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Absorbable suture anchor and knotless anchor techniques produced similar outcomes in arthroscopic anterior talofibular ligament repair

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study is to compare absorbable suture anchor with knotless anchor techniques for arthroscopic anterior talofibular ligament (ATFL) repair.

Method

A multicenter retrospective study was performed with 185 patients, who had undergone an arthroscopic ATFL repair procedure using absorbable suture anchor or knotless anchor between May 2017 and October 2019. The follow-up time was a minimum of 18 months. Karlsson–Peterson score, visual analogue scale (VAS), and Cumberland ankle instability tool (CAIT) were evaluated. The complications were also recorded.

Results

One hundred and seven patients underwent one absorbable suture anchor repair procedure (Group A [A]), and the other seventy-eight patients underwent one knotless anchor repair procedure (Group B [B]). At the final follow-up, both Karlsson–Peterson score (A, pre 61.0 ± 8.0 vs post 93.5 ± 5.3, P < 0.001; B, pre 59.5 ± 8.2 vs post 92.4 ± 6.3, P < 0.001), VAS score (A, pre 5.0 ± 1.3 vs post 0.5 ± 0.7, P < 0.001; B, pre 5.5 ± 1.2 vs post 0.9 ± 1.0, P < 0.001), and CAIT score (A, pre 53.1 ± 12.0 vs post 93.1 ± 6.6, P < 0.001; B, pre 51.6 ± 12.0 vs post 93.1 ± 6.5, P < 0.001) improved significantly in both groups. There was no significant difference between the two groups regarding the Karlsson–Peterson score (A, pre 61.0 ± 8.0 vs B, pre 59.5 ± 8.2, n.s; A, post 93.5 ± 5.3 vs B, post 92.4 ± 6.3, n.s), CAIT score (A, pre 53.1 ± 12.0 vs B, pre 51.6 ± 12.0, n.s; A, post 93.1 ± 6.6 vs B, post 93.1 ± 6.5, n.s) and the change ranges of VAS (A, 4.5 ± 1.0 vs B, 4.6 ± 1.2, n.s). Anchor complications were easier to occur in Group B (0/107 vs 6/78, P = 0.007). Knot irritation slightly increased in Group A (10/107 vs 0/78, P = 0.006). No significant difference was found regarding total complication rates (A, 10/107 vs B, 6/78, n.s).

Conclusion

Absorbable suture anchor and knotless anchor for arthroscopic ATFL repair produced similar clinical outcomes. The ankle stability scores increased significantly in both groups. However, the knotless anchor has a higher risk to loosen, deviated direction or break, while the absorbable suture anchor still has a slim chance of knot irritation.

Level of evidence

III.

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Acknowledgements

We would like to express gratitude to John Valerius, an English native speaker, for taking the time to revise our paper.

Funding

This research was partially supported by the Yuying Program of General Hospital of PLA Central Theater Command (ZZYFH202109).

Author information

Author notes

  1. Xiaosong Zhi, Yu Zhang and Weilin Li contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Foot and Ankle Sports Medicine Center, Department of Orthopaedics, General Hospital of Central Theater Command (Wuhan General Hospital of Guangzhou Command, previously), No. 627, Wuluo Road, Wuhan, 430030, Hubei Province, People’s Republic of China

    Xiaosong Zhi, Changwang Kong, Dan Xu & Shijun Wei

  2. The 2nd Department of Foot and Ankle, Sichuan Provincial Orthopedics Hospital, Sichuan Province, Chengdu, China

    Yu Zhang, Yong Wang & Lisha Lu

  3. Department of Foot and Ankle, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong Province, China

    Weilin Li, Yunxuan Zou & Yongzhan Zhu

  4. The First Clinical Medical School of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China

    Shijun Wei

Authors
  1. Xiaosong Zhi
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  2. Yu Zhang
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Contributions

XZ: manuscript preparation and literature research. YZ: Data review and follow-up assessment of the medical Center 2. WL: Data collection and follow-up assessment of the medical Center 3. YW: Data collection and follow-up assessment of the medical Center 2. YZ: Data review and follow-up assessment of the medical Center 3. LL: Data analysis and statistical analysis. CK: Data review and follow-up assessment of the medical Center 1. DX: Data collection and follow-up assessment of the medical Center 1. YZ: Designed study and manuscript review. SW: Designed study and manuscript revise.

Corresponding authors

Correspondence to Yongzhan Zhu or Shijun Wei.

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The study was approved by the institutional ethical committee of General Hospital of PLA Central Theater Command. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written consent was obtained from all participants.

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Zhi, X., Zhang, Y., Li, W. et al. Absorbable suture anchor and knotless anchor techniques produced similar outcomes in arthroscopic anterior talofibular ligament repair. Knee Surg Sports Traumatol Arthrosc 30, 2158–2165 (2022). https://doi.org/10.1007/s00167-021-06855-7

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