2017 ISAKOS Biennial Congress ePoster #145

 

Chronic Ankle Instability in Adolescents - Arthroscopic Treatment

Joao Caetano, MD, Carnaxide, Lisboa PORTUGAL
Rafael Dias PORTUGAL
Miguel Duarte-Silva, MD, Parede - Cascais, Lisboa PORTUGAL
Patrícia Wircker, MD, Lisboa PORTUGAL
Pedro Magro, MD, Lisboa PORTUGAL
Francisco Guerra Pinto, MD, Lisbon PORTUGAL
Teresa Alves-Da-Silva, MD, Lisbon PORTUGAL
Nuno Corte-Real, MD, Lisboa PORTUGAL

Hospital de Cascais, Dr. José de Almeida, Cascais, Lisboa, PORTUGAL

FDA Status Not Applicable

Summary

The authors report the use of an arthroscopic technique to treat Chronic Ankle Instability in adolescents, who failed to respond to conservative treatment, with excellent results.

Abstract

Ligamentous injuries to the lateral ankle complex are rare in child. In athletic adolescents, recurrent sprains may lead to ligament attenuation and instability. Reconstruction is indicated when instability interferes with daily living or athletic performance. The literature on reconstruction addresses primarily the adult population, and there is no consensus in treating the child and adolescent.

The authors report the use of an arthroscopic technique of lateral ligament repair with an anchor placed in the fibula, described by Corte-Real for use in the adult population and presently safely used in the adolescents with open physis. The technique is described and six cases are reported.

Six adolescents, competition athletes, ages between 14 and 17 years old who failed to respond to conservative treatment, had recurrent ankle sprains and disabling instability with AOFAS scores between 60 and 77 (mean - 66,5). All of them had a positive drawer sign and significant talar tilt on preoperative stress tests. Postoperatively all patients had a negative drawer sign and a reduction of talar tilt, with final AOFAS score between 87 and 100 (mean - 90,8), at 3 months of follow-up. All patients had their expectations met regarding the results of surgery and they returned to sports successfully.

The surgical technique presented is a safe and excellent technique to treat chronic ankle instability in the adolescent. It’s a simple minimally invasive procedure that we believe to produce an anatomical repair of the lateral ligament with clinical and functional results similar to other techniques.

The authors recommend this as an excellent means of treating children with chronic ankle instability who have failed to respond to conservative treatment.