{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T19:59:54Z","timestamp":1790539194488,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,4,13]],"date-time":"2015-04-13T00:00:00Z","timestamp":1428883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,4,13]],"date-time":"2015-04-13T00:00:00Z","timestamp":1428883200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2015,4,13]],"date-time":"2015-04-13T00:00:00Z","timestamp":1428883200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether concomitant chronic syndesmotic injury or chronic medial ankle instability is associated with unsatisfactory outcomes in patients with chronic lateral ankle instability (CAI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective review of prospectively collected data from 276 male military patients with CAI who had undergone a modified Brostr\u00f6m procedure between May 2007 and March 2010 and had been followed up for a mean of 26.7\u00a0months (range, 22\u00a0to 41\u00a0months). We evaluated clinical outcomes using American Orthopaedic Foot &amp; Ankle Society ankle\u2010hindfoot, visual analog scale, and ankle functional satisfactory scale scores. Possible associations with concomitant instability were reconstructed and investigated using the Pearson correlation coefficient and multivariate logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 236 patients with satisfactory outcomes, 19 (8%) had medial ankle instability and 13 (6%) had syndesmotic instability; in contrast, of the 40 patients with unsatisfactory outcomes, 14 (35%) had medial ankle instability and 12 (30%) had syndesmotic instability. The mean American Orthopaedic Foot &amp; Ankle Society scores for patients with satisfactory and unsatisfactory outcomes increased from 68.1 to 92.8 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and from 65.9 to 76.8 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), respectively. The mean visual analog scale scores for the groups with satisfactory and unsatisfactory outcomes decreased from 5.8 to 2.1 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and from 6.2 to 4.8 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), respectively. The mean ankle satisfaction score was 27.8 for patients with satisfactory outcomes and 18.7 for those with unsatisfactory outcomes (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Multivariate logistic regression analysis showed a 4\u2010fold higher risk of dissatisfaction (95% confidence interval [CI], 0.81 to 20.07;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .0880) with CAI and syndesmotic instability, a 3.8\u2010fold higher risk (95% CI, 0.96 to 15.07;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .0576) with CAI and medial ankle instability, and an 11.7\u2010fold higher risk (95% CI, 2.60 to 52.70;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .0014) with CAI and both syndesmotic and medial ankle instability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic syndesmotic instability and chronic medial ankle instability are significantly associated with unsatisfactory outcomes in patients with CAI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, therapeutic case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2015.02.021","type":"journal-article","created":{"date-parts":[[2015,4,15]],"date-time":"2015-04-15T19:07:51Z","timestamp":1429124871000},"page":"1548-1556","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":23,"title":["Concomitant Syndesmotic Instability and Medial Ankle Instability Are Risk Factors for Unsatisfactory Outcomes in Patients With Chronic Ankle Instability"],"prefix":"10.1002","volume":"31","author":[{"given":"Jin Su","family":"Kim","sequence":"first","affiliation":[{"name":"Surgery of Foot and Ankle Eulji Medical Center College of Medicine Eulji University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Won","family":"Young","sequence":"additional","affiliation":[{"name":"Surgery of Foot and Ankle Eulji Medical Center College of Medicine Eulji University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hun Ki","family":"Cho","sequence":"additional","affiliation":[{"name":"Surgery of Foot and Ankle Eulji Medical Center College of Medicine Eulji University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok Min","family":"Lim","sequence":"additional","affiliation":[{"name":"Surgery of Foot and Ankle Eulji Medical Center College of Medicine Eulji University Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Uk","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery College of Medicine Ajou University Suwon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Tai","family":"Lee","sequence":"additional","affiliation":[{"name":"KT Lee's Orthopedic Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,13]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505282616"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.0153"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-927330"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.11.018"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465020300031601"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0095399703258789"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2011.12.002"},{"key":"e_1_2_2_9_2","first-page":"575","article-title":"Evaluation and treatment of ankle syndesmosis injuries","volume":"58","author":"Porter D.A.","year":"2009","journal-title":"Instr Course 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Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}