Orthopedics Research Journal


Previous Issues Volume 1, Issue 1 - 2016

Research Article Full-Text  PDF  

Painful Chronic Lateral Instability of the Ankle: Benefits of Arthroscopy Combined with Hemi-Castaing Ligamentoplasty

Navraj S Nagra1 , Nicolas Poirier2,3, Marc-Pierre Henry2,3, Frédéric Dubrana2,3, Arnaud Clave1

1Oxford University Clinical Academic Graduate School (OUCAGS), Medical Sciences Division, John Radcliffe Hospital, Oxford, OX3 9DU UK

2Department of Orthopaedic and Trauma Surgery , CHU de la Cavale Blanche , Boulevard Tanguy Prigent, 29609 Brest.

3University of Western Brittany , Faculty of Medicine, 22 Rue Camille Desmoulins, 29200 Brest.

Corresponding Author: Clavé Arnaud, Orthopaedic Surgery and Traumatology of the Cavale Blanche, Boulevard Tanguy Prigent 29609 Brest, UK. Tel: +33298347273; Email: [email protected]

Received Date: 12 Jan 2016   
Accepted Date:18 Feb 2016   
Published Date:07 Mar 2016

Copyright © 2016 Clavé A

Citation: Nagra NS, Poirier N, Marc-Pierre H, Clavé A, et al. (2016). Painful Chronic Lateral Instability of the Ankle: Benefits of Arthroscopy Combined with Hemi-Castaing Ligamentoplasty. M J Orth. 1(1): 005.


Background and Aims

This study aimed to compare outcomes of chronic lateral instability of the ankle in patients treated by hemi- Castaingligamentoplasty with either arthrotomy or arthroscopy.

Patients and Methods

Eighty patients with painful chronic lateral instability who received lateral ligament reconstruction using a hemi-Castaing technique over a six-year period were included in this retrospective, single-centre study, with a mean follow-up of 36months (range 18-56months). Patients were divided into two groups: arthrotomy (n=50) and arthroscopy, (n=30). Preoperative and postoperative evaluation according to laxity, instability, pain, Olerud and Molander Ankle Scores and complications were compared between the groups.


No difference in the subjective assessment of outcome (91% were ‘very satisfied’ and‘satisfied’ in arthrotomy patients versus 90% in arthroscopy patients) was detected. However, significant differences regarding persistence of pain at review were noted (60% versus 30% - p=0.0126). Superiority in outcomes in the arthroscopy group were also observed in overall functional outcome and its assessment through the Olerud and Molander Ankle Score with a mean gain of 11 (range, 0 to 35) points for arthrotomy (87.5) versus 20.5 (range, -50 to 60) for arthroscopy (90.5) (p=0.021) patients.


Our study shows that, when compared with a simple arthrotomy, ankle arthroscopy in the context of the hemi-Castaing technique results in marked reduction of pain symptoms and improvement of ankle function without affecting morbidity.


Ankle; Painful chronic lateral instability; Arthroscopy; Ligamentoplasty; Chondral lesio

Creative Commons License

© 2015 Mathews Open Access Journals. All Rights Reserved.

Open Access by Mathews Open Access Journals is licensed under a
Creative Commons Attribution 4.0 International License.
Based On a Work at Mathewsopenaccess.com