ABSTRACT
Erratum to: Oper Orthop Traumatol 2017 https://doi.org/10.1007/s00064-017-0513-9 The article was wrongly published under the article type "Review". Please note that the article is an "Original Paper".The publisher apologizes to the authors and .
ABSTRACT
OBJECTIVES: Anatomical reconstruction of the lateral ligament complex in the ankle. INDICATIONS: Chronic lateral ankle instability. CONTRAINDICATIONS: Severe osteoarthritis, obesity, hindfoot varus, general contraindications (infection, circulatory disorders, diabetic foot syndrome). SURGICAL TECHNIQUE: Anatomical Vshaped reconstruction of the lateral ligament complex with half of the peroneus brevis tendon and additional retinaculum stabilization. POSTOPERATIVE MANAGEMENT: Lower leg orthesis (e. g. protect.CAT Walker, medi GmbH, Bayreuth, Germany) for 6 weeks. Week 1-2, no weight bearing, no active pro- and supination. Starting in week 3-4, begin with partial weight bearing, pain adapted. Starting in week 7, free range of motion, begin with progressive training. RESULTS: Between March 2014 and June 2016, 16 patients (6 female, 10 male) were treated with the above-named technique. Average age was 32.8 years (range 17.9-57.1 years). Ten patients completed the 6 and 12-month follow-ups. None of these 10 patients reported a feeling of instability. In the clinical examination, the lateral ligament complex was stable. Patients showed a free range of motion at the 12-month follow-up.
Subject(s)
Ankle Joint/surgery , Joint Instability/surgery , Ligaments, Articular/surgery , Adolescent , Adult , Chronic Disease , Female , Follow-Up Studies , Humans , Joint Instability/etiology , Male , Middle Aged , Orthotic Devices , Physical Therapy Modalities , Postoperative Care , Range of Motion, Articular/physiology , Young AdultABSTRACT
OBJECTIVES: Flexion and extension osteotomy of the knee for symptomatic malalignment in the sagittal plane. INDICATIONS: Congenital/posttraumatic bony deficiencies in flexion/pathologic hyperextension in the knee. Additional treatment for ligament reconstruction. CONTRAINDICATIONS: Absolute: Infection, critical soft tissue situation, circulatory disorders. Relative: Osteoporosis, heavy smoker, obesity, reduced patient compliance. SURGICAL TECHNIQUE: Diagnostic arthroscopy of the knee. If the malposition is located at the proximal tibia, an extending or flexing high tibial osteotomy with correction of the tibial slope is carried out. If the malalignment is referred to the distal femur, the adjustment is performed by a distal femoral osteotomy. POSTOPERATIVE MANAGEMENT: Partial weight bearing with 20 kg for the first 6 postoperative weeks. Due to the tuberositas tibiae osteotomy, it is necessary to restrict the movement of the knee for the first 6 weeks. RESULTS: Between 2015 and 2016, 11 patients (2 female, 9 male) were treated with a flexion or extension osteotomy of the knee. Of these patients, 2 had symptomatic hyperflexion, 7 had restriction of movement with an exaggerated tibial slope, and 2 patients had an extension deficiency according to a malalignment of the distal femur. After surgery, the symptomatic pathologic movement of the knee was improved in every patient. One patient had pseudarthrosis during the healing process, which required a second operation with reosteosynthesis and bony grafting. These results are also reflected in an improvement of the preoperative IKDC score from 52.7 (range 37-82) to 1 year postoperative 75.8 (range 67-84). The Lysholm score increased from preoperative 40.2 (range 15-73) to postoperative 84.3 (range 68-91).
