Пластика передней таранно-малоберцовой связки у пациентов с хронической нестабильностью голеностопного сустава (обзор литературы)

Травма голеностопного сустава признана одной из ведущих нозологий в общей структуре поражений опорно-двигательного аппарата не только среди профессиональных спортсменов, но и среди взрослого населения в общем. При неэффективности консервативной терапии развивается хроническая нестабильность голеностопного сустава, способная значительно снизить качество жизни пациентов, в этой ситуации безальтернативным становится оперативное лечение. Выбор метода хирургического вмешательства определяется не только характером травмы, но и состоянием связочно-сухожильного аппарата. Кроме того, в значительной степени хирургическая тактика выбирается на основании предпочтений конкретного хирурга. В статье описаны анатомо-физиологические особенности и факторы риска, определяющие возникновение острой нестабильности голеностопного сустава и ее переход в хроническое состояние, а также основные методики пластики передней таранно-малоберцовой связки и их распространенные модификации. Отдельное внимание уделено способам оценки эффективности оперативных методик на трупном связочном материале. Анализ литературы убеждает в том, что изученность вопроса остается недостаточной. Получение новых клинических данных позволит увеличить эффективность хирургической методики лечения нестабильности голеностопного сустава и значительно повысить качество жизни пациентов.

1. Al-Mohrej O.A., Al-Kenani N.S. Chronic ankle instability: Current perspectives. Avicenna J. Med. 2016;6(4):103–108. doi: 10.4103/2231-0770.191446

2. Hølmer P., Søndergaard L., Konradsen L., Nielsen P.T., Jørgensen L.N. Epidemiology of sprains in the lateral ankle and foot. Foot Ankle Int. 1994;15(2):72– 74. doi: 10.1177/107110079401500204

3. Waterman B.R., Belmont P.J. Jr., Cameron K.L., Svoboda S.J., Alitz C.J., Owens B.D. Risk factors for syndesmotic and medial ankle sprain: role of sex, sport, and level of competition. Am. J. Sports Med. 2011;39(5):992–998. doi: 10.1177/0363546510391462

4. Herzog M.M., Kerr Z.Y., Marshal S.W., Wikstrom E.A. Epidemiology of ankle sprains and chronic ankle instability. J. Athl. Train. 2019;54(6):603–610. doi: 10.4085/1062-6050-447-17

5. Giannini S., Ruffilli A., Pagliazzi G., Mazzotti A., Evangelisti G., Buda R., Faldini C. Treatment algorithm for chronic lateral ankle instability. Muscles Ligaments Tendons J. 2014;4(4):455–460.

6. Куров М.А., Голубев В.Г. Роль факторов риска в развитии хронической посттравматической нестабильности голеностопного сустава. Рос. мед.биол. вестн. 2018;26(3):430–439. doi: 10.23888/PAVLOVJ2018263430-439

7. Waterman B.R., Owens B.D., Davey S., Zacchilli M.A., Belmont P. Jr. The epidemiology of ankle sprains in the United States. J. Bone Joint Surg. Am. 2010;92(13):2279–2284. doi: 10.2106/JBJS.I.01537

8. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J. Athl. Train. 2002;37(4):364–375.

9. Sarcon A.K., Heyrani N., Giza E., Kreulen C. Lateral ankle sprain and chronic ankle instability. Foot Ankle Orthop. 2019;4(2):2473011419846938. doi: 10.1177/2473011419846938

10. Golanó P., Vega J., de Leeuw P.A., Malagelada F., Manzanares M.C., Götzens V., van Dijk C.N. Anatomy of the ankle: a pictorial essay. Knee Surg. Sports. Traumatol. Arthrosc. 2010;18(5):557–569. doi: 10.1007/s00167-010-1100-x

11. Clanton T.O., Campbell K.J., Wilson K.J. Qualitative and quantitative anatomic investigation of the lateral ankle ligaments for surgical reconstruction procedures. J. Bone Joint Surg. Am. 2014;96(12):e98. doi: 10.2106/JBJS.M.00798

12. Cao Y., Hong Y., Xu Y., Zhu Y., Xu X. Surgical management of chronic lateral ankle instability: a meta-analysis. J. Orthop. Surg. Res. 2018;13(1):159. doi: 10.1186/s13018-018-0870-6

13. Attarian D.E., McCrackin H.J., Devito D.P., McElhaney J.H., Garrett W.E. A biomechanical study of human lateral ankle ligaments and autogenous reconstructive grafts. Am. J. Sports Med. 1985;13(6):377– 381. doi: 10.1177/036354658501300602

14. van Rijn R.M., van Os A.G., Bernsen R.M., Luijsterburg P.A., Koes B.W., Bierma-Zeinstra S.M. What is the clinical course of acute ankle sprains? A systematic literature review. Am. J. Med. 2008;121(4):324–331. e6. doi: 10.1016/j.amjmed.2007.11.018

15. Renstrom P.A., Lynch S.A. Ankle ligament injuries. Br. J. Sports Med. 1997;31(1):11–20. doi: 10.1136/bjsm.31.1.11

16. Valovich McLeod T.C., Snyder A.R., Parsons J.T., Curtis Bay R., Michener L.A., Sauers E.L. Using disablement models and clinical outcomes assessment to enable evidence-based athletic training practice, part I: disablement models. J. Athl. Train. 2008;43(4):428–436. doi: 10.4085/1062-6050-43.4.437

17. Vuurberg G., Hoorntje A., Wink L.M., van der Doelen B.F.W., van den Bekerom M.P., Dekker R., van Dijk C.N., Krips R., Loogman M.C.M., Ridderikhof M.L., … Kerkhoffs G.M.M. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br. J. Sports. Med. 2018;52(15):956. doi: 10.1136/bjsports-2017-098106

18. Hiller C.E., Kilbreath S.L., Refshauge K.M. Chronic ankle instability: evolution of the model. J. Athl. Train. 2011;46(2):133–141. doi: 10.4085/10626050-46.2.133

19. Safran M.R., Benedetti R.S., Bartolozzi A.R. 3rd, Mandelbaum B.R. Lateral ankle sprains: a comprehensive review, part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. Med. Sci. Sports Exerc. 1999;31(7 Suppl):429–437. doi: 10.1097/00005768199907001-00004

20. Davis P.F., Trevino S.G. Ankle injuries. In: Baxter D.E., ed. The Foot and Ankle in Sport. Vol 1. St Louis, MO: Mosby-Yearbook, 1995. P. 158–164.

21. Karlsson J., Lansinger O. Lateral instability of the ankle joint. Clin. Orthop. Relat. Res. 1992;(276):253–261.

22. Bernier J.N., Perrin D.H., Rijke A. Effect of unilateral functional instability of the ankle on postural sway and inversion and eversion strength. J. Athl. Train. 1997;32(3):226–232.

23. Freeman M.A. Instability of the foot after injuries to the lateral ligament of the ankle. J. Bone Joint Surg. Br. 1965;47(4):669–677.

24. Coughlin M.J., Schenck R.C. Jr, Grebing B.R., Treme G. Comprehensive reconstruction of the lateral ankle for chronic instability using a free gracilis graft. Foot Ankle Int. 2004;25(4):231–241. doi: 10.1177/107110070402500407

25. Evans G.A., Hardcastle P., Frenyo A.D. Acute rupture of the lateral ligament of the ankle. To suture or not to suture? J. Bone Joint Surg. Br. 1984;66(2):209– 212. doi: 10.1302/0301-620X.66B2.6368563

26. Tropp H., Odenrick P., Gillquist J. Stabilometry recordings in functional and mechanical instability of the ankle joint. Int. J. Sports. Med. 1985;6(3):180–182. doi: 10.1055/s-2008-1025836

27. Casillas M.M. Ligament injuries of the foot and ankle in adult athletes. In: Sports Medicine: Principles and Practice. Vol 2. 2nd ed. Philadelphia, PA: WB Saunders, 2002. P. 2323–2348.

28. Konradsen L., Bech L., Ehrenbjerg M., Nickelsen T. Seven years follow-up after ankle inversion trauma. Scand. J. Med. Sci. Sports 2002;12(3):129– 135. doi: 10.1034/j.1600-0838.2002.02104.x

29. Ryan L. Mechanical stability, muscle strength and proprioception in the functionally unstable ankle. Aust. J. Physiother. 1994;40(1):41–47. doi: 10.1016/S0004-9514(14)60453-0

30. Rosenbaum D., Becker H.P., Gerngroß H., Claes L. Peroneal reaction times for diagnosis of functional ankle instability. Foot Ankle Surg. 2000;6(1):31– 38. doi: 10.1046/j.1460-9584.2000.00177.x

31. MacAuley D. Review Ankle injuries: same joint, different sports. Med. Sci. Sports. Exerc. 1999;31(7 Suppl):409–411. doi: 10.1097/00005768-19990700100001

32. Wester J.U., Jespersen S.M., Nielsen K.D., Neumann L. Wobble board training after partial sprains of the lateral ligaments of the ankle: a prospective randomized study. J. Orthop. Sports. Phys. Ther. 1996;23(5):332–336. doi: 10.2519/jospt.1996.23.5.332

33. Gribble P.A., Delahunt E., Bleakley C.M., Caulfield B., Docherty C.L., Fong D.T., Fourchet F., Hertel J., Hiller C.E., Kaminski T.W., … Wikstrom E.A. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. J. Athl. Train. 2014;49(1):121–127. doi: 10.4085/1062-6050-49.1.14

34. Gribble P.A., Bleakley C.M., Caulfield B.M., Docherty C.L., Fourchet F., Fong D.T.P., Hertel J., Hiller C.E., Kaminski T.W., McKeon P.O., … Delahunt E. 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br. J. Sports. Med. 2016;50(24):1493–1495. doi: 10.1136/bjsports-2016-096188

35. Delahunt E., Bleakley C.M., Bossard D.S., Caulfield B.M., Docherty C.L., Doherty C., Fourchet F., Fong D.T., Hertel J., Hiller C.E., … Gribble P.A. Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium. Br. J. Sports. Med. 2018;52(20):1304–1310. doi: 10.1136/bjsports-2017-098885

36. Ajis A., Maffulli N. Conservative management of chronic ankle instability. Foot Ankle Clin. 2006;11(3):531–537. doi: 10.1016/j.fcl.2006.07.004

37. Mattacola C.G., Dwyer M.K. Rehabilitation of the ankle after acute sprain or chronic instability. J. Athl. Train. 2002;37(4):413–429.

38. Janssen K.W., van Mechelen W., Verhagen E.A. Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial. Br. J. Sports. Med. 2014;48(16):1235–1239. doi: 10.1136/bjsports-2013-092947

39. Surve I., Schwellnus M.P., Noakes T., Lombard C. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am. J. Sports. Med. 1994;22(5):601–606. doi: 10.1177/036354659402200506

40. McGuine T.A., Keene J.S. The effect of a balance training program on the risk of ankle sprains in high school athletes. Am. J. Sports. Med. 2006;34(7):1103– 1111. doi: 10.1177/0363546505284191

41. Baumhauer J.F., O’Brien T. Surgical considerations in the treatment of ankle instability. J. Athl. Train. 2002;37(4):458–462.

42. McCriskin B.J., Cameron K.L., Orr J.D., Waterman B.R. Management and prevention of acute and chronic lateral ankle instability in athletic patient populations. World J. Orthop. 2015;6(2):161–171. doi: 10.5312/wjo.v6.i2.161

43. Guillo S., Bauer T., Lee J.W., Takao M., Kong S.W., Stone J.W., Mangone P.G., Molloy A., Perera A., Pearce C.J., … Calder J. Consensus in chronic ankle instability: aetiology, ssessment, surgical indications and place for arthroscopy. Orthop. Traumatol. Surg. Res. 2013;99(8 Suppl):411–419. doi: 10.1016/j.otsr.2013.10.009

44. Gerstner Garces J.B. Chronic ankle instability. Foot Ankle Clin. 2012;17(3):389–398. doi: 10.1016/j.fcl.2012.06.001

45. Chrisman O.D., Snook G.A. Reconstruction of lateral ligament tears of the ankle: an experimental study and clinical evaluation of seven patients treated by a new modification of the Elmslie procedure. J. Bone Joint Surg. Ser A. 1969;51:904–912. doi: 10.2106/00004623-196951050-00007

46. Evans D.L. Recurrent instability of the ankle; a method of surgical treatment. Proc. R. Soc. Med. 1953;46(5):343–344.

47. Watson-Jones R. Recurrent forward dislocation of the ankle joint. J. Bone Joint Surg. Br. 1952;34:519.

48. Bahr R., Pena F., Shine J., Lew W.D., Tyrdal S., Engebretsen L. Biomechanics of ankle ligament reconstruction. An in vitro comparison of the Brostrom repair, Watson-Jones reconstruction, and a new anatomic reconstruction technique. Am. J. Sports. Med. 1997;25(4):424–432. doi: 10.1177/036354659702500402

49. Bell S.J., Mologne T.S., Sitler D.F., Cox J.S. Twenty-six-year results after Brostrom procedure for chronic lateral ankle instability. Am. J. Sports. Med. 2006;34(6):975–978. doi: 10.1177/0363546505282616

50. Nakata K., Shino K., Horibe S., Natsuume T., Mae T., Ochi T. Reconstruction of the lateral ligaments of the ankle using solvent-dried and gamma-irradiated allogeneic fascia lata. J. Bone Joint Surg. Br. 2000;82(4):579–582. doi: 10.1302/0301-620x.82b4.10368

51. Boyer D.S., Younger A.S. Anatomic reconstruction of the lateral ligament complex of the ankle using a gracilis autograft. Foot Ankle Clin. 2006;11(3):585– 595. doi: 10.1016/j.fcl.2006.06.017

52. Xu X., Hu M., Liu J., Zhu Y., Wang B. Minimally invasive reconstruction of the lateral ankle ligaments using semitendinosus autograft or tendon allograft. Foot Ankle Int. 2014;35(10):1015–1021. doi: 10.1177/1071100714540145

53. Paterson R., Cohen B., Taylor D., Bourne A., Black J. Reconstruction of the lateral ligaments of the ankle using semi-tendinosis graft. Foot Ankle Int. 2000;21(5):413–419. doi: 10.1177/107110070002100510

54. Matheny L.M., Johnson N.S., Liechti D.J., Clanton T.O. Activity level and function after lateral ankle ligament repair versus reconstruction. Am. J. Sports. Med. 2016;44(5):1301–1308. doi: 10.1177/0363546515627817

55. Brostrom L. Sprained ankles. V. Treatment and prognosis in recent ligament ruptures. Acta Chir. Scand. 1966;132(5):537–550.

56. Brostrom L. Sprained ankles. VI. Surgical treatment of “chronic” ligament ruptures. Acta Chir. Scand. 1966;132(5):551–565.

57. Gould N. Repair of lateral ligament of ankle. Foot Ankle. 1987;8(1):55–58. doi: 10.1177/107110078700800111

58. Gould N., Seligson D., Gassman J. Early and late repair of lateral ligament of the ankle. Foot Ankle. 1980;1(2):84–89. doi: 10.1177/107110078000100206

59. Hamilton W.G., Thompson F.M., Snow S.W. The modified Brostrom procedure for lateral ankle instability. Foot Ankle. 1993;14(1):1–7. doi: 10.1177/107110079301400101

60. Liu W., Li H., Hua Y. Quantitative magnetic resonance imaging (MRI) analysis of anterior talofibular ligament in lateral chronic ankle instability ankles preand postoperatively. BMC Musculoskelet Disord. 2017;18(1):397. doi: 10.1186/s12891-017-1758-z

61. Drakos M.C., Behrens S.B., Paller D., Murphy C., DiGiovanni C.W. Biomechanical comparison of an open vs arthroscopic approach for lateral ankle instability. Foot Ankle Int. 2014;35(8):809–815. doi: 10.1177/1071100714535765

62. Maffulli N., Del Buono A., Maffulli G.D., Oliva F., Testa V., Capasso G., Denaro V. Isolated anterior Talofibular ligament Broström repair for chronic lateral ankle instability. Am. J. Sports. Med. 2013;41(4):858– 864. doi: 10.1177/0363546512474967

63. Yeo E.D., Lee K.T., Sung I.H., Lee S.G., Lee Y.K. Comparison of all-inside arthroscopic and open techniques for the modified Brostrom procedure for ankle instability. Foot Ankle Int. 2016;37(10):1037– 1045. doi: 10.1177/1071100716666508

64. Rigby R.B., Cottom J.M. A comparison of the “all-inside” arthroscopic Brostrom procedure with the traditional open modified Brostrom-Gould technique: a review of 62 patients. Foot Ankle Surg. 2019;25(1):31– 36. doi: 10.1016/j.fas.2017.07.642

65. Vega J., Golano P., Pellegrino A., Rabat E., Pena F. All-inside arthroscopic lateral collateral ligament repair for ankle instability with a knotless suture anchor technique. Foot Ankle Int. 2013;34(12):1701– 1709. doi: 10.1177/1071100713502322

66. Мацакян А.М., Кесян Г.А., Очкуренко А.А., Бутаев Б.Г., Ширмазанян А.Г., Процко В.Г. Использование модифицированной артроскопической стабилизации голеностопного сустава в лечении хронической наружной нестабильности. Вестн. травматол. и ортопедии. 2017;(1):32–36.

67. Guelfi M., Zamperetti M., Pantalone A., Usuelli F.G., Salini V., Oliva X.M. Open and arthroscopic lateral ligament repair for treatment of chronic ankle instability: a systematic review. Foot Ankle Surg. 2018;24(1):11–18. doi: 10.1016/j.fas.2016.05.315

68. Xu D.L., Gan K.F., Li H.J., Zhou S.Y., Lou Z.Q., Wang Y., Li G.Q., Ruan C., Hu X., Chen Y.L., Ma W.H. Modified Broström repair with and without augmentation using suture tape for chronic lateral ankle instability. Orthop. Surg. 2019;11(4):671–678. doi: 10.1111/os.12516

69. Petrera M., Dwyer T., Theodoropoulos J.S., Ogilvie-Harris D.J. Shortto medium-term outcomes after a modified Brostrom repair for lateral ankle instability with immediate postoperative weightbearing. Am. J. Sports Med. 2014;42(7):1542–1548. doi: 10.1177/0363546514530668

70. Waldrop N.E. 3rd, Wijdicks C.A., Jansson K.S., LaPrade R.F., Clanton T.O. Anatomic suture anchor versus the Brostrom technique for anterior talofibular ligament repair: a biomechanical comparison. Am. J. Sports. Med. 2012;40(11):2590–2596. doi: 10.1177/0363546512458420

71. Schuh R., Benca E., Willegger M., Hirtler L.3, Zandieh S., Holinka J., Windhager R. Comparison of Brostrom technique, suture anchor repair, and tape augmentation for reconstruction of the anterior talofibular ligament. Knee Surg. Sports Traumatol. Arthrosc. 2016;24(4):1101–1107. doi: 10.1007/s00167-0153631-7

72. Cho B.K., Park K.J., Park J.K., SooHoo N.F. Outcomes of the modified brostrom procedure augmented with suture-tape for ankle instability in patients with generalized ligamentous laxity. Foot Ankle Int. 2017;38(4):405–411. doi: 10.1177/1071100716683348

73. Messer T.M., Cummins C.A., Ahn J., Kelikian A.S. Outcome of the modified Brostrom procedure for chronic lateral ankle instability using suture anchors. Foot Ankle Int. 2000;21(12):996–1003. doi: 10.1177/107110070002101203

74. Cho B.K., Park K.J., Kim S.W., Lee H.J., Choi S.M. Minimal invasive suture-tape augmentation for chronic ankle instability. Foot Ankle Int. 2015;36(11):1330–1338. doi: 10.1177/1071100715592217

75. Li X., Killie H., Guerrero P., Busconi B.D. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Brostrom repair using suture anchors. Am. J. Sports Med. 2009;37(3):488–494. doi: 10.1177/0363546508327541