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Optimal suture anchor direction in arthroscopic lateral ankle ligament repair

Knee Surgery, Sports Traumatology, Arthroscopy volume 26, pages 2110–2115 (2018)Cite this article

Abstract

Purpose

In this study, the distance between the insertion point of the suture anchors and posterior surface of the fibula during arthroscopic lateral ankle ligament repair was investigated on computed tomography (CT) images. The hypothesis of this study was that there is an optimal insertional direction of the suture anchor to avoid anchor-related complications.

Methods

One hundred eleven ankles of 98 patients who had undergone three-dimensional CT scans for foot or ankle disorders without deformity of the fibula were assessed (59 males, 52 females; median age 25.5 years; age range 12–78 years). The shortest distance from the insertion point of the suture anchor to the deepest point of the fossa/top of the convex aspect of the fibula was measured on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°. The distance from the insertion point of the suture anchor to the posterior surface of the fibula was also measured in a direction parallel to the sagittal plane of the lateral surface of the talus on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°.

Results

The posterior fossa was observed in all cases on the 90° and 75° images. The distance from the insertion point to the posterior surface of the fibula in the parallel direction was 15.0 ± 3.4 mm at 90°, 17.5 ± 3.2 mm at 75°, 21.7 ± 3.3 mm at 60°, and 25.7 ± 3.6 mm at 45°. The posterior points in the parallel direction were located on the posterior fossa in 36.0% of cases at 90°, in 12.6% at 75°, and in 0.0% at 60° and 45°.

Conclusions

The suture anchor should be directed from anterior to posterior at an angle of <45° to the longitudinal axis of the fibula, parallel to the lateral surface of the talus, to avoid passing through the fibula.

Level of evidence

Cohort study, Level III.

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Affiliations

  1. Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 8140180, Japan

    Ichiro Yoshimura, Tomonobu Hagio, Masahiro Noda, Kazuki Kanazawa, So Minokawa & Takuaki Yamamoto

Authors
  1. Ichiro Yoshimura
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  2. Tomonobu Hagio
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  3. Masahiro Noda
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  4. Kazuki Kanazawa
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  5. So Minokawa
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  6. Takuaki Yamamoto
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Correspondence to Ichiro Yoshimura.

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The authors and institution have no conflict of interest.

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No grant was received for this study.

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This study did not involve any human participants.

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This study did not involve human participants so informed consent were not needed.

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Yoshimura, I., Hagio, T., Noda, M. et al. Optimal suture anchor direction in arthroscopic lateral ankle ligament repair. Knee Surg Sports Traumatol Arthrosc 26, 2110–2115 (2018). https://doi.org/10.1007/s00167-017-4587-6

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  • DOI: https://doi.org/10.1007/s00167-017-4587-6

Keywords

  • Suture anchor
  • Fibula
  • CT
  • Direction
  • Ankle lateral ligament
  • Arthroscopy