International Orthopaedics

, Volume 36, Issue 10, pp 2027–2031 | Cite as

Anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft

  • Yinghui Hua
  • Shiyi Chen
  • Yongjia Jin
  • Bimeng Zhang
  • Yunxia Li
  • Hong Li
Original Paper



The purpose of our study is to evaluate the clinical results of anatomical reconstruction of the lateral ligaments with semitendinosus allograft.


Thirty-six patients with chronic lateral instability underwent anatomical reconstruction of the lateral ligaments of the ankle with semitendinosus allograft. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score (AOFAS score) and the Karlsson score were used to evaluate the clinical results before and after surgery.


A total of 35 patients (97.2 %) (36 ankles) were followed up for a mean of 37.9 months. The mean AOFAS score improved from 42.3 ± 4.9 points preoperatively to 90.4 ± 6.7 postoperatively. The mean Karlsson score improved from 38.5 ± 3.2 preoperatively to 90.1 ± 7.8 postoperatively.


Anatomical reconstruction of the lateral ligaments with semitendinosus allograft achieves a satisfactory surgical outcome for chronic ankle instability.


  1. 1.
    Lassiter TE Jr, Malone TR, Garrett WE Jr (1989) Injury to the lateral ligaments of the ankle. Orthop Clin North Am 20:629–640PubMedGoogle Scholar
  2. 2.
    McConkey JP (1987) Ankle sprains, consequences and mimics. Med Sport Sci 23:39–55Google Scholar
  3. 3.
    MacAuley D (1999) Ankle injuries: same joint, different sports. Med Sci Sports Exerc 31:S409–S411PubMedCrossRefGoogle Scholar
  4. 4.
    Jackson W, McGarvey W (2006) Update on the treatment of chronic ankle instability and syndesmotic injuries. Curr Opin Orthop 17:97–102CrossRefGoogle Scholar
  5. 5.
    Karlsson J, Lansinger O (1993) Chronic lateral instability of the ankle in athletes. Sports Med 16:355–365PubMedCrossRefGoogle Scholar
  6. 6.
    Baumhauer JF, O’Brien T (2002) Surgical considerations in the treatment of ankle instability. J Athl Train 37:458–462PubMedGoogle Scholar
  7. 7.
    Carey JL, Dunn WR, Dahm DL, Zeger SL, Spindler KP (2009) A systematic review of anterior cruciate ligament reconstruction with autograft compared with allograft. J Bone Joint Surg Am 91:2242–2250PubMedCrossRefGoogle Scholar
  8. 8.
    Caprio A, Oliva F, Treia F, Maffulli N (2006) Reconstruction of the lateral ankle ligaments with allograft in patients with chronic ankle instability. Foot Ankle Clin 11:597–605PubMedCrossRefGoogle Scholar
  9. 9.
    Frost SC, Amendola A (1999) Is stress radiography necessary in the diagnosis of acute or chronic ankle instability? Clin J Sport Med 9:40–45PubMedCrossRefGoogle Scholar
  10. 10.
    Beighton P, Solomon L, Soskolne CL (1973) Articular mobility in an African population. Ann Rheum Dis 32:413–418PubMedCrossRefGoogle Scholar
  11. 11.
    Hua Y, Chen S, Li Y, Chen J, Li H (2010) Combination of modified Broström procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthroscopy 26:524–528PubMedCrossRefGoogle Scholar
  12. 12.
    van den Bekerom MP, Oostra RJ, Alvarez PG, van Dijk CN (2008) The anatomy in relation to injury of the lateral collateral ligaments of the ankle: a current concepts review. Clin Anat 21:619–626PubMedCrossRefGoogle Scholar
  13. 13.
    Fanelli GC, Tomaszewski DJ (2007) Allograft use in the treatment of the multiple ligament injured knee. Sports Med Arthrosc 15:139–148PubMedCrossRefGoogle Scholar
  14. 14.
    Sikka RS, Narvy SJ, Vangsness CT Jr (2011) Anterior cruciate ligament allograft surgery: underreporting of graft source, graft processing, and donor age. Am J Sports Med 39:649–655PubMedCrossRefGoogle Scholar
  15. 15.
    Horibe S, Shino K, Taga I, Inoue M, Ono K (1991) Reconstruction of lateral ligaments of the ankle with allogeneic tendon grafts. J Bone Joint Surg Br 73:802–805PubMedGoogle Scholar
  16. 16.
    Nakata K, Shino K, Horibe S, Natsu-ume T, Mae T, Ochi T (2000) Reconstruction of the lateral ligaments of the ankle using solvent-dried and gamma-irradiated allogeneic fascia lata. J Bone Joint Surg Br 82:579–582PubMedCrossRefGoogle Scholar
  17. 17.
    Su EP, Healey JH (2003) Salvage reconstruction for lateral ankle instability using a tendon allograft. Clin Orthop Relat Res 415:232–238PubMedCrossRefGoogle Scholar
  18. 18.
    Jung HG, Kim TH, Park JY, Bae EJ (2011) Anatomic reconstruction of the anterior talofibular and calcaneofibular ligaments using a semitendinosus tendon allograft and interference screws. Knee Surg Sports Traumatol Arthrosc. doi: 10.1007/s00167-011-1666-y
  19. 19.
    Burks RT, Morgan J (1994) Anatomy of the lateral ankle ligaments. Am J Sports Med 22:72–77PubMedCrossRefGoogle Scholar
  20. 20.
    Pagenstert GI, Valderrabano V, Hintermann B (2005) Lateral ankle ligament reconstruction with free plantaris tendon graft. Tech Foot Ankle Surg 4:104–112Google Scholar
  21. 21.
    Sugimoto K, Takakura Y, Kumai T, Iwai M, Tanaka Y (2002) Reconstruction of the lateral ankle ligaments with bone-patellar tendon graft in patients with chronic ankle instability: a preliminary report. Am J Sports Med 30:340–346PubMedGoogle Scholar
  22. 22.
    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 33:814–823PubMedCrossRefGoogle Scholar
  23. 23.
    Ahn JH, Choy WS, Kim HY (2011) Reconstruction of the lateral ankle ligament with a long extensor tendon graft of the fourth toe. Am J Sports Med 39:637–644PubMedCrossRefGoogle Scholar
  24. 24.
    Bahr R, Pena F, Shine J, Lew WD, Tyrdal S, Engebretsen L (1997) Biomechanics of ankle ligament reconstruction. An in vitro comparison of the Broström repair, Watson-Jones reconstruction, and a new anatomic reconstruction technique. Am J Sports Med 25:424–432PubMedCrossRefGoogle Scholar
  25. 25.
    Muramatsu K, Hachiya Y, Izawa H (2008) Serial evaluation of human anterior cruciate ligament grafts by contrast-enhanced magnetic resonance imaging: comparison of allografts and autografts. Arthroscopy 24:1038–1044PubMedCrossRefGoogle Scholar
  26. 26.
    Malinin TI, Levitt RL, Bashore C, Temple HT, Mnaymneh W (2002) A study of retrieved allografts used to replace anterior cruciate ligaments. Arthroscopy 18:163–170PubMedCrossRefGoogle Scholar
  27. 27.
    Horibe S, Shino K, Nagano J, Nakamura H, Tanaka M, Ono K (1990) Replacing the medial collateral ligament with an allogenic tendon graft. An experimental canine study. J Bone Joint Surg Br 72:1044–1049PubMedGoogle Scholar
  28. 28.
    Barrett GR, Luber K, Replogle WH, Manley JL (2010) Allograft anterior cruciate ligament reconstruction in the young, active patient: Tegner activity level and failure rate. Arthroscopy 26:1593–1601PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Yinghui Hua
    • 1
  • Shiyi Chen
    • 1
  • Yongjia Jin
    • 2
  • Bimeng Zhang
    • 3
  • Yunxia Li
    • 1
  • Hong Li
    • 1
  1. 1.Department of Sports Medicine and Arthroscopy SurgeryHuashan Hospital, Fudan UniversityShanghaiChina
  2. 2.Department of OrthopaedicsDianli HospitalShanghaiChina
  3. 3.Department of Acupuncture and MoxibustionShanghai First People’s Hospital, Shanghai JiaoTong UniversityShanghaiChina

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