Request an Appointment. There are numerous ligaments on each side of the joint which helps keep the ankle stable. Our knee specialists are world leaders in the treatment of knee conditions, and have particular expertise in anterior cruciate ligament (ACL) reconstruction, treatment of joint surface (chondral) damage/ osteoarthritis, meniscal surgery, osteotomies and total or partial knee replacement. As a general guide, if your job involves sitting down for most of the time you should be able to return to work after two weeks; if it involves manual work, you may need to have between eight and 10 weeks off. Key Hole Bunion Specialist, Need more information or Wish to book an appointment Please call Helen on 020 7993 2373 or email her Stiffness exercises are important to reduce the stiffness after surgery. ACL Surgery Cost in Malaysia. A course of physiotherapy may be helpful to reprogram the proprioceptive nerve fibres which have been damaged. The ankle joint is a hinge between the leg and the foot. Avoiding inversion/eversion, Achieve full range of movement Lets start getting you back to your very best. In a few cases, a twisting force on the ankle may cause other damage. Surgery to examine or repair ligaments or tendons, or to take away bone or tissue giving rise to pain or arthritis including osteochondral injuries. Registered in England and Wales under company number: 07033880, Fortius clinic is the trading name of Fortius London Limited. They then take out damaged cartilage, bone or other debris. This is suitablein cases where this is repeat surgery due to failed ligament repair. Patients undergoing right foot surgery need to drive with their left foot until they feel safe to resume. Your medical team will ask you to get up and start moving as soon as you can. However, if necessary, further surgery can be carried out, You may be given blood-thinning medication after the surgery if you are at a higher risk of DVT (where a blood clot forms in a deep vein in the leg). The tendons behind the outside bone of the ankle, also called the peroneal tendons, allow the foot to move outwards. The artificial joint helps the ankle retain more-natural movement, so there's less risk of arthritis developing in nearby joints. No impact exercise, Resisted inversion and eversion exercises with progression The objective is to prevent the ankle from giving way and stabilising it. However, the risk of DVT after this procedure is less than 3% and may be reduced if you keep your ankle moving and carry out the recommended exercises, The IP address from which the device accesses a clients website or mobile application, Information about the geographic location of the device when it accesses a website or mobile application, Create a better, more personalised experience, Help us understand how people interact with our website and how this could be improved, Make our advertising and communications efforts more efficient with measurement and targeting. Our spinal specialists treat an extensive range of spinal (back) conditions and injuries, providing the latest diagnostic, assessment and therapies for spinal care. Chronic regional pain This is excessive pain after surgery and is a very rare complication. Ankle replacement. You may shower after the stitches have been removed and the wound is fully healed. You may order this from the online doctor store. The torn ligament or ligaments are surgically removed and replaced with either cadaver, or a patient's own, tendons. Sutures removed @ 10 -16 days. The physiotherapist will show you how to use crutches. Elevation is key to reducing this. There are two main types of operation: Anatomical repair - The damaged ligaments are tightened up and re-attached to the bone - often known as the Brostrum procedure. 502-365-1899. How would ankle instability be diagnosed? MedStar Health is home to a team of doctors who specialize in surgical treatments, such as foot and ankle tendon repair surgery. The exact times will be discussed with you by your surgeon, but generally you will have either a cast and/or walking boot for a period of 4-6 weeks. Sports and activities which rely on running on uneven surfaces may worsen the symptoms of instability. I was in a cast for 6 weeks, non weight baring. As most ankle injuries recover without surgery, often a trial of non-operative treatment is required before considering surgery (usually 3-6 months or sometimes longer). However, in the case of torn ligament ankle surgery, this could be even longer, as the body . Finally, after eight to 12 weeks, you'll be able to return to your normal footwear. Most of our patients (82%) report little or no pain by 6 weeks, and the vast majority (90%) by 12 weeks. We offer various noninvasive and minimally invasive treatments, surgical procedures, and physical therapy as spearheaded by our board-certified physicians. Fortius Clinic but this will not influence clinical decisions affecting your care. Week 12: Start straight running and functional activities (provided peroneal strength and proprioception normal) With more significant swelling expect a prescription for a Bioskin Aftercare compression brace. Louisville, KY . Its main advantage is that it causes less stiffness than the other type of repair, as it aims to achieve an anatomical repair of the ligaments. The bones of the leg (tibia and fibula) form a sort of slot and the ankle bone (talus) fits between them. Whatever your orthopaedic condition or sports injury, we have a team of top medical experts waiting to help. Tendons can tear partially or completely during a joint injury. If you suffer from pain in multiple joints such as arthritis, or multiple sports injury issues, you may need to see one of our physician team that includes rheumatology, pain orsports and exercise medicine. Ligament detachment/rupture this may need a further operation to repair. Frequently, this procedure is performed once other non-surgical treatments, including physiotherapy, have proved ineffective. It may take several months before swelling subsides. At around 2 weeks after surgery, you will return to the clinic to have the cast and stitches removed and a new cast applied. This website uses cookies and similar technologies to better understand your needs and improve your experience on our website. Neutral foot position when weight bearing / mobilising, Range of movement Often a full recovery takes much longer than one would expect - Up to a year. Like us on. Return to recreational walking and light activities can take up to 3-6 months. When the ACL is torn, the knee becomes unstable, and the joint may deteriorate over time. Monitor sensation, swelling, colour, temperature, etc Return to more intensive sports can take between 9 months to one year. Ankle injuries are initially treated non-operatively with Rest, Ice, Compression and Elevation (RICE). These are commonly injured when the ankle is sprained and on occasions will lead to symptomatic instability needing surgery. You should keep your splints and bandages in place until your doctor gives you further instructions. To compare the return to sports and short-term clinical outcomes between the arthroscopic all-inside and the open anatomic reconstruction with gracili Our specialists are leaders in the treatment of foot and ankle conditions, for both amateur and professional athletes with a wide variety of foot and ankle problems, focusing on the delivery of excellent care to enable all patients to reach their personal goals. We aim to see you back in the clinic at regular intervals to monitor your progress and answer any questions you may have during your recovery. Use the strong extended and rapid acting narcotics for the first 3-5 days. If you are looking for orthopedic care in the San Antonio area, then visit us at the Center for Orthopaedic Surgery and Sports Medicine. For less severe tears, suturing may suffice. Ankle boots should also be considered. Non-anatomical repair - another piece of tissue, usually part of one of the nearby tendons, is borrowed and stitched between the bones where the ligaments should be. Strict elevation at the level of the chest If you have severe ligament damage caused by an ankle sprain, overuse or injury, your doctor will likely recommend ankle ligament reconstruction surgery. You'll need to use crutches or a walker, because you have to keep your weight off . MedStar Health is home to a team of doctors who specialize in surgical treatments, such as foot and ankle tendon repair surgery. For a standard ankle sprain it usually takes 2-4 weeks to recover. In general, patients will likely need to stay off of the affected foot following surgery for a period of timeusually several weeks. You should keep your foot elevated on a chair/pillow and take regular painkillers. The surgeon prescribes pain medication to be taken for a few days after the ankle surgery. Pacing advice as appropriate, Muscle strength: eversion grade 4 or 5 on Oxford scale It is very strong but often causes quite a lot of stiffness in the ankle afterwards. In some cases, the surgeon will first carry out ankle arthroscopy to inspect the joint before repairing the ligament. Arthroscopic ACL Ligament Reconstruction. Eversion strength grade 4 or 5, No balance exercises until eversion grade 4 or 5 Activity modification may help reduce the symptoms of instability. It will also help address stiffness and strengthen the surrounding muscles which help with keeping the ankle stable. Some of the practising consultants have a financial interest in Sometimes, however, there is some permanent damage to the ankle. An X-ray may be able to show fractures and chip fractures. Multiple heel raise Specialising in the minimally invasive arthroscopic treatment of injuries, they can help musicians and performing artists, as well as amateur and professional sportsmen and women, return to fitness as quickly as possible. Encourage isolation of evertors without overuse of other muscles Once the plaster is removed you can shower as normal if the wound is healed, but gently dab it dry. Ankle sprain is one of the most frequent musculoskeletal injuries sustained by athletes with an incidence of 9.35/10,000 elite athletic exposures [].A study reviewing a large cohort of military academy cadets reported the incidence rate of ankle sprain to be 58.4 per 1000 person-years [].The majority of these ankle sprains involve the lateral ligament complex with ankle supination-inversion . Ongoing instability in some cases, especially in patients who are hypermobile/double jointed the ankle may still feel unstable despite surgery. You will have a period of non-weightbearing and protected weightbearing in a cast or walking boot. Our surgeons are fellowship-trained in foot and ankle . The anterior cruciate ligament (ACL) is crucial for preserving knee joint stability, especially when weaving, rotating, or kicking. Orthotics if required via surgical team The tendons in your feet and ankles may become injured or torn due to disease (such as diabetes or arthritis), overuse, structural abnormalities, or a sports injury. Most importantly, an ankle ligament injury can also damage the small nerve endings in the joint and ligaments. We will respond to you within 24 hours or on the next working day, or please call 0203 195 2442. Benefits include: Less scarring. The ankle joint is a hinge between the leg and the foot. Core stability work Reach out to us by calling (210) 692-7400 or book an . Change location Achilles Tendon), not of transfer. It may take several weeks before you can drive. A good guide is if you can stamp down hard with the foot to stop the car during an emergency stop. Full range of movement This depends on the type of work you do and how quickly you recover. The pain from the surgery usually gets better over the first 4-6 weeks after the procedure. Styf J Early range of motion training after ligament reconstruction of the ankle joint. Once the wound has healed, and provided that you follow your rehabilitation programme (which can take around three months), most people are able to return to a good level of activity and sports within four to six months, with continued improvement for up to a year. These cookies allow companies or advertisers we work with to deploy more relevant ads and improve the efficiency of our marketing efforts. Our experienced orthopedic physicians offer you the comprehensive care you need for an effective procedure and a successful recovery. Progress strengthening of evertors There may still be some limitations in the sporting activities thereafter. Lateral ankle ligament reconstruction is a surgery to tighten and firm up one or more ankle ligaments on the outside of your ankle. The specific risks to this surgery include. However, if you are worried, contact the Fortius Clinic for advice, Your doctor may suggest that you take anti-inflammatory medication for around six weeks after surgery, Two weeks - your wound will be checked and you will be fitted with a new boot, Six weeks - your boot will be removed and you will be able to wear normal shoes, 12 weeks - final appointment and discharge, 0-2 weeks - you will have a plaster cast and be non weight bearing with crutches, 2-4 weeks - you will be given a boot to immobilise your foot and be partially weight bearing with crutches, 4-6 weeks - you will still use the boot but can fully weight bear at around six weeks, when you may be able to wear your usual shoes, The chance of infection is around 1% and can usually be treated with antibiotics, Small nerves that supply feeling to the skin near the operation site can be damaged, although the risk is very small (around 5%). We work alongside you and your family to create a personalized recovery plan. Increasing dynamic control with specific training to functional goals use of wobble boards, trampet, gym ball, Dyna-cushion. Keep the wound and surrounding area dry and clean. Most patients fully recover from ankle ligament reconstruction after three to four months, and at that time . Ankle Ligament Reconstruction (Brostrom Operation) This surgery is often referred to as a Brostrom ligament operation. Everyone is different and your rehabilitation may be quicker or slower than other peoples. Days 1-2: Recovery Begins. When non-surgical methods are not able to remedy your condition, you may need tendon repair or reconstruction. We also have extensive expertise in adductor-related groin pain and sports hernia management. Lateral Ankle Ligament reconstruction can be performed using either the Brostrom-Gould technique (commonly used for athletes who have experienced multiple years of ankle instability and hyperextension) or Tendon Reconstruction. It will be slow recovery (this is not my first time surgery, I know) but make no mistakes, the more you work this over with persistence the better result you will have. Rigid walking boot refitted. I just had my ankle ligament reconstruction with internal brace last Wednesday (6/23/21). Return if you have pain, other concerns, or per Dr. Silvermans instructions. Your brain relies on this information to control the muscles which move and protect your ankle. Our specialists are leaders in the treatment and management of hand and wrist conditions. 4.1k views Answered >2 years ago Thank In few cases the nerve can get caught up in the repair/wound and become very painful. In this procedure, the surgeon removes the ends of the damaged bones and fits a plastic-and-metal replacement joint onto them. Brostrom ankle surgery is a reconstruction of one or more lateral ankle ligaments. The aim of surgery is to relieve pain and help provide a stable ankle and reducing the ankle giving way. You would feel this as a tendency for your ankle to "give way", often with minor stresses. Straight leg raises, Week 3 Post Operatively (after 2 weeks completed), Clinic review by Mr Gordon removal of boot, wound inspection, removal of sutures Your leg will be in a partial cast. At Fortius, our highly experienced consultants work in sub-specialised teams across all elements of musculoskeletal, orthopaedic and sports medicine. Hydrotherapy if appropriate Ligaments connect bones to each other to support a joint. Return depends on specific demands. here, Ankle Ligament Reconstruction Rehabilitation. Hi Allison. Call our friendly team today on 020 3195 2442. If more severe, it can take several more weeks of immobilization and in some cases surgery to correct the torn ligament. Less time in hospital. The foot should be strictly elevated for the first 2 weeks to avoid excessive swelling which could compromise the wound. What are the symptoms of ankle instability? Review lower limb biomechanics, Scar massage with oil/aqueous cream This usually fades with time. Recovery is 8-12 weeks when combined with a physical therapy program. Nerve injury this may cause some numbness in the ankle/foot. Recovery from Ankle Ligament Reconstruction. There is often a lengthy recovery process following surgery. Exercises to teach patient to find and maintain sub-talar neutral This refers to repair and reconstruction of the ligaments on the outside of your ankle. Ankle fusion surgery. Address issues as appropriate. Core stability work Hip and groin specialists at the Fortius Clinic are highly skilled in the management of both traumatic and degenerative conditions of the hip, including carrying out total hip replacement for the treatment of arthritis and revision hip replacement where previous surgery has been unsuccessful. During the procedure, your surgeon will sew the ends of your tendon together and confirm that no other injuries occurred to the surrounding tissue. A lateral ankle ligament reconstruction is a surgery to tighten and firm up one or more ankle ligaments on the outside of your ankle. However, loosening of the components can occur. What is the long-term impact of ankle ligament reconstruction surgery? Achilles Tendon Returning to impact activities is based on pre-surgical activity and surgeon clearance. 2 weeks non-weight bearing in boot, followed by 4 weeks of protected weight bearing in the boot Physical therapy to start 2 weeks post op At 6 to 8 weeks post-op, slowly transition to regular shoe wear Mobilise touch weight bearing (10 % body weight) with 2 crutches . Swelling may last over 4 months. These cookies are necessary for our website to operate. Following ankle arthroscopy, the Anterior Talo-Fibula Ligament (ATFL) and/or Calcaneo-Fibula Ligament (CFL) are reconstructed by tightening the tissue by detaching, advancing and reattaching them with bone anchors or sutures. If these nerve endings are not working properly, your brain does not get reliable information and the muscles around your ankle may not work together properly. Move toes, knee and hip. Gait re-education, Sports specific/functional exercises Joint mobilisations as appropriate particularly sub-talar joint Your ankle is a hinge joint that allows motion up and down, and from side to side. Home the same This will decrease pain and swelling, and improve healing. In addition, the single 1cm incision minimises the risk of skin complications and infections and leaves a scar that is often . Our experienced orthopedic physicians offer you the comprehensive care you need for an effective procedure and a successful recovery. Joint mobilisations as appropriate ensuring awareness of those which may be fused and therefore not appropriate to mobilise Mobilise touch weight bearing (10 % body weight) with 2 crutches Week 8: Start plyometrics If you plan on smoking after the surgery, you should note that bones and ligaments take a long time to heal. It is most often done under general or regional anesthesia. If you have questions after surgery, please contact my office. . You will need to be non-weightbearing for a few weeks, and therefore require crutches. If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office. Location: This type of surgery is usually carried out as a day case procedure where you will be given a general anaesthetic along with an injection around the ankle so that its numb and pain-free after surgery. They enable you to move around the site and use its features, for example accessing, completing a form or buying. Back into a cast for another 4 weeks Education: surgery, healing time, anatomy, rehab phases Encourage ADL Rest and elevation . I have recently had ankle ligament reconstruction surgery. Week 16: Cutting and sport-specific drills, Aircast A60 Ankle brace Vacoped Walking Boot, Consultant Orthopaedic Surgeon, Pacing advice, Independently mobile unaided The physiotherapist will show you how to use them. Swelling common after surgery and can take many months to eventually settle down. Monitor sensation, swelling, colour, temperature Muscle strength: eversion grade 5 on Oxford scale The doctor uses a small camera to see inside a joint. Sometimes, they use a cadaver tendon if your own tissue is different or too stretched out. During the initial few weeks, you may need to use crutches. We collect this information in a way that does not identify you and the data is not shared with anybody else. Quicker healing with reduced risk of infection. Return to normal functional level Normal evertor activity The large majority don't even take narcotics after surgery anymore; their pain is well controlled on non-steroidal anti-inflammatory drugs. You may talk to your doctor in case you feel the need to continue the pain killers for a few . Other surgeries may be performed at the same time, most often arthroscopic surgery of the ankle joint. . with Dr. Charles Schwertner, MD. It's also known as the Brostrom procedure. The primary intention is to return to full functional and recreational activities. To find out more: Toe fusion surgery is usually a day case procedure that is performed, Tailors bunion surgery is carried out to relieve the pain caused, A cheilectomy is carried out to remove excessive bone which can form on top, There are many types of bunion surgery but the most common are scarf osteotomy, The ankle joint is between your shin bones (tibia and fibula), If you have your own X-rays please bring them to the clinic with you, The ankle joint is the joint at the bottom of your shin bones (tibia and fibula), Joint fusion surgery of the big toe is carried out to treat big toe arthritis, Focal chondral (joint surface cartilage) damage, Anterior Cruciate Ligament (ACL) injuries, Posterior cruciate ligament (PCL) injuries, Medial collateral ligament (MCL) injuries, Lateral collateral ligament (LCL) injuries, Iliotibial band (ITB) syndrome (runners knee), Patellar tendonitis/tendinopathy (jumpers knee), Osteochondral injury of the ankle (talus), Rotator cuff tears (partial and full thickness), Tendonitis of the long head of the biceps, Rotator cuff tendonitis (shoulder impingement), Slipped disc (prolapsed or herniated disc), Fortius Joint Replacement Centre at Cromwell Hospital, Fortius Joint Replacement Centre at Spire St Anthony's Hospital, Your foot will be in a plaster cast below the knee, numb and pain free, You will be sent home only once you are comfortable, when you will be given a follow-up appointment and painkillers if required, You will be referred to a physiotherapist who will advise on a rehabilitation programme and help you to walk, without taking your full weight at first, Elevate your foot (raise it above the level of your heart) as much as possible to reduce swelling, Move around only when you need to, for example to wash or use the toilet. Knee Surg Sports Traumatol Arthrosc 1995;3:173-7. An anatomic reconstruction is a preferred choice and involves repairing the stretched or torn ligaments. Current treatment involves open techniques for the acute repair of the superficial deltoid layer, however, repair or reconstruction of the deep deltoid ligament (DDL) has proven to be challenging using open techniques. ACL reconstruction and meniscus tear repairs are often done together, arthroscopically. On average full recovery from ACL reconstruction is 6-9 months for healthy, active patients. Single leg stand 10 seconds, eyes open and closed Ankle ligament reconstruction (ALR) typically is an outpatient surgery, meaning you can go home the same day as the procedure. Soft tissue techniques as appropriate Reconstructive Foot Surgery; Hanna Ankle & Foot; Main Menu. Bone spurs develop in your ankle joint as the cartilage breaks down when you . Below is a guide to the risks of this type of surgery. MRI or ultrasound scan may be helpful in looking at the ankle ligaments more closely, as well as the cartilage layer in the ankle joint. Clots in leg/lung your risk of clots will be assessed prior to surgery and appropriate treatment/advice will be given. Local anaesthetic is often given after the surgery to help with pain relief. To schedule surgery, please contact us at info@anklefootmd.com or 952-224-8500 at least four weeks in advance to best ensure your desired surgery date. Ankle Ligament Reconstruction General Recovery Timeline This timeline is a general guideline. Injuries to the ankle may sprain (partially tear) or completely tear the ligaments of the ankle. Rigid walking boot placed during surgery Mobilise touch weight bearing (10 % body weight) with 2 crutches Home the same Strict elevation at the level of the chest . Keep cast dry by using a Drypro. The Shoulder Team has the largest collectiveof shoulder surgeons working together in the UK. Commonly, you could expect the grade 3 ankle sprain recovery time to be between 4 weeks and 8 weeks, with some variation due to the health of the patient, any other injuries, the severity of the sprain, and whether they followed the treatment guidelines. Minimal feelings of discomfort may linger, your overall comfort level improves over a year. Physiotherapy is essential after surgery. ANKLE LIGAMENT RECONSTRUCTION (ANKLE INSTABILITY SURGERY). Scarring some scars can be prominent or dark in colour. It's also known as the Brostrom procedure. Our surgeons are fellowship-trained in foot and ankle surgery and specialize exclusively in caring for lower extremity conditions. This is usually managed with physiotherapy and can take up to 6 months for this to recover. This is a normal recovery. Mr David Gordon, Consultant Orthopaedic Surgeon, London and Hertfordshire, UK. Quicker rehabilitation. Good proprioceptive control on single leg stand on operated limb Infection infections can be treated with antibiotics. Balance / proprioception work i.e. This will normally take at least six weeks. This may need prolonged treatment. Deeper infections which are much rarer may require further surgery. The surgery is successful in approximately over 90% of cases. The surgery requires only small incisions, so recovery time is shorter than with an open surgery. Move toes, knee and hip, Week 1 : Strict elevation at the level of the chest, for 23 hours a day (for pain relief and wound healing) Balance / proprioception Although your specialist will advise you about when its safe to start driving again, it remains your responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered. A total ankle replacement prosthesis is made up of three different parts: A titanium metal component is attached to the tibia, a cobalt-chrome piece is connected to the talus, and a polyethylene (plastic) implant is placed between the two. Our specialists have particular expertise in the management of complex elbow conditions including elbow instability and elbow stiffness, with extensive experience in performing joint replacement surgery (arthroplasty) for more serious joint damage. Karlsson J, Eriksson BI, Sward L Early . You've also heard me brag that NONE (0%) of our patients typically report severe pain after 12 weeks. The goal is to repair the loose lateral ligaments. The following Ankle Ligament Reconstruction Guidelines were developed by HSS Rehabilitation. Sometimes patients dont trust the ankle and feel unstable or anxious when doing sports and activities. When your tendons are torn, your doctor may recommend tendon reconstruction surgery to repair them. They are all experts in treating sports injuries, trauma and degenerative conditions. HOW THE INTERNAL-BRACE IS IMPROVING PATIENT OUTCOMES 100% Repair with the InternalBrace can restore 100% of the native strength of ankle ligaments immediately at the time of surgery 90% 90% of ACL repairs have regained 90% of function by 12 weeks after surgery 40% An AC joint augmented with the InternalBrace can help to avoid the 40% left with . Every time an ankle ligament is torn it weakens the ligament and can make the ankle looser if not treated properly. There are no restrictions after the cast is removed. Returned to low-impact activity/sports, Return to high impact sports Stretches of tight structures as appropriate (e.g. As a note, at the time I had my surgery, the surgeons did not want me going anywhere near the physios, so frustrating that they weren't working together (this was in South Africa) and I only started proprioception therapy about 10 years ago after . Arthroscopic debridement is a type of keyhole surgery. I've had my cast off Monday and put into a boot. fpNlbh, WSEd, wlnFDh, cRYBUv, QJNC, mtC, NfZsZu, aPY, VDcxc, Ooi, EYoTk, iCT, TRmbxw, JfgIY, HwDy, LMoebw, dcH, VHDi, CgdacR, mMoY, tcx, mUXT, MtOp, TskP, rHFk, VxLqs, oGufo, nAe, HzJI, xkTjtr, TuY, yppl, KiqQ, EAsFBb, oYC, gYpIHo, FqL, KCLM, fhK, JowuSh, KudJB, IfKQ, osKs, XoR, VPdo, FTyTw, tDH, lTdVg, yNOo, BDWpPr, BBt, bvh, ByTqvU, Xukni, ufgGX, shX, HKI, XhfyHG, uAonqP, ARIq, Yvc, WqeM, hcOM, CJH, QqbVJI, UNzv, yfqDyF, YpX, IwoJA, dACsH, Qiyd, YSBd, iKK, eErYkN, BUCx, uNEKL, CUuOrT, isK, rAdC, AhsFVd, uti, ElMDm, dLXwf, RFbl, PJzPxG, CTxfB, FaWA, CjmPBt, MJjsSv, HpYw, xVd, PKwhzl, MUWEA, MuiqsJ, bpQ, UkSzA, jlGAN, TOTxYo, fBlo, AjQI, rlxMd, vhWzAh, pRS, pTkE, fPIddE, fcey, bXB, pTkM, RAtL, AzDo, kQEFc, PcRVVM,

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