Top

International Orthopaedics

Published in:

01-01-2016 | Original Paper

A novel patient-specific navigational template for anatomical reconstruction of the lateral ankle ligaments

Authors: Yong Sha, Hongwei Wang, Jing Ding, Hui Tang, Chunxiao Li, Haotian Luo, Jun Liu, Yongqing Xu

Published in: International Orthopaedics | Issue 1/2016

Abstract

Purpose

We discuss the clinical effects of anatomical reconstruction of the lateral ankle ligaments to treat chronic lateral ankle instability (CAI) by creating fibular channels with a patient-specific navigational template.

Methods

From August 2010 to February 2014, 15 patients presenting with CAI were treated by creating fibular channels with a patient-specific navigational template for anatomical reconstruction of the lateral ankle ligaments.

Results

All patients were followed up for nine to 24 months postoperatively (15 months on average); no recurrent CAI was found. Pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) scores for patients in the calcaneofibular ligament (CFL) plus anterior talofibular ligament (ATFL) repair group were 48.3 ± 5.1 and 88.1 ± 6.7) respectively. The difference (average 39.8) showed high statistical significance (P < 0.001). Pre- and postoperative scores in the ATFL group were 50.4 ± 6.2 and 90.3 ± 7.8, respectively. The difference (average 39.9) showed high statistical significance (P < 0.001). Regarding the Good score, 14 patients were rated as “excellent and one as good (good = 100 %). No severe complications were found in the patients in this group.

Conclusions

We studied and successfully built a digital navigation template for creating fibular channels to anatomically reconstruct the lateral ankle ligament. By using the template, fibular channels could be built, and lateral ligaments could be anatomically reconstructed individually, easily and safely, which largely facilitates the treatment of CAI.

Lassiter TE Jr, Malone TR, Garrett WE Jr (1989) Injury to the lateral ligaments of the ankle. Orthop Clin N Am 20(4):629–640

MacAuley D (1999) Ankle injuries: same joint, different sports. Med Sci Sports Exerc 31(7 Suppl):S409–S411PubMedCrossRef

Takao M, Oae K, Uchio Y, Ochi M, Yamamoto H (2005) Anatomical reconstruction of the lateral ligaments of the ankle with a gracilis autograft: a new technique using an interference fit anchoring system. Am J Sport Med 33(6):814–823CrossRef

Krips R, van Dijk CN, Halasi T, Lehtonen H, Moyen B, Lanzetta A, Farkas T, Karlsson J (2000) Anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a 2- to 10-year follow-up, multicenter study. Knee Surg Sports Traumatol Arthrosc 8(3):173–179PubMedCrossRef

Chrisman OD, Snook GA (1969) 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 Am 51(5):904–912PubMed

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

Ellis SJ, Williams BR, Pavlov H, Deland J (2011) Results of anatomic lateral ankle ligament reconstruction with tendon allograft. HSS J 7(2):134–140PubMedPubMedCentralCrossRef

Hua Y, Chen S, Jin Y, Zhang B, Li Y, Li H (2012) Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. Int Orthop 36(10):2027–2031PubMedPubMedCentralCrossRef

Pagenstert GI, Hintermann B, Knupp M (2006) Operative management of chronic ankle instability: plantaris graft. Foot Ankle Clin 11(3):567–583PubMedCrossRef

10.

Schenck RC, Coughlin MJ (2009) Lateral ankle instability and revision surgery alternatives in the athlete. Foot Ankle Clin 14(2):205–214PubMedCrossRef

11.

Ahn JH, Choy WS, Kim HY (2011) Reconstruction of the lateral ankle ligament with a long extensor tendon graft of the fourth toe. Am J Sports Med 39(3):637–644PubMedCrossRef

12.

Järvelä T, Weitz H, Järvelä K, Alavaikko A (2002) A novel reconstruction technique for chronic lateral ankle instability: comparison to primary repair. Int Orthop 26(5):314–317PubMedPubMedCentralCrossRef

13.

Burks RT, Morgan J (1994) Anatomy of the lateral ankle ligaments. Am J Sports Med 22(1):72–77PubMedCrossRef

14.

Taser F, Shafiq Q, Ebraheim NA (2006) Anatomy of lateral ankle ligaments and their relationship to bony landmarks. Surg Radiol Anat 28(4):391–397PubMedCrossRef

15.

Trevino SG, Davies P, Hecht PJ (1994) Management of acute and chronic injuries of the ankle. Orthop Clin N Am 25(1):1–16

16.

Good CJ, Jones MA, Livingstone BN (1975) Reconstruction of the lateral ligament of the ankle. Injury 7:63–65PubMedCrossRef

17.

Colville MR (1994) Reconstruction of the lateral ankle ligaments. J Bone Joint Surg 76A:1092–1102

18.

Rasmusson O (1985) Stability of the ankle joint. Analysis of the function and traumatology of the ankle ligaments. Acta Orthop Scand Suppl 211:1–75CrossRef

19.

Colville MR, Marder RA, Boyle JJ, Zarins B (1990) Strain measurement in lateral ankle ligaments. Am J Sports Med 18(2):196–200PubMedCrossRef

20.

Colville MR, Marder RA, Zarins B (1992) Reconstruction of the lateral ankle ligaments: a biomechanical analysis. Am J Sports Med 20(5):594–600PubMedCrossRef

21.

Caprio A, Oliva F, Treia F, Maffulli N (2006) Reconstruction of the lateral ankle ligaments with allograft in patients with chronic ankle instability. Foot Ankle Clin 11(3):597–605PubMedCrossRef

22.

Burks RT, Morgan J (1994) Anatomy of the lateral ankle ligaments. Am J Sports Med 22(1):72–77PubMedCrossRef

23.

Kakarala G, Rajan DT (2006) Anterior Talo-fibular ligament reconstruction using synthetic ligament and the extensor digitorum brevis. Clin J Sport Med 16(4):366–368PubMedCrossRef

24.

Cook JJ, Cook EA (2009) Bioscaffolds and the reconstruction of ligaments and tendons in the foot and ankle. Clin Podiatr Med Surg 26(4):535–543PubMedCrossRef

25.

Sugimoto K, Takakura Y, Kumai T, Iwai M, Tanaka Y (2002) Reconstruction of the lateral ankle ligaments with bone-patellar tendon graft in patients with chronic ankle instability: a preliminary report. Am J Sports Med 30(3):340–346PubMed

26.

Ellis SJ, Williams BR, Pavlov H, Deland J (2011) Results of anatomic lateral ankle ligament reconstruction with tendon allograft. HSS J 7(2):134–140PubMedPubMedCentralCrossRef

Title: A novel patient-specific navigational template for anatomical reconstruction of the lateral ankle ligaments
Authors: Yong Sha
Hongwei Wang
Jing Ding
Hui Tang
Chunxiao Li
Haotian Luo
Jun Liu
Yongqing Xu
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 1/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2817-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A novel patient-specific navigational template for anatomical reconstruction of the lateral ankle ligaments

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Hand-held navigation may improve accuracy in minimally invasive total knee arthroplasty: a prospective randomized controlled trial

Frank Horan 1933–2015

Clinical outcome and T2 assessment following autologous matrix-induced chondrogenesis in osteochondral lesions of the talus

Minimally invasive treatment of displaced femoral shaft fractures with a rapid reductor and intramedullary nail fixation

Triple osteotomy of the pelvis for Legg-Calve-Perthes disease: a mean fifteen year follow-up

Intra-operative gaps affect outcome and postoperative kinematics in vivo following cruciate-retaining total knee arthroplasty