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International Orthopaedics

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01-05-2017 | Original Paper

All-arthroscopic anatomical reconstruction of anterior talofibular ligament using semitendinosus autografts

Authors: Bin Song, Changchuan Li, Na Chen, Zhong Chen, Yan Zhang, Yunfeng Zhou, Weiping Li

Published in: International Orthopaedics | Issue 5/2017

Abstract

Purpose

We introduced a new technique of all-arthroscopic anatomical anterior talofibular ligament (ATFL) reconstruction using semitendinosus autografts.

Methods

From June 2012 to June 2013, 28 patients with chronic ATFL rupture underwent arthroscopic anatomic reconstruction of the ATFL. They were divided into the Broström group (n = 16) and reconstruction group (n = 12). The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue score (VAS) was recorded before the operation, 12 months after the operation and 30 months after the operation. Physical examination and radiographs were performed in follow-ups.

Results

The patients had higher AOFAS score after the operation in both the Broström group and the reconstruction group. 12 months after operation, the patients in the reconstruction group showed significantly higher AOFAS score and lower VAS score than those in the Broström group (P = 0.003 and 0.001, respectively), while the difference between the two groups was not statistically significant 30 months later (P = 0.425 and 0.323, respectively). Contemporary numbness of the lateral dorsal part of the foot appeared in one (8.3%) patient in the reconstruction group and two (12.5%) patients in the Broström group, and the symptoms diminished after neurotrophic treatment. No other complications, including recurrent instability, were encountered. No donor-side morbidity such as infection or delayed wound healing was observed.

Conclusions

The novel surgical technique enhanced post-operative rehabilitation by providing better ankle joint function than modified Broström procedure at 12 months after operation, while the advantage was not statistically significant 30 months later. The long-term outcome requires further investigation. The technique of all-arthroscopic anatomical ATFL reconstruction using semitendinosus autografts proved to be a viable option for ATFL injuries.

O’Loughlin PF, Murawski CD, Egan C, Kennedy JG (2009) Ankle instability in sports. Phys Sportsmed 37(2):93–103. doi:10.3810/psm.2009.06.1715 CrossRefPubMed

Gerber JP, Williams GN, Scoville CR, Arciero RA, Taylor DC (1998) Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle Int 19(10):653–660CrossRefPubMed

Ferran NA, Oliva F, Maffulli N (2009) Ankle instability. Sports Med Arthrosc Rev 17(2):139–145. doi:10.1097/JSA.0b013e3181a3d790 CrossRef

Czajka CM, Tran E, Cai AN, DiPreta JA (2014) Ankle sprains and instability. Med Clin North Am 98(2):313–329. doi:10.1016/j.mcna.2013.11.003 CrossRefPubMed

Mabit C, Tourne Y, Besse JL, Bonnel F, Toullec E, Giraud F, Proust J, Khiami F, Chaussard C, Genty C, Sofcot (2010) Chronic lateral ankle instability surgical repairs: the long term prospective. Orthop Traumatol Surg Res 96(4):417–423. doi:10.1016/j.otsr.2010.04.004 CrossRefPubMed

Guillo S, Bauer T, Lee JW, Takao M, Kong SW, Stone JW, Mangone PG, Molloy A, Perera A, Pearce CJ, Michels F, Tourne Y, Ghorbani A, Calder J (2013) Consensus in chronic ankle instability: aetiology, assessment, surgical indications and place for arthroscopy. Orthop Traumatol Surg Res 99(8 Suppl):S411–S419. doi:10.1016/j.otsr.2013.10.009 CrossRefPubMed

Petrera M, Dwyer T, Theodoropoulos JS, Ogilvie-Harris DJ (2014) Short- to medium-term outcomes after a modified Broström repair for lateral ankle instability with immediate postoperative weightbearing. Am J Sports Med 42(7):1542–1548. doi:10.1177/0363546514530668 CrossRefPubMed

Lui TH (2015) Modified arthroscopic Brostrom procedure. Foot Ankle Surg 21(3):216–219. doi:10.1016/j.fas.2015.01.008 CrossRefPubMed

Huang B, Kim YT, Kim JU, Shin JH, Park YW, Kim HN (2016) Modified Broström procedure for chronic ankle instability with generalized joint hypermobility. Am J Sports Med 44(4):1011–1016. doi:10.1177/0363546515623029 CrossRefPubMed

10.

Corte-Real NM, Moreira RM (2009) Arthroscopic repair of chronic lateral ankle instability. Foot Ankle Int 30(3):213–217. doi:10.3113/FAI.2009.0213 CrossRefPubMed

11.

Giza E, Shin EC, Wong SE, Acevedo JI, Mangone PG, Olson K, Anderson MJ (2013) Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study. Am J Sports Med 41(11):2567–2572. doi:10.1177/0363546513500639 CrossRefPubMed

12.

Guillo S, Cordier G, Sonnery-Cottet B, Bauer T (2014) Anatomical reconstruction of the anterior talofibular and calcaneofibular ligaments with an all-arthroscopic surgical technique. Orthop Traumatol Surg Res 100(8 Suppl):S413–S417. doi:10.1016/j.otsr.2014.09.009 CrossRefPubMed

13.

Nery C, Raduan F, Del Buono A, Asaumi ID, Cohen M, Maffulli N (2011) Arthroscopic-assisted Broström-Gould for chronic ankle instability: a long-term follow-up. Am J Sports Med 39(11):2381–2388. doi:10.1177/0363546511416069 CrossRefPubMed

14.

Guillo S, Takao M, Calder J, Karlson J, Michels F, Bauer T; Ankle Instability Group (2016) Arthroscopic anatomical reconstruction of the lateral ankle ligaments. Knee Surg Sports Traumatol Arthrosc 24(4):998–1002. doi:10.1007/s00167-015-3789-z CrossRefPubMed

15.

Piraino JA, Busch EL, Sansosti LE, Pettineo SJ, Creech C (2015) Use of an all-suture anchor for re-creation of the anterior talofibular ligament: a case report. J Foot Ankle Surg 54(1):126–129. doi:10.1053/j.jfas.2014.08.020 CrossRefPubMed

16.

Golano P, Vega J, de Leeuw PA, Malagelada F, Manzanares MC, Gotzens V, van Dijk CN (2010) Anatomy of the ankle ligaments: a pictorial essay. Knee Surg Sports Traumatolo Arthrosc 18(5):557–569. doi:10.1007/s00167-010-1100-x CrossRef

17.

Clanton TO, Campbell KJ, Wilson KJ, Michalski MP, Goldsmith MT, Wijdicks CA, LaPrade RF (2014) Qualitative and quantitative anatomic investigation of the lateral ankle ligaments for surgical reconstruction procedures. J Bone Joint Surg Am 96(12):e98. doi:10.2106/JBJS.M.00798 CrossRefPubMed

18.

Cho BK, Kim YM, Kim DS, Choi ES, Shon HC, Park KJ (2013) Outcomes of the modified Brostrom procedure using suture anchors for chronic lateral ankle instability—a prospective, randomized comparison between single and double suture anchors. J Foot Ankle Surg 52(1):9–15. doi:10.1053/j.jfas.2012.10.004 CrossRefPubMed

19.

Krips R, Brandsson S, Swensson C, van Dijk CN, Karlsson J (2002) Anatomical reconstruction and Evans tenodesis of the lateral ligaments of the ankle. Clinical and radiological findings after follow-up for 15 to 30 years. J Bone Joint Surg Br 84(2):232–236CrossRefPubMed

20.

Becker HP, Ebner S, Ebner D, Benesch S, Frossler H, Hayes A, Gritze G, Rosenbaum D (1999) 12-year outcome after modified Watson-Jones tenodesis for ankle instability. Clin Orthop Relat Res 358:194–204CrossRef

21.

Giza E, Nathe R, Nathe T, Anderson M, Campanelli V (2012) Strength of bone tunnel versus suture anchor and push-lock construct in Brostrom repair. Am J Sports Med 40(6):1419–1423. doi:10.1177/0363546512443947 CrossRefPubMed

22.

Jeys LM, Harris NJ (2003) Ankle stabilization with hamstring autograft: a new technique using interference screws. Foot Ankle Int 24(9):677–679CrossRefPubMed

23.

Jeys L, Korrosis S, Stewart T, Harris NJ (2004) Bone anchors or interference screws? A biomechanical evaluation for autograft ankle stabilization. Am J Sports Med 32(7):1651–1659CrossRefPubMed

24.

Singhatat W, Lawhorn KW, Howell SM, Hull ML (2002) How four weeks of implantation affect the strength and stiffness of a tendon graft in a bone tunnel: a study of two fixation devices in an extraarticular model in ovine. Am J Sports Med 30(4):506–513PubMed

25.

Li HY, Hua YH, Wu ZY, Chen B, Chen SY (2013) Strength of suture anchor versus transosseous tunnel in anatomic reconstruction of the ankle lateral ligaments: a biomechanical study. Arthroscopy 29(11):1817–1825. doi:10.1016/j.arthro.2013.08.015 CrossRefPubMed

Title: All-arthroscopic anatomical reconstruction of anterior talofibular ligament using semitendinosus autografts
Authors: Bin Song
Changchuan Li
Na Chen
Zhong Chen
Yan Zhang
Yunfeng Zhou
Weiping Li
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 5/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3410-9

At a glance: The STEP trials

Springer Medicine

All-arthroscopic anatomical reconstruction of anterior talofibular ligament using semitendinosus autografts

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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