{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:56:31Z","timestamp":1781769391251,"version":"3.54.5"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aims to illustrate the assessment and treatment strategies of acute and chronic deltoid ligament injuries, providing a treatment algorithm for each scenario.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was conducted on 39 patients, who had either an acute deltoid ligament injury or suffered chronic deltoid ligament insufficiency. All patients were operated on between January 2016 and December 2022. The cases represent a range of different clinical scenarios, including acute trauma, chronic insufficiency or instability situations. Clinical and imaging evaluation, surgical techniques and clinical outcomes are presented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean follow\u2010up time was 21.3 months (\u00b14.5). Acute trauma represented 18 (46%) of the ankles, while 21 (54%) had chronic instability. Treatment options were tailored according to the aetiology, patient characteristics, injury pattern and associated lesions. In 11 of the 18 acute deltoid ruptures (64%), repair was performed using suture anchors, while the remaining 7 cases were treated with direct suture. In chronic deltoid insufficiency, re\u2010tensioning with suture anchor was performed in 14 (67%) ankles, suture imbrication in 5 (24%) and reconstruction in 6 (9%). The most common associated injuries were syndesmotic injuries (<jats:italic>n<\/jats:italic>\u2009=\u200912, 56%) and osteochondral lesions (<jats:italic>n<\/jats:italic>\u2009=\u200913, 36%). The complication rate was 18% (<jats:italic>n<\/jats:italic>\u2009=\u20097), the majority related to persistent stiffness (<jats:italic>n<\/jats:italic>\u2009=\u20094, 10%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The decision on when and how to repair the deltoid ligament should be guided by the characteristics of the injury and the individual patient. The current treatment rationale may serve as a working basis for evaluating and treating these ankles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12576","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T08:08:36Z","timestamp":1735546116000},"page":"1874-1883","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Deltoid ligament injuries: When and how to repair"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6403-3563","authenticated-orcid":false,"given":"Emanuel Cortes\u00e3o","family":"Sei\u00e7a","sequence":"first","affiliation":[{"name":"Hospital Beatriz \u00c2ngelo Lisboa Portugal"},{"name":"Hospital Particular do Algarve Gambelas Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mendes","sequence":"additional","affiliation":[{"name":"Hospital CUF Tejo Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Resende","family":"Sousa","sequence":"additional","affiliation":[{"name":"Hospital da Luz Lisboa Portugal"},{"name":"Sport Lisboa e Benfica Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Vide","sequence":"additional","affiliation":[{"name":"Hospital Particular do Algarve Gambelas Portugal"},{"name":"Hospital da Luz Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100720909138"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.52855"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2020.08.009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.otsm.2009.10.001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100719839176"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2019.06.005"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00870"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.43071"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2024.04.003"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12173"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3180413835"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100720950742"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12345"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.5.200019"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100719891157"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-023-04462-7"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-7515(03)00147-5"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465020300031601"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2006.08.001"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2023.102328"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2024.109933"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-014-1842-5"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2015.06.004"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12274"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2021.05.004"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12244"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2023.03.007"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2024.1386401"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/22104917211035552"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717750577"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100720929007"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2023.11.011"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/10711007241245363"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2159-3"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fuspru.2023.08.004"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2021.03.006"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473011419860073"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.11.006"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.00046"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12328"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/10711007231184844"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2020.02.014"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.976181"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2708-4"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.12576","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T10:22:52Z","timestamp":1760869372000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.12576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,30]]},"references-count":44,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/ksa.12576"],"URL":"https:\/\/doi.org\/10.1002\/ksa.12576","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,30]]},"assertion":[{"value":"2024-06-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}