Do small talar osteochondral defects need repair during lateral ligament reconstruction with internal brace augmentation in chronic ankle instability?

BACKGROUND

Chronic lateral ankle instability (CLAI) is frequently associated with intra-articular pathology.

PURPOSE OF THE STUDY: The study compared functional outcomes of lateral ligament reconstruction in patients with isolated CLAI versus CLAI with concomitant talar OCD.

STUDY

DESIGN

We conducted a retrospective review of patients who underwent lateral ligament reconstruction between January 2018 and December 2023.

METHODS

Preoperative MRI was used to confirm CLAI and identify talar OCD. Patients were classified into two groups: Group A - isolated CLAI, and Group B - CLAI with talar OCD (<1 cm²). Functional outcomes were measured using the Manchester-Oxford Foot Questionnaire (MOxFQ), EQ-5D, and EQ-VAS.

RESULTS

Seventy patients met the inclusion criteria: 39 in Group A (55.7%) and 31 in Group B (44.3%). Mean follow-up was 54.2 months (range 36.8-66.4). Group A: MOxFQ improved from 61.8 ± 20.4 to 22.5 ± 12.2; EQ-5D from 18.3 ± 7.7 to 4.4 ± 2.7; EQ-VAS from 54.6 ± 11.9 to 68.3 ± 19.8.

GROUP B: MOxFQ improved from 44.4 ± 10.0 to 18.0 ± 7.8; EQ-5D from 15.1 ± 2.5 to 8.5 ± 1.3; EQ-VAS from 46.7 ± 17.8 to 72.8 ± 29.3. There was no statistically significant difference in functional outcomes between the two groups (p = 0.145).

CONCLUSION

Lateral ligament reconstruction with suture tape augmentation in patients with chronic lateral ankle instability, with or without concomitant talar osteochondral defects, demonstrated no significant differences in functional outcomes between groups, suggesting that smaller osteochondral lesions less than 1cm2 in size may not require surgical repair.