[Clinical results of anatomical reconstruction of the lateral ligaments for chronic ankle instability].

OBJECTIVE: To investigate the clinical and radiological results of lateral stabilization with reconstruction of the lateral ligaments for the treatment of chronic lateral instability of the ankle.

METHODS: From September 2005 to March 2010, 29 patients with chronic lateral instability of the ankle were reviewed. There were 24 males and 5 females with an average age of 24 years (15 to 35 years). The duration of the disease ranged from 7 to 10 years, averaged 10 months. The main symptom was repeated ankle sprain. During physical examination, ankle varus and the anterior talar transition were conducted. There was (12.5 +/- 3.2) degrees more inversion activity than the contralateral ankle. Arthroscopy was performed for the chondral injury, and anatomic reconstruction of the lateral ligament with an autologous gracilis tendon graft was performed for lateral instability of the ankle. Clinical and radiological evaluations were performed before surgery and at the most recent follow-up.

RESULTS: All the patients with successful surgery, there was no fracture or infection. All the patients were followed up,and the duration ranged from 16 to 60 months, with an average of 28 months. There was no ankle instability or limited mobility of the 29 cases at the latest follow-up. According to the American Orthopedic Foot and Ankle Society ankle-hind foot scale, the mean score was 48.0 +/- 6.7 before surgery and 92.8 +/- 6.2 at the most recent follow-up (P = 0.010). The talar tilt angles on standard stress radiography were (12.5 +/- 3.2) degrees before surgery and (2.5 +/- 0.8) degrees at the most recent follow-up (P = 0.012). The mean distance of anterior talar translation was (16.3 +/- 4.0) mm before surgery and (3.5 +/- 0.8) mm at the most recent follow-up (P = 0.002). There were no severe complications, the results were satisfactory.

CONCLUSION: Anatomical reconstruction of the lateral ligament with autologous gracilis tendon graft for the treatment of chronic lateral instability of the ankle can be recommended.