Improved Outcome and Earlier Return to Activity After Suture Tape Augmentation Versus Broström Repair for Chronic Lateral Ankle Instability? A Systematic Review

Wittig, Ulrike; Hohenberger, Gloria; Ornig, Martin; Schuh, Reinhard; Reinbacher, Patrick; Leithner, Andreas; Holweg, Patrick

doi:10.1016/j.arthro.2021.06.028

Cited by 21 publications

(13 citation statements)

References 40 publications

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“…Suture tape reinforcement has shown promising results in early return to activity in Broström ankle ligament repair procedures. 41 …”

Section: Discussionmentioning

confidence: 99%

“…Suture tape reinforcement has shown promising results in early return to activity in Brostro ¨m ankle ligament repair procedures. 41 Bachmaier et al 4 provided biomechanical data of soft tissue ACL reconstruction grafts with independent suture tape reinforcement. A comparison was made between 8-mm and 9-mm grafts with suture tape reinforcement showing a synergistic load-sharing configuration.…”

Section: Discussionmentioning

confidence: 99%

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Biomechanical Evaluation of Suture Tape Internal Brace Reinforcement of Soft Tissue Allografts for ACL Reconstruction Using a Porcine Model

Wicks

Stack

Rezaie

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Internal bracing of anterior cruciate ligament (ACL) surgery is a newer concept gaining popularity. Purpose/Hypothesis: To assess the biomechanical performance of soft tissue ACL reconstruction allografts reinforced with suture tape. It was hypothesized that load to failure would increase and cyclic displacement would decrease at time zero in the constructs reinforced with internal brace suture tape compared with those without suture tape augmentation. Study Design: Controlled laboratory study. Methods: We performed ACL reconstruction on porcine knees using bovine extensor tendon soft tissue allografts: 10 knees without (control) and 10 knees with (reinforced) suture tape reinforcement. An all-inside reconstruction technique was utilized with retrograde tunnel creation. An adjustable-loop device was used for femoral and tibial fixation of all grafts. The suture tape was placed through the tension loop in the femoral fixation construct and independently fixed in the tibia with an interference screw anchor. For each specimen, the authors recorded ultimate load, yield load, stiffness, cyclic displacement, and mode of failure. Outcomes between groups were compared using the Student t test. Results: There was a 33% decrease in mean cyclic displacement in the specimens with reinforced grafts (reinforced vs control: 3.9 ± 0.7 vs 5.8 ± 1.5 mm; P = .001). The reinforced grafts also had a 22% higher mean ultimate load (921 ± 180 vs 717 ± 122 N; P = .008) and a 25% higher mean yield load (808 ± 201 vs 602 ± 155 N; P = .020). There was no significant difference in stiffness between the reinforced versus nonreinforced grafts (136 ± 16 vs 132 ± 18 N/mm; P = .617). Three of the 10 control specimens failed at the graft, compared with 1 of 10 reinforced grafts. All other constructs in both groups failed at the tibial fixation site. Conclusion: Suture tape reinforcement of soft tissue grafts significantly decreased cyclic displacement while significantly increasing ultimate and yield loads without increasing graft construct stiffness during biomechanical testing at time zero in a porcine animal model. Clinical Relevance: The improved biomechanical performance of suture tape–reinforced graft constructs could allow patients to participate in earlier advancement of aggressive rehabilitation and potentially reduce failure rates as graft remodeling progresses.

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“…Suture tape reinforcement has shown promising results in early return to activity in Broström ankle ligament repair procedures. 41 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation of Suture Tape Internal Brace Reinforcement of Soft Tissue Allografts for ACL Reconstruction Using a Porcine Model

Wicks

Stack

Rezaie

et al. 2022

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…The results of this study also have to be compared to outcomes following alternative techniques performing internal bracing by suture tape augmentation. While the patient populations and surgical indication in these studies slightly differ, the reported clinical outcome, with a total FAOS score ranging from 91.7 ± 7.7 to 93.7 ± 6.0 [ 30 , 46 ], indicates that suture tape bracing may be a viable alternative.…”

Section: Discussionmentioning

confidence: 99%

High return to sports and return to work rates after anatomic lateral ankle ligament reconstruction with tendon autograft for isolated chronic lateral ankle instability

Rupp

Degenhardt

Winkler

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate clinical outcomes as well as return to sports (RTS) and return to work (RTW) rates following anatomic lateral ankle ligament reconstruction with a tendon autograft for chronic lateral ankle instability (CLAI) in a high-risk population, and to compare these outcome parameters between patients having received a gracilis tendon autograft (GT) and free split peroneus brevis tendon (PBT) autograft. Methods Twenty-eight consecutive patients, who were diagnosed with CLAI, presenting with ≥ 1 risk factor (ligamentous hyperlaxity, insufficient substance of native ligament and/or high-demand athlete), who underwent ankle ligament reconstruction with a tendon autograft between January 2011 and December 2018, were included in this retrospective study. At 63.7 ± 28.0 months (24–112), 23 patients with a mean age of 29.7 ± 10.9 years were available for follow-up. The Karlsson Score, the Foot and Ankle Outcome Score (FAOS), the Tegner Activity Scale and the visual analog scale (VAS) for pain were collected at a minimum follow-up of 24 months. RTS and RTW were evaluated by questionnaire. A subgroup analysis with regard to the graft used for ankle ligament reconstruction (GT versus PBT) was performed. Results Patients reported a Karlsson score of 82.1 ± 17.5 (37–100), a FAOS score of 87.8 ± 8.4 (73–99), a median Tegner activity scale of 5.0 (IQR 4–6) and a VAS for pain of 0.5 ± 0.9 (0–4) at rest and of 2.0 ± 2.1 (0–7) during activities at final follow-up. Postoperatively, 96% of patients had returned to sports after 8.3 ± 6.2 months. All patients (100%) had returned to work at 3.5 ± 5.7 (0–24) months, with 87% reporting an equal or improved working ability compared to that preoperatively. Postoperatively, exercise hours per week were significantly reduced compared to preoperatively in patients with a split PBT (n = 12; 13.0 ± 12.9 to 5.6 ± 6.4 h, p = 0.038) autograft as opposed to patients with a GT autograft (n = 11; 13.1 ± 8.7 to 12.4 ± 7.1 h, n.s.). No other group differences were observed. Conclusion Good patient-reported outcomes as well as excellent RTS and RTW rates can be achieved in high-risk patients undergoing ankle ligament reconstruction with a tendon autograft for CLAI. These results may be helpful in preoperatively managing patients’ expectations regarding sports- and work-related outcomes and provide tangible data on the expectable time frame of the individual return to sports and work trajectory. Level of evidence IV.

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“… 5 Further augmentation with IB has shown excellent results with no major differences in complications. 8 However, Wittig et al 8 noted an increase in occurrence of peroneal nerve and tendon irritation with IB augmentation compared with Broström repair alone in a systematic review of clinical trials, and Pellegrini et al 7 reported 2 implant failures without compromise of construct stability in a prospective study of 13 patients who received IB augmentation of the deltoid ligament. In this report, we present 2 cases of a major complication where placement of the suture anchor during lateral ligamentous IB augmentation violated the subtalar joint, leading to early arthritic changes.…”

Section: Discussionmentioning

confidence: 99%

“…6 Although the IB has a reportedly low complication profile, with the rise in its usage, providers should be aware of potential detrimental complications. 8 Intra-articular placement of suture anchors is a potential complication warned against in the manufacturer surgical technique videos of the IB; however, to our knowledge, this complication has yet to be reported in the literature. 1,3 In the current article, we present 2 cases of suture anchor violation of the subtalar joint during IB augmentation for lateral ligamentous complex repair of the ankle.…”

Section: Introductionmentioning

confidence: 95%

Violation of the Subtalar Joint With Novel Suture Tape Augmentation of Lateral Ligament Reconstruction: A Report of 2 Cases

Kung

Hallman

Humbyrd

2022

Foot & Ankle Orthopaedics

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Improved Outcome and Earlier Return to Activity After Suture Tape Augmentation Versus Broström Repair for Chronic Lateral Ankle Instability? A Systematic Review

Abstract: Improved outcome and earlier return to activity after suture tape augmentation versus Broström repair for chronic lateral ankle instability? A systematic review.

Cited by 21 publications

References 40 publications

Biomechanical Evaluation of Suture Tape Internal Brace Reinforcement of Soft Tissue Allografts for ACL Reconstruction Using a Porcine Model

Biomechanical Evaluation of Suture Tape Internal Brace Reinforcement of Soft Tissue Allografts for ACL Reconstruction Using a Porcine Model

High return to sports and return to work rates after anatomic lateral ankle ligament reconstruction with tendon autograft for isolated chronic lateral ankle instability

Violation of the Subtalar Joint With Novel Suture Tape Augmentation of Lateral Ligament Reconstruction: A Report of 2 Cases

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