Arthroscopic ankle lateral ligament repair alone versus arthroscopic ankle lateral ligament repair with reinforcement by inferior extensor retinaculum

Samejima, Yuji; Inokuchi, Ryota; Iwashita, Kosui; Musha, Yoshiro; Jujo, Yasuyuki; Takao, Masato

doi:10.1007/s00402-021-03771-w

Cited by 16 publications

(19 citation statements)

References 37 publications

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“…Chronic ankle instability (CAI) is a common pathological condition secondary to ankle sprains in professional athletes and the general population (1)(2)(3)(4)(5). Between 20 and 40% patients experience CAI ensuing from repeated sprains or inappropriate initial management of acute sprains (6).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of anterior tibiofibular ligament’s distal fascicle transfer versus ligament reconstruction with InternalBrace™ for chronic ankle instability patients

Tian

Mok

Sin

et al. 2021

Arch Orthop Trauma Surg

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Purpose Treatment of chronic ankle instability (CAI) for ankle sprain patients remains a challenge. If initial treatments fail, surgical stabilization techniques including ligament reconstruction should be performed. Anterior tibiofibular ligament (ATiFL) distal fascicle transfer for CAI was recently introduced. The goal of the study is to assess the 1-year clinical effectiveness of ATiFL’s distal fascicle transfer versus ligament reconstruction with InternalBrace™ (Fa. Arthrex, Naples). Methods Between October 2019 and February 2021, 25 patients (14 males and 11 females) scheduled for ligament reconstruction treatment of CAI were enrolled after propensity score matching. Twelve underwent ligament reconstruction with InternalBrace™ (InternalBrace™ group) and thirteen underwent ATiFL’s distal fascicle transfer (ATiFL’s distal fascicle transfer group). We recorded the American Orthopedic Foot & Ankle Society (AOFAS) score, Visual Analogue Scale (VAS), anterior drawer test grade, patient satisfaction and complications. All results of this study were retrospectively analyzed. Results Statistically significant (p = 0.0251, independent-samples t test) differences in the AOFAS can be found between the ATiFL’s distal fascicle transfer group and the InternalBrace™ group. No substantial changes in the VAS (p = 0.1778, independent-samples t test), patient satisfaction (p = 0.1800, independent-samples t test) and anterior drawer test grade (p = 0.9600, independent-samples t test) were found between the two groups. There was one patient with superficial wound infection and one patient with sural nerve injury in the InternalBrace™ group and ATiFL’s distal fascicle transfer group, respectively. Conclusion This is the first study that assessed a cohort of CAI patients and suggests that the ATiFL’s distal fascicle transfer operation has the potential to attain good-to-excellent clinical outcomes after 1-year recovery. The AOFAS scores were significantly higher for patients with ATiFL’s distal fascicle transfer, indicating that this technique may be considered a viable option for both patients and their surgeon, while long-term outcomes should be investigated in the future.

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Section: Introductionmentioning

confidence: 99%

Clinical outcomes of anterior tibiofibular ligament’s distal fascicle transfer versus ligament reconstruction with InternalBrace™ for chronic ankle instability patients

Tian

Mok

Sin

et al. 2021

Arch Orthop Trauma Surg

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“…The goal of the ligament reattachment should be focused on the durable biomechanical stability and improving ligament-bone interfaced healing. Even though the modified Broström-Gould repair technique was considered the gold standard, there is still some controversy on the augmentation of the inferior extensor retinaculum (IER) [ 5 , 6 , 21 , 22 ]. Behrens reported that there is no significant biomechanical difference between traditional Broström repair and the modified Broström-Gould repair; reinforcement of the IER may be a marginal procedure at the time of surgery [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Arthro-Broström with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques

Yang

Han

et al. 2022

BMC Musculoskelet Disord

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Background There is still some controversy about the augmentation of the inferior extensor retinaculum after arthroscopic anterior talofibular ligament repair. The aim of this study was to evaluate the novel arthro-Broström procedure with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques for chronic lateral ankle instability. Methods Thirty-four cases with grade-2 or grade-3 chronic anterior talofibular ligament lesions who underwent the novel arthro-Broström procedure with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques were assessed retrospectively. A total of 30 cases (30 ankles) were followed up for a mean of 26.67 ± 4.19 months (range, 24—36 months). four cases were excluded due to insufficient medical records or loss of follow-up reports. The Cumberland Ankle Instability Tool scores, The Karlsson-Peterson scores and Visual Analogue Scale scores were evaluated before surgery and at the final follow-up time. Also, the results of stress fluoroscopic tests and complications were recorded. Results At the final follow-up, the average of the Cumberland Ankle Instability Tool scores, The Karlsson-Peterson scores and Visual Analogue Scale scores were 86.63 ± 6.69 (range, 77—100), 90.17 ± 4.64 (range, 85—100) and 0.53 ± 0.63 (range, 0—2), respectively. Moreover, the results of stress fluoroscopic tests were improved significantly after surgery. Mild keloid formation and/or knot irritation were observed in four cases. No wound infections, nerve injuries and recurrent instability were recorded. Also, no stiffness or arthritis of the subtalar joint was encountered. Conclusions The arthro-Broström procedure combined with endoscopic retinaculum augmentation using all-inside lasso-loop techniques is reliable and safe due to the advantage of direct endoscopic visualization.

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“…The goal of the ligament reattachment should be focused on the durable biomechanical stability and improving ligament-bone interfaced healing. Even though the modi ed Broström-Gould repair technique was considered the gold standard, there is still controversy on the augmentation of the inferior extensor retinaculum (IER) [5,6,20,21]. Behrens reported that there is no signi cant biomechanical difference between traditional Broström repair and the modi ed Broström-Gould repair; reinforcement of the IER may be a marginal procedure at the time of surgery [22].…”

Section: Discussionmentioning

confidence: 99%

“…These procedures were gradually developed from formal open techniques to minimally invasive ones over the years. However, there are still debates related to the reliability and necessity of the augmentation of the inferior extensor retinaculum (IER) after arthroscopic anterior talo bular ligament (ATFL) repair [4][5][6]. For those cases with an insu cient ATFL remnant, however, the augmentation of the IER is a good choice, except for ligament reconstruction [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Arthro-Broström with Endoscopic Retinaculum Augmentation using All-inside Lasso-loop Stitch Techniques

Yang

Han

et al. 2022

Preprint

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Background: There is still controversy about the augmentation of the inferior extensor retinaculum (IER) after arthroscopic anterior talofibular ligament (ATFL) repair. The aim of this study was to evaluate the arthro-Broström procedure with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques for chronic lateral ankle instability. Methods: Thirty-four cases with type-2 or type-3 chronic ATFL lesions who underwent the arthro-Broström procedure with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques were assessed retrospectively. A total of 30 cases (30 ankles) were followed up for a mean of 26.67 ± 4.19 months (range, 24 - 36 months). Five cases were excluded due to insufficient medical records or loss of follow-up reports. The Cumberland Ankle Instability Tool (CAIT) scores, The Karlsson-Peterson scores and Visual Analogue Scale (VAS) scores were evaluated before surgery and at the final follow-up time. Also, the results of stress fluoroscopic tests and complications were recorded. Results: At the final follow-up, the average of the Cumberland Ankle Instability Tool (CAIT) scores, The Karlsson-Peterson scores and VAS scores were 86.63 ± 6.69 (range, 77 - 100), 90.17 ± 4.64 (range, 85 - 100) and 0.53 ± 0.63 (range, 0 - 2), respectively. Moreover, the results of stress fluoroscopic tests were improved significantly after surgery. Mild keloid formation and/or knot irritation were observed in four cases. No wound infections, nerve injuries and recurrent instability were recorded. Also, no stiffness or arthritis of the subtalar joint was encountered. Conclusions: The arthro-Broström procedure combined with endoscopic retinaculum augmentation using all-inside lasso-loop techniques is reliable and safe due to satisfactory clinical results and avoiding nerve injuries.

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Arthroscopic ankle lateral ligament repair alone versus arthroscopic ankle lateral ligament repair with reinforcement by inferior extensor retinaculum

Cited by 16 publications

References 37 publications

Clinical outcomes of anterior tibiofibular ligament’s distal fascicle transfer versus ligament reconstruction with InternalBrace™ for chronic ankle instability patients

Clinical outcomes of anterior tibiofibular ligament’s distal fascicle transfer versus ligament reconstruction with InternalBrace™ for chronic ankle instability patients

Arthro-Broström with endoscopic retinaculum augmentation using all-inside lasso-loop stitch techniques

Arthro-Broström with Endoscopic Retinaculum Augmentation using All-inside Lasso-loop Stitch Techniques

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