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Background: During the modified Broström procedure for chronic ankle instability, surgeons often experience cases with insufficiently restored mechanical stability even after anatomical ligament repair. In these cases, longer postoperative immobilization and delayed rehabilitation can be required, and a risk for recurrence of instability may persist. This study aimed to evaluate the clinical usefulness of suture-tape augmentation based on intraoperative stress radiographs during anatomical ligament repair for chronic ankle instability. Methods: Twenty-four patients who underwent additional suture-tape reinforcement because of residual mechanical instability on intraoperative stress radiographs were followed up ≥3 years. Clinical assessment was performed using the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). Changes in mechanical stability were analyzed through periodic stress radiographs, and postural control ability was evaluated with the modified Romberg test. Results: FAOS and FAAM scores improved significantly from preoperative mean 55.1 and 52.4 points to 92.3 and 90.2 points at final follow-up, respectively (P <.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean 15.8 degrees and 13.6 mm to 2.9 degrees and 4.2 mm, respectively (P <.001). Balance retention time improved significantly from preoperative mean 3.6 to 6.4 seconds (P <.001). Although 9 patients experienced sprain injury after surgery, no patient showed recurrence of mechanical and subjective instability, and 21 patients (87.5%) were able to return to preinjury level of sports activity. Conclusion: Evaluation of residual mechanical instability through intraoperative stress view and additional suture-tape augmentation showed satisfactory clinical outcomes at midterm follow-up. Suture-tape augmentation based on intraoperative stress radiographs seems to be a useful surgical option for patients with insufficiently restored mechanical stability even after anatomical ligament repair. This combined procedure can provide a reliable mechanical stability that can be performed after recognition of residual instability during the index surgery. [ABSTRACT FROM AUTHOR]

Background: Autologous osteochondral transplantation (AOT) is an option to treat large osteochondral lesions of the talus (OLTs), accompanying subchondral cyst, and previous unsuccessful bone marrow stimulation (BMS) procedures. Although there is extensive literature on the outcomes of surgical interventions for medial osteochondral lesions, research focusing on lateral lesions remains limited. This article presents the intermediate-term clinical and radiologic outcomes following AOT for lateral OLTs., Methods: Twenty-eight patients with lateral OLTs were followed up for a minimum of 3 years after AOT. Clinical evaluations included the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). Radiographic assessments evaluated articular surface (subchondral plate) irregularity, progression of degenerative arthritis, and changes in talar tilt and anterior talar translation. The quality of osteochondral graft was evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score., Results: The average FAOS and FAAM scores significantly increased from 39.6 to 91.2 and from 37.8 to 89.8 points, respectively, at the final follow-up ( P  < .001). Radiologic assessments revealed 2 patients (7.1%) with articular step-off ≥2 mm and 1 patient (3.6%) with progressive arthritis. The average MOCART score reached 92.8 points. Postoperative complications included 2 patients with wound problems, 1 with a superficial peroneal nerve injury, and 1 with donor site morbidity. The rate of return to preinjury level of sports activity was 82.1%. At a mean follow-up of 68.5 months, no patient required reoperation for OLT or recurrent ankle instability., Conclusion: AOT for lateral OLTs demonstrated favorable intermediate-term clinical and radiologic outcomes. Most lateral OLTs were accessible via lateral ankle ligament division and capsulotomy, with minimal occurrence of iatrogenic complications such as recurrent ankle instability. AOT appears to be an effective surgical option for patients with large lateral osteochondral lesions unresponsive to conservative treatment, large subchondral cysts, and prior unsuccessful BMS procedures., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Disclosure forms for all authors are available online.