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

The Esska-Afas Ankle Instability Group

Research output: Contribution to journalArticle

26 Citations (Scopus)

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: V.

Original languageEnglish
Pages (from-to)2095-2102
Number of pages8
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume26
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

Fingerprint

Ankle
Ligaments
Therapeutics
Collateral Ligaments
Expert Testimony
Treatment Failure
Athletes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{74c65ab8dada4dfb9933d4a931edcb4c,
title = "Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert",
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: V.",
author = "{The Esska-Afas Ankle Instability Group} and Frederick Michels and H. Pereira and J. Calder and G. Matricali and M. Glazebrook and S. Guillo and J. Karlsson and Jorge Acevedo and Jorge Batista and Thomas Bauer and James Calder and Dominic Carreira and Woojin Choi and Nuno Corte-real and Mark Glazebrook and Ali Ghorbani and Eric Giza and St{\'e}phane Guillo and Kenneth Hunt and Jon Karlsson and Kong, {S. W.} and Lee, {Jin Woo} and Frederick Michels and Andy Molloy and Peter Mangone and Kentaro Matsui and Caio Nery and Saturo Ozeki and Chris Pearce and H{\'e}lder Pereira and Anthony Perera and Bas Pijnenburg and Fernando Raduan and James Stone and Masato Takao and Yves Tourn{\'e} and Jordi Vega",
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language = "English",
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pages = "2095--2102",
journal = "Knee Surgery, Sports Traumatology, Arthroscopy",
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Searching for consensus in the approach to patients with chronic lateral ankle instability : ask the expert. / The Esska-Afas Ankle Instability Group.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 26, No. 7, 01.07.2018, p. 2095-2102.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Searching for consensus in the approach to patients with chronic lateral ankle instability

T2 - ask the expert

AU - The Esska-Afas Ankle Instability Group

AU - Michels, Frederick

AU - Pereira, H.

AU - Calder, J.

AU - Matricali, G.

AU - Glazebrook, M.

AU - Guillo, S.

AU - Karlsson, J.

AU - Acevedo, Jorge

AU - Batista, Jorge

AU - Bauer, Thomas

AU - Calder, James

AU - Carreira, Dominic

AU - Choi, Woojin

AU - Corte-real, Nuno

AU - Glazebrook, Mark

AU - Ghorbani, Ali

AU - Giza, Eric

AU - Guillo, Stéphane

AU - Hunt, Kenneth

AU - Karlsson, Jon

AU - Kong, S. W.

AU - Lee, Jin Woo

AU - Michels, Frederick

AU - Molloy, Andy

AU - Mangone, Peter

AU - Matsui, Kentaro

AU - Nery, Caio

AU - Ozeki, Saturo

AU - Pearce, Chris

AU - Pereira, Hélder

AU - Perera, Anthony

AU - Pijnenburg, Bas

AU - Raduan, Fernando

AU - Stone, James

AU - Takao, Masato

AU - Tourné, Yves

AU - Vega, Jordi

PY - 2018/7/1

Y1 - 2018/7/1

N2 - 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: V.

AB - 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: V.

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