Search

The problem of chronic instability of lateral ankle ligaments has been approached with both conservative and surgical measures. Many operative procedures have been devised to correct this problem, and of these the Watson-Jones, modified Elmslie and Evans procedures are the most commonly used in our community. This paper was designed to: 1) compare the results of the three procedures; 2) investigate subtalar motion in a population of uninjured ankles; and 3) compare these results to subtalar motion in ankles after lateral ligament reconstruction.We found that each of the three procedures had a surprisingly high incidence of postoperative pain. All procedures had a high rate of return to preinjury activity level, and the majority of the patients were satisfied with the results of the operation. Postoperatively, the Watson-Jones repair exhibited the highest percentage of subjective instability. Twenty-four per cent of the Watson-Jones repairs had a postoperative talar tilt greater than 5°.It was determined that subtalar motion was affected by the type of reconstructive procedure, and although this fact had been theorized in the literature, it had not been documented by objective data.

In 1972 the original ICLH ankle was first used clinically, and since then the authors have implanted 75 ICLH ankles. The overall percentage of acceptable results in this series is about 70%.The most frequent complication seen was delayed wound healing. Talomalleolar contact with resultant pain was a significant problem early in the series. Partial collapse of the talus has occurred in five ankles. Our experience has shown that it is possible to replace the ankle and initially achieve a functioning, pain-free arthroplasty. There are many factors that may adversely influence the ultimate outcome; and thus, the procedure should be approached with caution.