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

Tian, Jiaxin; Mok, Tsz Ngai; Sin, Tat‐Hang; Zha, Zhengang; Zheng, Xiaofei; Teng, Qiang; Hou, Huige

doi:10.1007/s00402-021-04214-2

Cited by 7 publications

(9 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8,9 Some authors have transferred AITFL's distal fascicle to reconstruct ankle stability. 16,28,31 Therefore, the distal fascicle of the AITFL and ATFL are in close proximity in open or arthroscopic views. 6,16,31 The anatomic feature allows the distal fascicle of the AITFL to be used as an alternative anatomic landmark to locate the ATFL and CFL, particularly under the arthroscopic view.…”

Section: Discussionmentioning

confidence: 99%

The Distal Fascicle of the Anterior Inferior Tibiofibular Ligament: A Potential Landmark for Lateral Ankle Ligament Reconstruction

Wang,

Zhao,

Shi

et al. 2023

Foot Ankle Int.

View full text Add to dashboard Cite

Background: A reliable landmark and precise distances from the ligament attachments are needed for lateral ankle stabilization surgery. The distal fascicle of the anterior inferior tibiofibular ligament (AITFL) has been used to locate the anterior talofibular ligament (ATFL) or calcaneofibular ligament (CFL) centers on the fibula. However, there is no anatomic study to validate the distal fascicle of the AITFL as a landmark of lateral ankle ligament stabilization, and more importantly, the exact distances from the ATFL or CFL attachments to the distal fascicle of the AITFL are unknown. Methods: Sixteen frozen cadaveric specimens (8 paired specimens) with no previous history of ankle injury were used in this study. Whether the distal fascicle of AITFL was present in each specimen was confirmed. Then, the distances from the most distal insertion of the AITFL’s distal fascicle to the footprint centers of the ATFL and CFL on the fibula were measured. All measurements were performed by 2 observers, and the intraobserver and interobserver reliabilities were analyzed by intraclass correlation coefficients (ICCs). Results: The distal fascicle of the AITFL was found in all specimens (100%). The mean distance from the most distal insertion of the AITFL’s distal fascicle to the footprint centers of the ATFL, CFL, and the intersection center of the 2 ligaments on the fibula was 6.0 to 7.1 mm, 11.5 to 13.2 mm, and 9.0 to 10.0 mm, respectively. Excellent interobserver and intraobserver agreement (all ICCs > 0.9, P < .01) was shown in the anatomic measurements of these distances. Conclusion: In this cadaveric study, we found that the distal fascicle was a constant structure of the AITFL in the lateral ankle. The distances from the most distal insertion of the AITFL’s distal fascicle to the ligamentous footprint centers were reliable and may be used to identify the origins of the ATFL and CFL for lateral ankle ligament reconstruction. Clinical Relevance: This anatomic study validates the AITFL’s distal fascicle as a potential landmark and, more importantly, determines the range of distances from AITFL’s distal fascicle to the attachment centers of lateral ankle ligaments by anatomic measurements. The data may be used to identify the ATFL and CFL for lateral ankle stabilization surgery and become particularly valuable for endoscopic or arthroscopic techniques.

show abstract

Section: Discussionmentioning

confidence: 99%

The Distal Fascicle of the Anterior Inferior Tibiofibular Ligament: A Potential Landmark for Lateral Ankle Ligament Reconstruction

Wang,

Zhao,

Shi

et al. 2023

Foot Ankle Int.

View full text Add to dashboard Cite

show abstract

“…Furthermore, the ultimate failure load of Broström-Gould + ATiFL-DF transfer can also withstand an average of 54.39 N more than the normal state. In a cohort study that compared ATiFL-DF transfer and InternalBrace TM ligament reconstruction, Tian et al ( Tian et al, 2022 ) discovered that 1 year after recovery, ATiFL-DF transfer could yield positive clinical outcomes, and patients who underwent this technique exhibited significant improvement in AOFAS scores compared with the control group. This is consistent with our experimental biomechanical findings, demonstrating that this method is viable for surgeons and patients.…”

Section: Discussionmentioning

confidence: 99%

“…This implies that tendons and ligaments serve distinct biological functions and that maintaining ligaments is crucial for proper joint proprioception. Recently, researchers proposed using the distal fascicle of the anterior tibiofibular ligament (ATiFL) to augment the ATFL and increase postoperative ankle joint stability ( Vega et al, 2020 ; Tian et al, 2022 ; Xiao et al, 2022 ). The ATiFL distal fascicle (ATiFL-DF) is situated at the tibiofibular syndesmosis, also called the Bassett ligament ( Fisher et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic lateral ankle instability using anterior tibiofibular ligament distal fascicle transfer augmentation repair: an anatomical, biomechanical, and histological study

Wang,

Yang,

You

et al. 2024

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Background: The transfer of the anterior tibiofibular ligament distal fascicle (ATiFL-DF) for the augmentation repair of the anterior talofibular ligament (ATFL) shows potential as a surgical technique. However, evidences on the benefits and disadvantages of this method in relation to ankle joint function are lacking.Purpose: This study aimed to provide comprehensive experimental data to validate the feasibility of ATiFL-DF transfer augmentation repair of the ATFL.Methods: This study included 50 embalmed ankle specimens to measure various morphological features, such as length, width, thickness, and angle, for evaluating similarities between the ATiFL-DF and ATFL. Furthermore, 24 fresh-frozen ankle specimens were examined for biomechanical testing of the ATiFL-DF transfer augmented repair of the ATFL. Finally, 12 pairs of ATiFL-DF and ATFL tissues from fresh-frozen ankle specimens were treated with gold chloride staining to analyze mechanoreceptor densities.Results: Anatomical studies found that the lengths and thicknesses of the ATFL and ATiFL-DF are similar. Biomechanical outcomes showed that performing ATiFL-DF transfer for ATFL repair can improve the stability of the talus and ankle joints. This is evident from the results of the anterior drawer, axial load, and ultimate failure load tests. However, performing ATiFL-DF transfer may compromise the stability of the distal tibiofibular joint, based on the Cotton and axial load tests at an external rotation of 5°. Analysis of the histological findings revealed that mechanoreceptor densities for four types of mechanoreceptors were comparable between the ATiFL-DF and ATFL groups.Conclusion: ATiFL-DF transfer is a viable method for augmenting ATFL repair. This technique helps to improve the stability of the talus and ankle joints while compensating for proprioception loss. Although ATiFL-DF transfer augmented repair of the ATFL may negatively affect the stability of the distal tibiofibular joint, this procedure can enhance the stability of the talus and ankle joints.

show abstract

“…Twenty-one articles were included in this systematic review [3,8,11,14,19,23,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Of the 21 studies, 13 (62%) were retrospective, and 8 (38%) were prospective studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

Epidemiology and Treatment of Surgical Infection after Ankle Arthroscopy: A Systematic Review

De Fazio,

Bocchi,

Miele

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Ankle arthroscopy is indicated for both diagnosis and treatment of a large spectrum of common ankle disorders. It has certain advantages over the open procedure; however, it is important to recognize that there are some complications associated with it. Infections after this procedure are quite uncommon, with an overall estimated incidence of 2%. Given the low incidence of infections after ankle arthroscopy, not a great deal of literature on the topic has been published. The present review aims to provide an overview of the incidence, diagnosis, and treatment of infections after ankle arthroscopy. Methods: A systematic review of the literature indexed in the PubMed, MEDLINE, and Cochrane Library databases using search term “ankle arthroscopy infections” was performed in November 2023. No restrictions were applied concerning the date of publication. The Preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. Among all surgical operations for the treatment of ankle and foot pathologies, we included articles with a described superficial or deep infection after ankle arthroscopy. Results: The search resulted in 201 studies. Only 21 studies met our inclusion criteria, and they were included in this systematic review. We evaluated 1706 patients who underwent 1720 arthroscopic tibiotalar procedures at an average age of 42 years old. Out of the 1720 procedures, 41 (2%) were complicated by infection. We divided infectious complications into superficial (68%; 28/41) and deep (32%; 13/41) infections. The most common pathogen isolated was Staphylococcus aureus. Arthroscopic arthrodesis was found to be the most affected by deep infections. Conclusions: Infection after ankle arthroscopy is an uncommon complication. Superficial infections were successfully treated with antibiotics, while surgical debridement, arthroscopic drainage, and intravenous antibiotics were necessary in cases of deep infections. Considering the amount of information on pathogens associated with knee and shoulder infections, there is still a lack of literature on pathogens associated with ankle infections, which makes their management difficulty.

show abstract

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

Cited by 7 publications

References 39 publications

The Distal Fascicle of the Anterior Inferior Tibiofibular Ligament: A Potential Landmark for Lateral Ankle Ligament Reconstruction

The Distal Fascicle of the Anterior Inferior Tibiofibular Ligament: A Potential Landmark for Lateral Ankle Ligament Reconstruction

Chronic lateral ankle instability using anterior tibiofibular ligament distal fascicle transfer augmentation repair: an anatomical, biomechanical, and histological study

Epidemiology and Treatment of Surgical Infection after Ankle Arthroscopy: A Systematic Review

Contact Info

Product

Resources

About