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Comparison of chondral versus osteochondral lesions of the talus after arthroscopic microfracture
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Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
and body mass index were matched between the two groups. The laxity group (44 ankles, Beighton score; 5) and the normal group (56 ankles) were defined, and mean follow-up duration was 43.3 months and 42.9 months, respectively. Results: The mean postoperative Karlsson and AOFAS scores improved to 87.4 points and 89.5 points in the laxity group and to 94.1 points and 94.8 points in the nonlaxity group at final follow-up. The mean postoperative talar tilt angle and anterior talar translation improved to 7.3 degrees and 6.0 mm in the laxity group and to 5.2 degrees and 5.0 mm in the nonlaxity group at final followup. Failure rates were 11.4% (five patients) in the laxity group and 1.8% (one patient) in the normal group. Significant differences were found between the two groups in terms of clinical and radiographic outcomes (p < 0.05). Conclusion: Patients with GJL showed inferior outcomes and high failure rate compared to patients without GJL. Therefore, GJL appears to be a risk factor associated with recurrent instability after the modified Broström procedure. http://dx.doi.org/10.1016/j.fas.2017.07.365
277 Comparison of chondral versus osteochondral lesions of the talus after arthroscopic microfracture G.W. Lee ∗ , H.W. Park, K.B. Lee Department of Orthopaedic Surgery Chonnam National University Medical School and Hospital, Republic of Korea Background: An osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar cartilage. Aims: This study was to compare chondral versus osteochondral lesions of the talusafter arthroscopic microfracture Method: One hundred and four ankles were divided into two groups, namely chondral group (58 ankles) and osteochondral group (46 ankles). Outcomes were measured using the American Orthopaedic Foot and Ankle Society, ankle-hindfoot scale, and ankle activity score. Results: AOFAS score was 64.9 points (95% CI 63.0;66.9) in the chondral group and 68.2 points (95% CI 65.8;70.5) in the osteochondral group and it had improved to 88.8 points (95% CI 86.8;90.8) and 93.5 points (95% CI 91.4;95.6) at final follow-up. AAS changed from 2.7 (95% CI 2.5;2.9) to 6.4 (95% CI 6.0;6.8) in the chondral group, and from 2.5 (95% CI 2.3;2.8) to 6.6 (95% CI 6.3;6.9) in the osteochondral group at final follow-up. No significant differences were found between the two groups in terms of AOFAS and AAS. The chondral group showed older age, less trauma history, longer symptom duration, smaller lesion size, and more frequent degenerative changes such as subchondral cyst and synovitis. Conclusion: Both chondral and osteochondral lesions of the talus treated with arthroscopic microfracture showed good clinical outcomes. Microfracture could improve clinical outcomes significantly both chondral and osteochondral lesions of talus despite their different characteristics http://dx.doi.org/10.1016/j.fas.2017.07.366
278 Comparison of the modified Broström procedure for chronic lateral ankle instability with and without subfibular ossicle G.W. Lee ∗ , H.W. Ahn, K.B. Lee, M.C. Kim Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital, Republic of Korea Background: Subfibular ossicles are frequently found in patients with chronic lateral ankle instability (CLAI). However, there is a lack of consensus about the optimal surgical treatment for CLAI with subfibular ossicle. Aims: To evaluate the clinical and radiographic outcomes of the modified Broström procedure with subfibular ossicle excision compared with the same procedure without subfibular ossicle. Methods: Ninety-six patients (96 ankles) were divided into two groups; ossicle group (42 ankles) and nonossicle group (54 ankles). Mean follow-up duration was 63.7 and 62.1 months, respectively. Subfibular ossicles were excised in the ossicle group. Results: Mean Karlsson scores improved to 95.3 in the ossicle group and to 94.8 in the nonossicle group at final follow-up. Mean AOFAS ankle-hindfoot scores improved to 95.9 in the ossicle group and to 95.1 in the nonossicle group at final follow-up. Mean talar tilt angles decreased to 7.6◦ in the ossicle group and 6.8◦ in nonossicle group, respectively. Mean anterior talar translations also improced to 5.8 and 5.7 mm at final follow-up, respectively. No significant differences were found between the 2 groups in terms of clinical and radiographic outcomes at final follow-up (p > 0.05). Conclusion: The modified Broström procedure with subfibular ossicle excision provided similarly good clinical and radiographic outcomes compared with the same procedure without subfibular ossicle excision. Accordingly, the study results suggest that these procedures appear to be effective and reliable method for the treatment of CLAI with subfibular ossicle. http://dx.doi.org/10.1016/j.fas.2017.07.367
279 Comparison of arthroscopic versus fluoroscopic assisted syndesmotic screw fixation for distal tibiofibular stndesmosis injury D.Y. Kim ∗ , K.B. Lee Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital, Republic of Korea Background: The management of syndesmotic injury remains controversial in the treatment of ankle fractures. Arthroscopic assisted reduction provide accurate assessment of syndesmosis. Aim: The purpose of present study is to compare clinical and radiographic outcomes of arthroscopic versus fluoroscopicassisted syndesmotic screw fixation for distal tibiofibular syndesmosis injury. Methods: The study cohorts consist of forty-six ankles of fortysix patients who underwent operation for acute ankle fractures accompanied with distal tibiofibular syndesmotic injury during January 2010 and December 2014 with minimum follow-up duration of twelve months. Forty-six ankles were divided into two groups of twenty cases of arthroscpopic-assisted syndesmotic screw fixation group and twenty-six cases of fluoroscopic-assisted group. Mean duration of follow-up was thirty-two and thirty-three
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
and body mass index were matched between the two groups. The laxity group (44 ankles, Beighton score; 5) and the normal group (56 ankles) were defined, and mean follow-up duration was 43.3 months and 42.9 months, respectively. Results: The mean postoperative Karlsson and AOFAS scores improved to 87.4 points and 89.5 points in the laxity group and to 94.1 points and 94.8 points in the nonlaxity group at final follow-up. The mean postoperative talar tilt angle and anterior talar translation improved to 7.3 degrees and 6.0 mm in the laxity group and to 5.2 degrees and 5.0 mm in the nonlaxity group at final followup. Failure rates were 11.4% (five patients) in the laxity group and 1.8% (one patient) in the normal group. Significant differences were found between the two groups in terms of clinical and radiographic outcomes (p < 0.05). Conclusion: Patients with GJL showed inferior outcomes and high failure rate compared to patients without GJL. Therefore, GJL appears to be a risk factor associated with recurrent instability after the modified Broström procedure. http://dx.doi.org/10.1016/j.fas.2017.07.365
277 Comparison of chondral versus osteochondral lesions of the talus after arthroscopic microfracture G.W. Lee ∗ , H.W. Park, K.B. Lee Department of Orthopaedic Surgery Chonnam National University Medical School and Hospital, Republic of Korea Background: An osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar cartilage. Aims: This study was to compare chondral versus osteochondral lesions of the talusafter arthroscopic microfracture Method: One hundred and four ankles were divided into two groups, namely chondral group (58 ankles) and osteochondral group (46 ankles). Outcomes were measured using the American Orthopaedic Foot and Ankle Society, ankle-hindfoot scale, and ankle activity score. Results: AOFAS score was 64.9 points (95% CI 63.0;66.9) in the chondral group and 68.2 points (95% CI 65.8;70.5) in the osteochondral group and it had improved to 88.8 points (95% CI 86.8;90.8) and 93.5 points (95% CI 91.4;95.6) at final follow-up. AAS changed from 2.7 (95% CI 2.5;2.9) to 6.4 (95% CI 6.0;6.8) in the chondral group, and from 2.5 (95% CI 2.3;2.8) to 6.6 (95% CI 6.3;6.9) in the osteochondral group at final follow-up. No significant differences were found between the two groups in terms of AOFAS and AAS. The chondral group showed older age, less trauma history, longer symptom duration, smaller lesion size, and more frequent degenerative changes such as subchondral cyst and synovitis. Conclusion: Both chondral and osteochondral lesions of the talus treated with arthroscopic microfracture showed good clinical outcomes. Microfracture could improve clinical outcomes significantly both chondral and osteochondral lesions of talus despite their different characteristics http://dx.doi.org/10.1016/j.fas.2017.07.366
278 Comparison of the modified Broström procedure for chronic lateral ankle instability with and without subfibular ossicle G.W. Lee ∗ , H.W. Ahn, K.B. Lee, M.C. Kim Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital, Republic of Korea Background: Subfibular ossicles are frequently found in patients with chronic lateral ankle instability (CLAI). However, there is a lack of consensus about the optimal surgical treatment for CLAI with subfibular ossicle. Aims: To evaluate the clinical and radiographic outcomes of the modified Broström procedure with subfibular ossicle excision compared with the same procedure without subfibular ossicle. Methods: Ninety-six patients (96 ankles) were divided into two groups; ossicle group (42 ankles) and nonossicle group (54 ankles). Mean follow-up duration was 63.7 and 62.1 months, respectively. Subfibular ossicles were excised in the ossicle group. Results: Mean Karlsson scores improved to 95.3 in the ossicle group and to 94.8 in the nonossicle group at final follow-up. Mean AOFAS ankle-hindfoot scores improved to 95.9 in the ossicle group and to 95.1 in the nonossicle group at final follow-up. Mean talar tilt angles decreased to 7.6◦ in the ossicle group and 6.8◦ in nonossicle group, respectively. Mean anterior talar translations also improced to 5.8 and 5.7 mm at final follow-up, respectively. No significant differences were found between the 2 groups in terms of clinical and radiographic outcomes at final follow-up (p > 0.05). Conclusion: The modified Broström procedure with subfibular ossicle excision provided similarly good clinical and radiographic outcomes compared with the same procedure without subfibular ossicle excision. Accordingly, the study results suggest that these procedures appear to be effective and reliable method for the treatment of CLAI with subfibular ossicle. http://dx.doi.org/10.1016/j.fas.2017.07.367
279 Comparison of arthroscopic versus fluoroscopic assisted syndesmotic screw fixation for distal tibiofibular stndesmosis injury D.Y. Kim ∗ , K.B. Lee Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital, Republic of Korea Background: The management of syndesmotic injury remains controversial in the treatment of ankle fractures. Arthroscopic assisted reduction provide accurate assessment of syndesmosis. Aim: The purpose of present study is to compare clinical and radiographic outcomes of arthroscopic versus fluoroscopicassisted syndesmotic screw fixation for distal tibiofibular syndesmosis injury. Methods: The study cohorts consist of forty-six ankles of fortysix patients who underwent operation for acute ankle fractures accompanied with distal tibiofibular syndesmotic injury during January 2010 and December 2014 with minimum follow-up duration of twelve months. Forty-six ankles were divided into two groups of twenty cases of arthroscpopic-assisted syndesmotic screw fixation group and twenty-six cases of fluoroscopic-assisted group. Mean duration of follow-up was thirty-two and thirty-three