Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 6, pp 1877–1885 | Cite as

Lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon

  • Hyong Nyun Kim
  • June Young Jeon
  • Quanyu Dong
  • Kyu Cheol Noh
  • Kook Jin Chung
  • Hong Kyun Kim
  • Ji Hyo Hwang
  • Yong Wook ParkEmail author
Ankle

Abstract

Purpose

The purpose of this study was to assess the results of a novel surgical technique for the treatment of chronic lateral ankle instability with attenuated or deficient ligamentous tissue that the modified Broström procedure could not be performed. A lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon has been performed.

Methods

Thirty-four consecutive patients treated with lateral ankle ligament reconstruction using anterior half of the peroneus longus tendon were enrolled. Median age at surgery was 24 years (range 19–46 years). The clinical and radiologic outcomes were evaluated preoperatively and at a median of 21 months (range 12–51 months) follow-up.

Results

The Karlsson–Peterson ankle score significantly improved from 58.2 ± 10.9 points preoperatively to 83.9 ± 7.0 points at the last follow-up. Mechanical stability was achieved. The mean talar tilt angle significantly improved from 15.7° ± 3.5° preoperatively to 4.6° ± 1.7° at the last follow-up, and the mean anterior talar translation significantly improved from 7.3 ± 2.6 mm preoperatively to 4.1 ± 1.7 mm at the last follow-up. Fifteen patients (52 %) were very satisfied with the results, nine patients (31 %) were satisfied, four patients (14 %) were fair, and one patient (3 %) was dissatisfied with the results.

Conclusions

Lateral ankle ligament reconstruction using the anterior half of the peroneus longus tendon can be a surgical option for chronic lateral ankle instability with attenuated or deficient ligaments.

Level of evidence

Case-series, Level IV.

Keywords

Chronic lateral ankle instability Chronic ligamentous insufficiency Lateral ankle ligament reconstruction Peroneus longus tendon Autograft 

Supplementary material

Supplementary material 1 (MPG 17696 kb)

Supplementary material 2 (MPG 2920 kb)

Supplementary material 3 (MPG 1526 kb)

References

  1. 1.
    Ahn JH, Choy W, Kim H (2011) Reconstruction of the lateral ankle ligament with a long extensor tendon graft of the fourth toe. Am J Sports Med 39(3):637–644CrossRefPubMedGoogle Scholar
  2. 2.
    Ajis A, Younger AS, Maffulli N (2006) Anatomic repair for chronic lateral ankle instability. Foot Ankle Clin 11(3):539–545CrossRefPubMedGoogle Scholar
  3. 3.
    Anderson ME (1985) Reconstruction of the lateral ligaments of the ankle using the plantaris tendon. J Bone Joint Surg Am 67(6):930–934PubMedGoogle Scholar
  4. 4.
    Beighton P, Horan F (1969) Orthropaedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg Br 51:444–453PubMedGoogle Scholar
  5. 5.
    Bohnsack M, Sürie B, Kirsch L, Wülker N (2002) Biomechanical properties of commonly used autogenous transplants in the surgical treatment of chronic lateral ankle instability. Foot Ankle Int 23(7):661–664PubMedGoogle Scholar
  6. 6.
    Boyer DS, Younger AS (2006) Anatomic reconstruction of the lateral ligament complex of the ankle using a gracilis autograft. Foot Ankle Clin 11(3):585–595CrossRefPubMedGoogle Scholar
  7. 7.
    Budny AM, Schuberth JM (2012) Autologous split peroneus longus lateral ankle stabilization. J Foot Ankle Surg 51(5):588–592CrossRefPubMedGoogle Scholar
  8. 8.
    Caffrey E, Docherty CL, Schrader J, Klossner J (2009) The ability of 4 single-limb hopping tests to detect functional performance deficits in individuals with functional ankle instability. J Orthop Sports Phys Ther 39(11):799–806CrossRefPubMedGoogle Scholar
  9. 9.
    Caprio A, Oliva F, Treia F, Maffullin N (2006) Reconstruction of the lateral ankle ligaments with allograft in patients with chronic ankle instability. Foot Ankle Clin 11(3):597–605, 2007:1455–1458Google Scholar
  10. 10.
    Colville MR (1998) Surgical treatment of the unstable ankle. J Am Acad Orthop Surg 6(6):368–377PubMedGoogle Scholar
  11. 11.
    Coughlin MJ, Schenck RC, Grebing BR, Treme G (2004) Comprehensive reconstruction of the lateral ankle for chronic instability using a free gracilis graft. Foot Ankle Int 25(4):231–241PubMedGoogle Scholar
  12. 12.
    Espinosa N, Smerek J, Kadakia AR, Myerson MS (2006) Operative management of ankle instability: reconstruction with open and percutaneous methods. Foot Ankle Clin 11(3):547–565CrossRefPubMedGoogle Scholar
  13. 13.
    Ibrahim SA, Hamido F, Al Misfer AK, Ghafar SA, Awad A, Salem HKh, Alhran H, Khirait S (2011) Anatomical reconstruction of the lateral ligaments using Gracilis tendon in chronic ankle instability; a new technique. Foot Ankle Surg 17(4):239–246CrossRefPubMedGoogle Scholar
  14. 14.
    Jung HG, Kim TH, Park JY, Bae EJ (2012) Reconstruction of the anterior talofibular and calcaneofibular ligaments using a semitendinosus tendon allograft and interference screws. Knee Surg Sports Traumatol Arthrosc 20(8):1432–1437CrossRefPubMedGoogle Scholar
  15. 15.
    Karlsson J, Eriksson BI, Bergsten T, Rudholm O, Swärd L (1997) Comparison of two reconstructions for chronic lateral instability of the ankle joint. Am J Sports Med 25(1):48–53CrossRefPubMedGoogle Scholar
  16. 16.
    Karlsson J, Peterson L (1991) Evaluation of ankle joint function: the use of a scoring scale. The Foot 1(1):15–19CrossRefGoogle Scholar
  17. 17.
    Kennedy JG, Smyth NA, Fansa AM, Murawski CD (2012) Anatomic lateral ligament reconstruction in the ankle: a hybrid technique in the athletic population. Am J Sports Med 40(10):2309–2317CrossRefPubMedGoogle Scholar
  18. 18.
    Kim BS, Choi WJ, Kim YS, Lee JW (2010) The effect of an ossicle of the lateral malleolus on ligament reconstruction of chronic lateral ankle instability. Foot Ankle Int 31(3):191–196CrossRefPubMedGoogle Scholar
  19. 19.
    Krips R, van Dijk CN, Halasi T, Lehtonen H, Moyen B, Lanzetta A, Farkas T, Karlsson J (2000) Anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a 2- to 10-year follow-up, multicenter study. Knee Surg Sports Traumatol Arthrosc 8(3):173–179CrossRefPubMedGoogle Scholar
  20. 20.
    Löfvenberg R, Kärrholm J, Sundelin G, Ahlgren O (1995) Prolonged reaction time in patients with chronic lateral instability of the ankle. Am J Sports Med 23(4):414–417CrossRefPubMedGoogle Scholar
  21. 21.
    Pagenstert GI, Hintermann B, Knupp M (2006) Operative management of chronic ankle instability: plantaris graft. Foot Ankle Clin 11(3):567–583CrossRefPubMedGoogle Scholar
  22. 22.
    Petersen W, Bobka T, Stein V, Tillmann B (2000) Blood supply of the peroneal tendons: injection and immunohistochemical studies of cadaver tendons. Acta Orthop Scand 71(2):168–174CrossRefPubMedGoogle Scholar
  23. 23.
    Sammarco GJ, Idusuyi OB (1999) Reconstruction of the lateral ankle ligaments using a split peroneus brevis tendon graft. Foot Ankle Int 20(2):97–103CrossRefPubMedGoogle Scholar
  24. 24.
    Sekir U, Yildiz Y, Hazneci B, Ors F, Saka T, Aydin T (2008) Reliability of a functional test battery evaluating functionality, proprioception, and strength in recreational athletes with functional ankle instability. Eur J Phys Rehabil Med 44(4):407–415PubMedGoogle Scholar
  25. 25.
    Sharma N, Sharma A, Sandhu J (2011) Functional performance testing in athletes with functional ankle instability. Asian J Sports Med 2(4):249–258PubMedCentralPubMedGoogle Scholar
  26. 26.
    Snook GA (1985) Long-term results of the Chrisman-Snook operation for reconstruction of the lateral ligaments of the ankle. J Bone Joint Surg Am 67(1):1–7PubMedGoogle Scholar
  27. 27.
    Takahashi T, Nakahira M, Kaho K, Kawakami T (2003) Anatomical reconstruction of chronic lateral ligament injury of the ankle using pedicle tendon of the extensor digitorum longus. Arch Orthop Trauma Surg 123(4):175–179PubMedGoogle Scholar
  28. 28.
    Takao M, Oae K, Uchio Y, Ochi M, Yamamoto H (2005) Anatomical reconstruction of the lateral ligaments of the ankle with a gracilis autograft: a new technique using an interference fit anchoring system. Am J Sports Med 33(6):814–823CrossRefPubMedGoogle Scholar
  29. 29.
    Yoshida M, Taniguchi K, Katayose M (2011) Analysis of muscle activity and ankle joint movement during the side-hop test. J Strength Cond Res 25(8):2255–2264CrossRefPubMedGoogle Scholar
  30. 30.
    Youn H, Kim YS, Lee J, Choi WJ, Lee JW (2012) Percutaneous lateral ligament reconstruction with allograft for chronic lateral ankle instability. Foot Ankle Int 33(2):99–104CrossRefPubMedGoogle Scholar
  31. 31.
    Zhao J, Huangfu X (2012) The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft source. Am J Sports Med 40(3):662–671CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Hyong Nyun Kim
    • 1
  • June Young Jeon
    • 1
  • Quanyu Dong
    • 1
  • Kyu Cheol Noh
    • 1
  • Kook Jin Chung
    • 1
  • Hong Kyun Kim
    • 1
  • Ji Hyo Hwang
    • 1
  • Yong Wook Park
    • 1
    Email author
  1. 1.Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, College of MedicineHallym UniversitySeoulSouth Korea

Personalised recommendations