Biomechanical Analysis of an Arthroscopic Broström Ankle Ligament Repair and a Suture Anchor–Augmented Repair

Giza, Eric; Whitlow, Scott; Williams, Brady T.; Acevedo, Jorge I.; Mangone, Peter G.; Haytmanek, C. Thomas; Curry, Eugene E.; Turnbull, Travis Lee; LaPrade, Robert F.; Wijdicks, Coen A.; Clanton, Thomas O.

doi:10.1177/1071100715576539

Cited by 43 publications

(35 citation statements)

References 35 publications

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“…In addition to directing diagnostic efforts toward determining the functionality of the calcaneofibular ligament in patients with suspected subtalar instability, our results suggest that, if calcaneofibular ligament insufficiency is established, its reconstruction or repair should be considered in preference to interosseous talocalcaneal or cervical ligament reconstruction. Moreover, there has been a trend toward repairing only the anterior talofibular ligament in patients with ankle instability [25][26][27] , neglecting the important calcaneofibular ligament. Our results suggest that this approach may not be optimal.…”

Section: Discussionmentioning

confidence: 99%

Systematic Quantification of Stabilizing Effects of Subtalar Joint Soft-Tissue Constraints in a Novel Cadaveric Model

Pellegrini

Glisson

Wurm

et al. 2016

The Journal of Bone and Joint Surgery

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Section: Discussionmentioning

confidence: 99%

Systematic Quantification of Stabilizing Effects of Subtalar Joint Soft-Tissue Constraints in a Novel Cadaveric Model

Pellegrini

Glisson

Wurm

et al. 2016

The Journal of Bone and Joint Surgery

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“…Ligament rupture in mid-substance was the most frequent mode of failure in the native ATFL group which confirms our test set-up to be effective in simulation of in vivo ankle sprain kinematics. Anchor pull-out is the most common mode of failure in biomechanical studies testing suture anchor reconstruction [ 16 , 17 , 34 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical stability of tape augmentation for anterior talofibular ligament (ATFL) repair compared to the native ATFL

Willegger

Benca

Hirtler

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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PurposeCurrent methods of anterior talofibular ligament (ATFL) reconstruction fail to restore the stability of the native ATFL. Therefore, augmented anatomic ATFL reconstruction gained popularity in patients with attenuated tissue and additional stress on the lateral ankle ligament complex. The aim of the present study was to evaluate the biomechanical stability of the InternalBrace® (Arthrex Inc., Naples, FL, USA), a tape augmentation designed to augment the traditional Broström procedure. MethodsTwelve (12) fresh-frozen human anatomic lower leg specimens were randomized into two groups: a native ATFL (ATFL) and a tape augmentation group (IB). Dual-energy X-ray absorptiometry (DEXA) scans were carried out to determine bone mineral density (BMD) of the specimens. The ligaments were stressed by internally rotating the tibia against the inverted fixated hindfoot. Torque at failure (Nm) and angle at failure (°) were recorded.ResultsThe ATFL group failed at an angle of 33 ± 10°. In the IB group, construct failure occurred at an angle of 46 ± 16°. Failure torque reached 8.3 ± 4.5 Nm in the ATFL group, whereas the IB group achieved 11.2 ± 7.1 Nm. There was no correlation between angle at ATFL or IB construct failure or torque at failure, respectively, and BMD for both groups.ConclusionThis study reveals that tape augmentation for ATFL reconstruction shows similar biomechanical stability compared to an intact native ATFL in terms of torque at failure and angle at failure. BMD did not influence the construct stability. Tape augmentation proved an enhanced initial stability in ATFL reconstruction which may allow for an accelerated rehabilitation process.Level of evidence II.

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“…[21][22][23][24][25][26][27] The described implant can be considered reliable and user-friendly. It also avoids bulky knots, 4,14 which are another possible source of complaints.…”

Section: Discussionmentioning

confidence: 97%

Arthroscopic Repair of Ankle Instability With All-Soft Knotless Anchors

Pereira

Vuurberg²,

Gomes

et al. 2016

Arthroscopy Techniques

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In recent years, arthroscopic and arthroscopically assisted techniques have been increasingly used to reconstruct the lateral ligaments of the ankle. Besides permitting the treatment of several comorbidities, arthroscopic techniques are envisioned to lower the amount of surgical aggression and to improve the assessment of anatomic structures. We describe our surgical technique for arthroscopic, two-portal ankle ligament repair using an all-soft knotless anchor, which is made exclusively of suture material. This technique avoids the need for classic knot-tying methods. Thus it diminishes the chance of knot migration caused by pendulum movements. Moreover, it avoids some complications that have been related to the use of metallic anchors and some currently available biomaterials. It also prevents prominent knots, which have been described as a possible cause of secondary complaints.A nkle sprain is the most frequent injury during sports activity. About 20% of cases eventually require surgical treatment for ankle instability after nonoperative treatment failure.1 The Broström procedure, with its several modifications, has been considered the gold standard of surgical treatment for several years.

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Biomechanical Analysis of an Arthroscopic Broström Ankle Ligament Repair and a Suture Anchor–Augmented Repair

Cited by 43 publications

References 35 publications

Systematic Quantification of Stabilizing Effects of Subtalar Joint Soft-Tissue Constraints in a Novel Cadaveric Model

Systematic Quantification of Stabilizing Effects of Subtalar Joint Soft-Tissue Constraints in a Novel Cadaveric Model

Biomechanical stability of tape augmentation for anterior talofibular ligament (ATFL) repair compared to the native ATFL

Arthroscopic Repair of Ankle Instability With All-Soft Knotless Anchors

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