Arthroscopic findings associated with the unstable ankle
Arthroscopic findings associated with the unstable ankle
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DOI：
10.1177/107110079902001106
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发表时间：
1999-11-01
影响因子：
2.7
通讯作者：
Ferkel, RD
中科院分区：
文献类型：
--
作者：
Komenda, GA;Ferkel, RD
在踝关节外侧稳定之前，对 54 名患有慢性踝关节不稳定的患者（55 只脚踝）进行了关节镜手术。所有患者病历、X 光片、手术报告和手术录像均经过审查。所有患者均回答了详细的调查问卷。研究人群包括 31 名男性和 23 名女性，平均年龄为 31 岁（范围为 14-64 岁）。 64% 的病例累及右脚踝。平均随访时间为 9.6 个月。关节镜手术使用小型关节器械进行，包括 30 度和 70 度 2.7 毫米关节镜以及 30 度 1.9 毫米关节镜。手术时，51 名踝关节 (93%) 出现关节内异常，包括游离体 (12)、滑膜炎 (38)、距骨骨软骨病变 (9)、小骨 (14)、骨赘 (6)、粘连 (8) 和软骨软化 (12)。最常见的关节镜手术是滑膜切除术、游离体和听小骨的去除、骨软骨病变的切除和钻孔、外侧沟清创、骨赘切除以及粘连和疤痕组织的去除。软骨损伤的发生率为 25%，这与 Taga 等人的结果有很大不同，Taga 等人发现 95% 的踝关节存在侧向不稳定的软骨损伤。总体而言，96% 的脚踝获得了优秀或良好的结果。工伤补偿患者中优良结果的发生率较低，因为抱怨活动时疼痛的发生率较高。骨软骨病变的存在或距骨倾斜的程度与结果之间没有相关性。
Before lateral ankle stabilization, arthroscopic surgery was performed on 54 patients (55 ankles) with chronic ankle instability. All patient charts, x-rays, operative reports, and surgical videotapes were reviewed. A detailed questionnaire was answered by all patients. The study population included 31 males and 23 females, with a mean age of 31 years (range, 14-64 years). The right ankle was involved in 64% of cases. Average follow-up was 9.6 months. Arthroscopic surgery was performed using small joint instrumentation including 30 degrees and 70 degrees 2.7-mm arthroscopes and a 30 degrees 1.9-mm arthroscope. At surgery, 51 ankles (93%) had intra-articular abnormalities including loose bodies (12), synovitis (38), osteochondral lesions of the talus (9), ossicles (14), osteophytes (6), adhesions (8), and chondromalacia (12). The most common arthroscopic procedures were synovectomy, removal of loose bodies and ossicles, excision and drilling of osteochondral lesions, debridement of the lateral gutter, excision of osteophytes, and removal of adhesions and scar tissue. There was a 25% incidence of chondral injuries, which differs considerably from the results of Taga et al., who found chondral injuries in 95% of ankles with lateral instability. Overall, there were excellent or good results in 96% of ankles. The incidence of excellent results was lower in the worker's compensation patients because of a greater incidence of complaints of pain with activity. There was no correlation between the presence of osteochondral lesions or amount of talar tilt and results.