The role of ankle arthroscopy and surgical approach in lateral ankle ligament repair

Lateral ankle instability may be associated with intra-articular ankle pathology and peroneal tendon pathology. This study was conducted to determine the relative incidence of associated pathology identified during lateral ligament repair. This information was analysed to determine if a standard surgical protocol of arthroscopic ankle assessment followed by ligament repair through a longitudinal postero-lateral incision (to include exposure of the peronei) is warranted. A retrospective review of 79 patient notes was conducted. All patients had peroneal tendon inspection at surgery and 58 underwent ankle arthroscopy immediately prior to ligament repair. Chondral and osteochondral lesions were identified in 29%; loose bodies in 24%; anterior osteophytes in 41% and peroneal tendon pathology in 14%. The presence of a number of lesions was not evident preoperatively (27% of chondral lesions and 36% of peroneal tendon tears). These results suggest that with unstable ankles requiring stabilisation, a protocol including ankle arthroscopy followed by lateral ligament repair through a postero-lateral approach is warranted. q 2004 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.