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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2016

01-04-2016 | Ankle

Minimally invasive surgical treatment for chronic ankle instability: a systematic review

Authors: Kentaro Matsui, Bernard Burgesson, Masato Takao, James Stone, Stéphane Guillo, Mark Glazebrook, ESSKA AFAS Ankle Instability Group

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2016

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Abstract

Purpose

The purpose of this study was to determine the evidence-based support for the treatment for chronic ankle instability (CAI) using minimally invasive surgery (MIS) techniques.

Methods

A systematic comprehensive review of the literature was performed on 4 September 2015 using PubMed, EMBASE, Cochrane databases and Web of Science along with the two search concepts: lateral ligament of the ankle (patients) and minimally invasive surgical procedure (intervention). Articles of clinical study on MIS for CAI were included in this review and classified into four MIS categories (arthroscopic repair, non-arthroscopic minimally invasive repair, arthroscopic reconstruction and non-arthroscopic minimally invasive reconstruction) based on the adopted surgical procedure. Included articles were reviewed and assigned a classification according to the research method quality of evidence (Level I–V evidence). Analysis of these studies was then conducted to provide a grade of recommendation for each MIS category.

Results

The systematic literature review generated 430 articles, and 33 articles met our inclusion criteria. The highest recommendation was Grade C (poor-quality evidence) to support the use of the arthroscopic repair, arthroscopic reconstruction and non-arthroscopic minimally invasive reconstruction. Insufficient evidence was currently available to make any recommendation (Grade I) for non-arthroscopic minimally invasive repair category.

Conclusions

Despite recent increases in publications on MIS for the treatment for CAI, there was currently poor quality of evidence that was insufficient to allow a high grade of recommendation to support the use of the MIS. This paper should stimulate those surgeons performing higher quality studies in the form of prospective and preferably randomized comparative studies that will be necessary to allow better recommendations for the treatment for CAI with MIS. The present study showed thorough evidence-based recommendation for the clinical use of the MIS based on the comprehensive review of the literature.

Level of evidence

Systematic review, Level IV.
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Metadata
Title
Minimally invasive surgical treatment for chronic ankle instability: a systematic review
Authors
Kentaro Matsui
Bernard Burgesson
Masato Takao
James Stone
Stéphane Guillo
Mark Glazebrook
ESSKA AFAS Ankle Instability Group
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4041-1

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