Chronic deltoid ligament insufficiency repair with Internal Brace™ augmentation
•Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation.•The treatment armamentarium ranges from simple ligament repair to complex reconstructions. Direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option.•Our results...
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| Veröffentlicht in: | Foot and ankle surgery 2019-12, Vol.25 (6), p.812-818 |
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| creator | Pellegrini, M.J. Torres, N. Cuchacovich, N.R. Huertas, P. Muñoz, G. Carcuro, G.M. |
| description | •Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation.•The treatment armamentarium ranges from simple ligament repair to complex reconstructions. Direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option.•Our results suggest that deltoid ligament repair with Internal Brace™ augmentation in patients with CDLI is a reliable option with good functional outcomes and high satisfaction grade in short term follow-up.
Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation. Although numerous procedures have been described, optimal treatment is still a matter of debate. While the treatment armamentarium ranges from simple ligament repair to complex reconstructions with or without realignment osteotomies, direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option. We investigated functional outcomes and complications in patients with CDLI operated on using Internal Brace™ augmentation.
A prospective study was conducted. Patients were included if they presented medial ankle pain and/or giving way, exhibited asymmetric flexible hindfoot valgus, failed conservative treatment, and had a positive MRI evaluated by an independent radiologist. Patients with stage IV flatfoot deformity, neuropathy and/or inflammatory arthritis were excluded. CDLI was confirmed intraoperatively with the arthroscopic drive-through sign. Patients were evaluated preoperatively and postoperatively using FAAM, SF-36 and grade of satisfaction. Paired t-tests were used to assess FAAM and SF-36 scores variation.
Thirteen patients met inclusion criteria. No patient was lost to follow-up, with a mean follow-up time of 13.5 months (range 6-21). Preoperative FAAM and SF-36 scores improved from 58.7 to 75.3 and from 60.2 to 84.4 postoperatively, respectively (p |
| doi_str_mv | 10.1016/j.fas.2018.10.004 |
| format | Article |
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Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation. Although numerous procedures have been described, optimal treatment is still a matter of debate. While the treatment armamentarium ranges from simple ligament repair to complex reconstructions with or without realignment osteotomies, direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option. We investigated functional outcomes and complications in patients with CDLI operated on using Internal Brace™ augmentation.
A prospective study was conducted. Patients were included if they presented medial ankle pain and/or giving way, exhibited asymmetric flexible hindfoot valgus, failed conservative treatment, and had a positive MRI evaluated by an independent radiologist. Patients with stage IV flatfoot deformity, neuropathy and/or inflammatory arthritis were excluded. CDLI was confirmed intraoperatively with the arthroscopic drive-through sign. Patients were evaluated preoperatively and postoperatively using FAAM, SF-36 and grade of satisfaction. Paired t-tests were used to assess FAAM and SF-36 scores variation.
Thirteen patients met inclusion criteria. No patient was lost to follow-up, with a mean follow-up time of 13.5 months (range 6-21). Preoperative FAAM and SF-36 scores improved from 58.7 to 75.3 and from 60.2 to 84.4 postoperatively, respectively (p<.01). Two implant failures were observed, with no apparent compromise of construct stability. No patient was re-operated.
Our results suggest that deltoid ligament repair with Internal Brace™ augmentation in patients with CDLI is a reliable option with good functional outcomes and high satisfaction grade in short term follow-up.
Level of evidence: Level IV.</description><identifier>ISSN: 1268-7731</identifier><identifier>EISSN: 1460-9584</identifier><identifier>DOI: 10.1016/j.fas.2018.10.004</identifier><identifier>PMID: 30478015</identifier><language>eng</language><publisher>France: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Ankle instability ; Arthroscopy ; Augmentation ; Chronic deltoid ligament insufficiency ; Female ; Follow-Up Studies ; Foot - physiopathology ; Foot - surgery ; Humans ; Internal Brace ; Internal Fixators ; Ligaments, Articular - physiopathology ; Ligaments, Articular - surgery ; Male ; Middle Aged ; Patient Satisfaction ; Prospective Studies ; Young Adult</subject><ispartof>Foot and ankle surgery, 2019-12, Vol.25 (6), p.812-818</ispartof><rights>2018 European Foot and Ankle Society</rights><rights>Copyright © 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-83857e5cb2d450e01d7af590baa2702506bcbaf092939cf88929b78b099257c13</citedby><cites>FETCH-LOGICAL-c353t-83857e5cb2d450e01d7af590baa2702506bcbaf092939cf88929b78b099257c13</cites><orcidid>0000-0002-8874-8528</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.fas.2018.10.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30478015$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pellegrini, M.J.</creatorcontrib><creatorcontrib>Torres, N.</creatorcontrib><creatorcontrib>Cuchacovich, N.R.</creatorcontrib><creatorcontrib>Huertas, P.</creatorcontrib><creatorcontrib>Muñoz, G.</creatorcontrib><creatorcontrib>Carcuro, G.M.</creatorcontrib><title>Chronic deltoid ligament insufficiency repair with Internal Brace™ augmentation</title><title>Foot and ankle surgery</title><addtitle>Foot Ankle Surg</addtitle><description>•Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation.•The treatment armamentarium ranges from simple ligament repair to complex reconstructions. Direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option.•Our results suggest that deltoid ligament repair with Internal Brace™ augmentation in patients with CDLI is a reliable option with good functional outcomes and high satisfaction grade in short term follow-up.
Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation. Although numerous procedures have been described, optimal treatment is still a matter of debate. While the treatment armamentarium ranges from simple ligament repair to complex reconstructions with or without realignment osteotomies, direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option. We investigated functional outcomes and complications in patients with CDLI operated on using Internal Brace™ augmentation.
A prospective study was conducted. Patients were included if they presented medial ankle pain and/or giving way, exhibited asymmetric flexible hindfoot valgus, failed conservative treatment, and had a positive MRI evaluated by an independent radiologist. Patients with stage IV flatfoot deformity, neuropathy and/or inflammatory arthritis were excluded. CDLI was confirmed intraoperatively with the arthroscopic drive-through sign. Patients were evaluated preoperatively and postoperatively using FAAM, SF-36 and grade of satisfaction. Paired t-tests were used to assess FAAM and SF-36 scores variation.
Thirteen patients met inclusion criteria. No patient was lost to follow-up, with a mean follow-up time of 13.5 months (range 6-21). Preoperative FAAM and SF-36 scores improved from 58.7 to 75.3 and from 60.2 to 84.4 postoperatively, respectively (p<.01). Two implant failures were observed, with no apparent compromise of construct stability. No patient was re-operated.
Our results suggest that deltoid ligament repair with Internal Brace™ augmentation in patients with CDLI is a reliable option with good functional outcomes and high satisfaction grade in short term follow-up.
Level of evidence: Level IV.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Ankle instability</subject><subject>Arthroscopy</subject><subject>Augmentation</subject><subject>Chronic deltoid ligament insufficiency</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Foot - physiopathology</subject><subject>Foot - surgery</subject><subject>Humans</subject><subject>Internal Brace</subject><subject>Internal Fixators</subject><subject>Ligaments, Articular - physiopathology</subject><subject>Ligaments, Articular - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Satisfaction</subject><subject>Prospective Studies</subject><subject>Young Adult</subject><issn>1268-7731</issn><issn>1460-9584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1OwzAQhS0E4v8AbFCWbFLGcRzbYgUVP5UqISRYW44zAVdpUuwE1D0n4WicBJcWlqzmzei9J81HyAmFEQVanM9GtQmjDKiM-wgg3yL7NC8gVVzm21FnhUyFYHSPHIQwAwChgO2SPQa5kED5PnkYv_iudTapsOk7VyWNezZzbPvEtWGoa2cdtnaZeFwY55N3178kk7ZH35omufLG4tfHZ2KG51XG9K5rj8hObZqAx5t5SJ5urh_Hd-n0_nYyvpymlnHWp5JJLpDbMqtyDgi0EqbmCkpjMgEZh6K0palBZYopW0sZRSlkCUplXFjKDsnZunfhu9cBQ6_nLlhsGtNiNwSdUSaLXFEQ0UrXVuu7EDzWeuHd3PilpqBXJPVMR5J6RXJ1iiRj5nRTP5RzrP4Sv-ii4WJtwPjkm0Ovww8rrJxH2-uqc__UfwOqeYSk</recordid><startdate>201912</startdate><enddate>201912</enddate><creator>Pellegrini, M.J.</creator><creator>Torres, N.</creator><creator>Cuchacovich, N.R.</creator><creator>Huertas, P.</creator><creator>Muñoz, G.</creator><creator>Carcuro, G.M.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8874-8528</orcidid></search><sort><creationdate>201912</creationdate><title>Chronic deltoid ligament insufficiency repair with Internal Brace™ augmentation</title><author>Pellegrini, M.J. ; Torres, N. ; Cuchacovich, N.R. ; Huertas, P. ; Muñoz, G. ; Carcuro, G.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-83857e5cb2d450e01d7af590baa2702506bcbaf092939cf88929b78b099257c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Ankle instability</topic><topic>Arthroscopy</topic><topic>Augmentation</topic><topic>Chronic deltoid ligament insufficiency</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Foot - physiopathology</topic><topic>Foot - surgery</topic><topic>Humans</topic><topic>Internal Brace</topic><topic>Internal Fixators</topic><topic>Ligaments, Articular - physiopathology</topic><topic>Ligaments, Articular - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Satisfaction</topic><topic>Prospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pellegrini, M.J.</creatorcontrib><creatorcontrib>Torres, N.</creatorcontrib><creatorcontrib>Cuchacovich, N.R.</creatorcontrib><creatorcontrib>Huertas, P.</creatorcontrib><creatorcontrib>Muñoz, G.</creatorcontrib><creatorcontrib>Carcuro, G.M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Foot and ankle surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pellegrini, M.J.</au><au>Torres, N.</au><au>Cuchacovich, N.R.</au><au>Huertas, P.</au><au>Muñoz, G.</au><au>Carcuro, G.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic deltoid ligament insufficiency repair with Internal Brace™ augmentation</atitle><jtitle>Foot and ankle surgery</jtitle><addtitle>Foot Ankle Surg</addtitle><date>2019-12</date><risdate>2019</risdate><volume>25</volume><issue>6</issue><spage>812</spage><epage>818</epage><pages>812-818</pages><issn>1268-7731</issn><eissn>1460-9584</eissn><abstract>•Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation.•The treatment armamentarium ranges from simple ligament repair to complex reconstructions. Direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option.•Our results suggest that deltoid ligament repair with Internal Brace™ augmentation in patients with CDLI is a reliable option with good functional outcomes and high satisfaction grade in short term follow-up.
Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation. Although numerous procedures have been described, optimal treatment is still a matter of debate. While the treatment armamentarium ranges from simple ligament repair to complex reconstructions with or without realignment osteotomies, direct repair augmented with an Internal Brace™ device appears to be an attractive intermediate option. We investigated functional outcomes and complications in patients with CDLI operated on using Internal Brace™ augmentation.
A prospective study was conducted. Patients were included if they presented medial ankle pain and/or giving way, exhibited asymmetric flexible hindfoot valgus, failed conservative treatment, and had a positive MRI evaluated by an independent radiologist. Patients with stage IV flatfoot deformity, neuropathy and/or inflammatory arthritis were excluded. CDLI was confirmed intraoperatively with the arthroscopic drive-through sign. Patients were evaluated preoperatively and postoperatively using FAAM, SF-36 and grade of satisfaction. Paired t-tests were used to assess FAAM and SF-36 scores variation.
Thirteen patients met inclusion criteria. No patient was lost to follow-up, with a mean follow-up time of 13.5 months (range 6-21). Preoperative FAAM and SF-36 scores improved from 58.7 to 75.3 and from 60.2 to 84.4 postoperatively, respectively (p<.01). Two implant failures were observed, with no apparent compromise of construct stability. No patient was re-operated.
Our results suggest that deltoid ligament repair with Internal Brace™ augmentation in patients with CDLI is a reliable option with good functional outcomes and high satisfaction grade in short term follow-up.
Level of evidence: Level IV.</abstract><cop>France</cop><pub>Elsevier Ltd</pub><pmid>30478015</pmid><doi>10.1016/j.fas.2018.10.004</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8874-8528</orcidid></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adolescent Adult Ankle instability Arthroscopy Augmentation Chronic deltoid ligament insufficiency Female Follow-Up Studies Foot - physiopathology Foot - surgery Humans Internal Brace Internal Fixators Ligaments, Articular - physiopathology Ligaments, Articular - surgery Male Middle Aged Patient Satisfaction Prospective Studies Young Adult |
| title | Chronic deltoid ligament insufficiency repair with Internal Brace™ augmentation |
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