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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-07-2018 | Ankle

Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert

Authors: Frederick Michels, H. Pereira, J. Calder, G. Matricali, M. Glazebrook, S. Guillo, J. Karlsson, Jorge Acevedo, Jorge Batista, Thomas Bauer, James Calder, Dominic Carreira, Woojin Choi, Nuno Corte-real, Mark Glazebrook, Ali Ghorbani, Eric Giza, Stéphane Guillo, Kenneth Hunt, Jon Karlsson, S. W. Kong, Jin Woo Lee, Frederick Michels, Andy Molloy, Peter Mangone, Kentaro Matsui, Caio Nery, Saturo Ozeki, Chris Pearce, Hélder Pereira, Anthony Perera, Bas Pijnenburg, Fernando Raduan, James Stone, Masato Takao, Yves Tourné, Jordi Vega, The ESSKA-AFAS Ankle Instability Group

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2018

Abstract

Purpose

The purpose of this study is to propose recommendations for the treatment of patients with chronic lateral ankle instability (CAI) based on expert opinions.

Methods

A questionnaire was sent to 32 orthopaedic surgeons with clinical and scientific experience in the treatment of CAI. The questions were related to preoperative imaging, indications and timing of surgery, technical choices, and the influence of patient-related aspects.

Results

Thirty of the 32 invited surgeons (94%) responded. Consensus was found on several aspects of treatment. Preoperative MRI was routinely recommended. Surgery was considered in patients with functional ankle instability after 3–6 months of non-surgical treatment. Ligament repair is still the treatment of choice in patients with mechanical instability; however, in patients with generalized laxity or poor ligament quality, lateral ligament reconstruction (with grafting) of both the ATFL and CFL should be considered.

Conclusions

Most surgeons request an MRI during the preoperative planning. There is a trend towards earlier surgical treatment (after failure of non-surgical treatment) in patients with mechanical ligament laxity (compared with functional instability) and in high-level athletes. This study proposes an assessment and a treatment algorithm that may be used as a recommendation in the treatment of patients with CAI.

Level of evidence

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Title: Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert
Authors: Frederick Michels
H. Pereira
J. Calder
G. Matricali
M. Glazebrook
S. Guillo
J. Karlsson
Jorge Acevedo
Jorge Batista
Thomas Bauer
James Calder
Dominic Carreira
Woojin Choi
Nuno Corte-real
Mark Glazebrook
Ali Ghorbani
Eric Giza
Stéphane Guillo
Kenneth Hunt
Jon Karlsson
S. W. Kong
Jin Woo Lee
Frederick Michels
Andy Molloy
Peter Mangone
Kentaro Matsui
Caio Nery
Saturo Ozeki
Chris Pearce
Hélder Pereira
Anthony Perera
Bas Pijnenburg
Fernando Raduan
James Stone
Masato Takao
Yves Tourné
Jordi Vega
The ESSKA-AFAS Ankle Instability Group
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-017-4556-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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