Comments on Monograph Pertaining to Persistent Problems After Ankle Sprains
It was my pleasure to help to assemble and edit this monograph on persistent problems after ankle sprains. The topic of lateral ankle ligament reconstruction has been covered widely in the literature and now with online educational videos. It was not revisited in this monograph. The main message that has emerged over the past few years is to match the reconstruction to the patient’s demands. Anticipate patients’ postoperative demands based upon their vocation, hobbies, and comorbidities. Prevent recurrent instability, be it lateral or medial or syndesmotic instability. The rule still stands that recurrent ankle sprains will result in acute or chronic cartilage damage. Progression of disease can be multifactorial, but a lack of congruency of a joint in addition to persistent laxity will lead to damage to the surrounding soft tissue structures as well as arthritis. I have covered various techniques of lateral ankle ligament reconstruction in my section of the AAOS Publication: Atlas of Essential Orthopaedic Procedures, Second Edition. The purpose of this monograph is to cover the persistent or frequently overlooked issues which pertain to problems that develop acutely or chronically after ankle sprains, both inversion and eversion injuries. Along with the spirit of this journal, rather than citing large volumes of data, we have boiled the topics down to practical takeaways. The progressive availability of new Food and Drug Administration (FDA) approved surgical materials and orthobiologics have to be considered for efficacy while keeping in mind budgetary impact analysis on clinical outcomes. Surgical repair for persistent problems after ankle sprains continues to advance. I would like to thank the authors for their time, clinical expertise, and dedication to their specialty. Their advice will result in far reaching excellent clinical care for persistent problems after ankle sprains across multiple venues.
Nicholas A. Abidi, MD
N.A.A. receives royalties from Arthrex for products that are not discussed in this monograph and is a consultant for Acumed for products that are not discussed in this monograph.