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Sports Activity Level after Surgical Treatment for Chronic Anterolateral Ankle Instability

A Multicenter Study

Rover Krips, MD^*, C. Niek van Dijk, MD, PhD^*,, Hannu Lehtonen, MD, Tamas Halasi, MD, Bernard Moyen, MD^|| and Jon Karlsson, MD, PhD^a

^* Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, Department of Orthopaedic Surgery, University of Tampere, Tampere, Finland, National Institute for Sports Medicine, Budapest, Hungary, ^|| Centre Hospitalier Lyon-Sud, Lyon, France, ^a Sahlgrenska University Hospital, University of Göteborg, Göteborg, Sweden

Address correspondence and reprint requests to C. Niek van Dijk, MD, PhD, Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, POB 22700, 1100 DE Amsterdam, The Netherlands

The objective of this retrospective multicenter study was to determine whether anatomic reconstruction or tenodesis produces better results in athletic patients with lateral ankle instability. Forty-one patients who underwent anatomic reconstruction and 36 patients who underwent tenodesis were followed up. The median preinjury Tegner score for both groups was 9 (range, 7 to 10). At follow-up, 2 to 10 years after surgical treatment, the median Tegner score for both groups was 8 (range, 4 to 10). In the tenodesis group, 17 patients had a lower Tegner score than before the operation, but in the anatomic reconstruction group only 4 patients had lower scores. Significantly more patients in the tenodesis group (15) had limited ankle dorsiflexion than in the anatomic reconstruction group (3). Plain radiographs revealed that 11 patients in the tenodesis group had medially located osteophytes, compared with only 2 patients in the anatomic reconstruction group. Stress radiographs revealed that more patients in the anatomic reconstruction group had normal laxity values than in the tenodesis group (38 and 28, respectively). According to the rating system developed by Good et al., 36 patients in the anatomic reconstruction group had a good or excellent result, versus 21 patients in the tenodesis group. Anatomic reconstruction was found to be superior to tenodesis in all of the investigated outcome measures.

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