Arthroscopic all-inside anterior talo-fibular ligament repair with suture augmentation gives excellent results in case of poor ligament tissue remnant quality

Vega, Jordi; Montesinos, Erik; Malagelada, Francesc; Baduell, Albert; Guelfi, Matteo; Dalmau-Pastor, Miki

doi:10.1007/s00167-018-5117-x

Cited by 52 publications

(57 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is less trauma to the surrounding tissue than in the case of open surgery, which reduces postoperative pain and permits an early rehabilitation protocol, leading to a faster recovery. [3][4][5][6]8,10,11 Using only 2 arthroscopic portals limits synovial injury, which reduces the risk of excessive edema and avoids extensive adhesion formation. Moreover, arthroscopic visualization of the joint enables one to anatomically restore the course of the ATFL from its fibular to talar footprint.…”

Section: Discussionmentioning

confidence: 99%

“…They can be divided into 2 categories: ligament repair or ligament reconstruction using a tendon graft or transfer. [3][4][5][6][7][8][9][10][11][12] The surgical procedure should be selected based on the tissue quality determined during arthroscopic assessment of the ATFL remnant. 11,13 The aim of this article was to present an arthroscopic technique for all-inside ATFL repair that allows for restoration of the ankle joint stability in a minimally invasive way.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Arthroscopic Anatomic Anterior Talofibular Ligament Repair for Anterolateral Ankle Instability

Malinowski¹,

Paszkowski²,

Góralczyk³

et al. 2020

Arthroscopy Techniques

View full text Add to dashboard Cite

Ankle instability is due to repetitive inversion injuries and is usually treated conservatively; however, after repeated sprains, chronic instability occurs and usually requires a surgical procedure. Recently, arthroscopic repair of a torn anterior talofibular ligament (ATFL) has become more popular owing to its minimal invasiveness and high efficacy. An all-inside technique allows for anatomic restoration of the injured ATFL, provides stability to the ankle joint, prevents a limitation of ankle range of motion, and may prevent arthritic development. We present an all-inside arthroscopic ATFL repair technique.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Arthroscopic Anatomic Anterior Talofibular Ligament Repair for Anterolateral Ankle Instability

Malinowski¹,

Paszkowski²,

Góralczyk³

et al. 2020

Arthroscopy Techniques

View full text Add to dashboard Cite

show abstract

“…The remnant quality of the ATFL was evaluated using the classification of the remnant ligament quality reported by Vega et al, 37 with some modifications. The remnants were divided into 4 groups: (1) poor = arthroscopic observation of a clearly hypoplastic ligament with poorly defined margins; (2) moderate = arthroscopic observation of fibrotic tissue or synovitis demonstrating a stretched hyperplastic or hypoplastic ligament; (3) excellent = arthroscopic observation of normal synovial tissue demonstrating a ligament with sharply defined margins; (4) subfibular ossicle = arthroscopic observation of an ossicle-connected ATFL fiber, detached from the distal end of the fibula.…”

Section: Methodsmentioning

confidence: 99%

Bone Mineralization Changes in the Subchondral Bone of the Medial Gutter in Chronic Lateral Ankle Instability

et al. 2020

View full text Add to dashboard Cite

Background: Chronic ankle instability (CAI) induces osteoarthritis (OA) by inflicting abnormal stresses on the medial gutter. It is important to detect early OA change and to explore factors likely to induce the OA. The purpose of this study was to evaluate subchondral bone change in the medial gutter of CAI using computed tomography (CT) scans. Methods: Thirty-five ankles with CAI (CAI group) and 35 ankles without CAI (control group) were included. The region of interest (ROI) in the subchondral bone of the medial gutter on CT axial images was set on the tibia and talus. The Hounsfield unit (HU) in ROIs was measured and corrected by the HU of the fibula in the same slice. HU ratios were compared between the CAI and control groups. In the CAI group, the relationship between the HU ratio and the talar tilt angle (TTA), OA change, and the anterior talofibular ligament (ATFL) remnant quality were analyzed. Results: The mean HU ratio in the CAI group was significantly higher than that in the control. In the CAI group, HU ratios in ≥10 degrees of TTA were significantly higher than those in <10 degrees. But there was no significant difference in the HU ratios with or without OA change in the medial gutter. A good-quality ATFL remnant showed a low HU ratio compared with that with poor quality. Conclusion: CAI patients exhibited subchondral bone change in the medial gutter, which suggests that the elimination of instability may help to prevent or decrease the development and/or progression of osteoarthritis. Level of Evidence: Level III, comparative series.

show abstract

“…Anatomic ATFL repair with suture augmentation offers the benefit of maintaining some proprioceptive properties of the native ligament while reinforcing the repair, especially in patients whose remnant ligament tissue is of poor quality. 8,9,13,54 ST-augmented repair has become an effective option because it may protect the repaired ligament during healing. 2,14,31,57 BR with ST augmentation has been demonstrated to be effective for young female patients, 8 revision surgeries, 6 and patients with generalized ligamentous laxity.…”

mentioning

confidence: 99%

No Differences in Clinical Outcomes of Suture Tape Augmented Repair Versus Broström Repair Surgery for Chronic Lateral Ankle Instability

Zhao

Chen

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Suture tape (ST) augmented repair, an alternative to traditional Broström repair (BR), may protect the repaired anterior talofibular ligament during ligament healing. No systematic review of cohort studies has been conducted to compare traditional BR with ST-augmented repair for chronic lateral ankle instability. Purpose: To review the current evidence in the literature to ascertain whether ST-augmented repair is superior to traditional BR in managing chronic lateral ankle instability. Study Design: Systematic review; Level of evidence, 3. Methods: A literature search was performed to identify relevant articles published in PubMed, Embase, and Cochrane Library databases in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included cohort studies comparing the efficacy of BR and ST-augmented repair procedures in terms of incidence of instability recurrence, functional scores, talar tilt angle (TTA), anterior talar translation (ATT), and complication rate. Methodological quality was assessed using the Jadad scale for randomized studies and the Newcastle-Ottawa Scale for nonrandomized studies. Results: A total of 4 clinical trials with 254 patients were included. No significant differences were detected between BR and ST-augmented repair procedures in terms of incidence of recurrent instability, American Orthopaedic Foot & Ankle Society score, Foot and Ankle Outcome Score, Foot and Ankle Ability Measure, TTA, ATT, or complication rate. The ST group appeared to have a shorter operation time compared with the BR group. Conclusion: No significant differences were found between ST-augmented repair and BR surgery regarding incidence of recurrent instability, functional outcome scores, or complication rates. Although technically challenging, the ST-augmented repair procedure appears to be a safe and fast option.

show abstract

Arthroscopic all-inside anterior talo-fibular ligament repair with suture augmentation gives excellent results in case of poor ligament tissue remnant quality

Abstract: IV, retrospective case series.

Cited by 52 publications

References 37 publications

Arthroscopic Anatomic Anterior Talofibular Ligament Repair for Anterolateral Ankle Instability

Arthroscopic Anatomic Anterior Talofibular Ligament Repair for Anterolateral Ankle Instability

Bone Mineralization Changes in the Subchondral Bone of the Medial Gutter in Chronic Lateral Ankle Instability

No Differences in Clinical Outcomes of Suture Tape Augmented Repair Versus Broström Repair Surgery for Chronic Lateral Ankle Instability

Contact Info

Product

Resources

About