostrom method restored the biomechanical stability of the lateral ankle joint,short operation time and less postoperative complications.The ankle function recovery is better than others and widely used in the repair of lateral collateral ligament.There are a variety of surgical ways to treat the chronic ankle instability,but if only repair the ligament without treat the intra-articular lesions will greatly reduce the postoperative efficacy,so when we repair the lateral collateral ligament at the same time to deal with the intra-articular lesions is particularly important.we repair the lateral collateral ligament and ankle arthroscopic clearance of the intra-articular lesions,we assess the efficacy of our surgery through observe the patients with different stages of postoperative ankle function score.Objective Evaluation of lateral collateral ligament repair combined with ankle joint debridement through arthroscopy for treatment of chronic ankle instability.Methods From October 2012 to October 2014 28 patients with chronic ankle instability were selected from the first affiliated hospital of Anhui Medical University,All patients treat the articular lesions through arthroscopy and then repair the lateral collateral ligament,AOFAS was applied to evaluation thefunction scores between preopration and 3 months,6 months,1 years after operation.Results All patients were followed up for one year,the scores of preoperative was(40.63±4.75)points,3 months after the surgery was(68.75±3.65)points,6 months was(90± 1.31)points and the score was(91.25±1.28)points in 1 year.Postoperative ankle function score was significantly different than preoperative(P<0.001).Conclusion Repair of lateral collateral ligament is an effective method for the treatment of chronic lateral ankle instability,Through the ankle arthroscopy can effectively deal with intra-articular synovial membrane,free body,cartilage injury and other intra-articular lesions,This combination of surgery can significantly improve the ankle function,it can effectively alleviate ankle pain and delay the ankle joint symptoms further deterioration.Lateral collateral ligament repair combined with arthroscopy ankle joint debridement for treatment of chronic ankle instability have a good effect.