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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2018

01-10-2018 | Ankle

Lower complication rate and faster return to sports in patients with acute syndesmotic rupture treated with a new knotless suture button device

Authors: Christian Colcuc, Marc Blank, Thomas Stein, Florian Raimann, Sanjay Weber-Spickschen, Sebastian Fischer, Reinhard Hoffmann

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2018

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Abstract

Purpose

Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization, but complications including knot irritation have been reported. No randomized trials of the new knotless suture button devices have been performed. We hypothesized that knotless suture button devices eliminate knot irritation and facilitate quicker return to sports. This study was performed to compare the clinical outcomes, complication rates, and time to return to sports between a new knotless suture button device and syndesmotic screw fixation.

Methods

This study included 54 patients treated for ankle syndesmotic injury from 2012 to 2014 with a knotless suture button device or syndesmotic screw fixation. Clinical outcomes were measured using the American Orthopaedics Foot and Ankle Society score, Foot and Ankle Disability Index, Olerud and Molander score, and visual analog scale for pain and function. Secondary outcome measures were the complication rate and time required to return to sports. Patients underwent clinical and radiological evaluations preoperatively and three times during the 1-year postoperative follow-up.

Results

54 of 62 eligible patients were analyzed, median age 37 (18–60) and underwent the 1-year follow-up. The screw fixation and knotless suture button groups comprised 26 and 28 patients, respectively. The complication rate was significantly lower (p = 0.03) and time to return to sports was significantly shorter in the knotless suture button than screw fixation group (average, 14 versus 19 weeks, respectively; p = 0.006). No significant differences were identified in clinical outcomes or visual analog scale scores for pain and function between the groups. Age, injury mechanism, and body mass index did not significantly affect the time required to return to sports activities. The type of fixation was the only independent variable that reached statistical significance (p = 0.006).

Conclusion

Syndesmotic screw fixation and the new knotless suture button device both resulted in good clinical results. Lower complication rate and the earlier time to return to sports make the new knotless suture button device recommendable especially for highly active patients.

Level of evidence

Randomized controlled trial, Level I.
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Metadata
Title
Lower complication rate and faster return to sports in patients with acute syndesmotic rupture treated with a new knotless suture button device
Authors
Christian Colcuc
Marc Blank
Thomas Stein
Florian Raimann
Sanjay Weber-Spickschen
Sebastian Fischer
Reinhard Hoffmann
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4820-3

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