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The anterior talofibular ligament–posterior talofibular ligament angle decreased after ankle lateral stabilization surgery

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The angle between the anterior talofibular ligament (ATFL) and the posterior talofibular ligament (PTFL) is increased in patients with chronic ATFL injury. This study aimed to compare the AFTL–PTFL angle before versus after ankle lateral stabilization surgery, and to evaluate whether the ATFL–PTFL angle correlates with the ligament injury severity.

Methods

This retrospective study included 48 patients with mechanical ankle instability treated between 2016 and 2018. After arthroscopic evaluation, all patients underwent ankle lateral stabilization surgery comprising ligament repair (n = 28) or reconstruction (n = 20). The ATFL–PTFL angle was measured in the axial plane on pre- and postoperative MRI. Comparisons were made of the pre- versus postoperative ATFL–PTFL angles, and the ATFL–PTFL angle of the repair versus reconstruction groups. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of the ATFL–PTFL angle in selecting the surgical technique.

Results

The postoperative ATFL–PTFL angle was significantly decreased compared with preoperatively. The ATFL–PTFL angle was significantly smaller in the repair group than the reconstruction group preoperatively and postoperatively. The area under the ROC curve was 0.741 (P < 0.01). The optimal cutoff point for the selection of ligament reconstruction was an ATFL–PTFL angle of 89.4° (sensitivity 0.85, specificity 0.61).

Conclusion

The ATFL–PTFL angle decreases after ankle lateral stabilization surgery. The ATFL–PTFL angle is related to the severity of the ATFL injury. Ankle lateral ligament reconstruction should be considered when the ATFL–PTFL angle is > 89.4°.

Level of Evidence

Level III.

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Acknowledgements

This work was supported by a grant awarded to Ying-Hui Hua from the National Natural Science Foundation of China (NSFC81572209).

Funding

This study was funded by National Natural Science Foundation of China (NSFC81572209).

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Author notes

  1. Hong-Yun Li and Ao Guo contribute equally to this work.

Authors and Affiliations

  1. Sports Medicine Center of Fudan University, Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, No. 12 Urumq Middle Road, Shanghai, 20040, China

    Hong-Yun Li, Ying-Hui Hua & Shi-Yi Chen

  2. Department of Sports Medicine, Taizhou Orthopedics Hospital, Taizhou, 317500, Zhejiang, China

    Ao Guo

  3. Department of Foot and Ankle Surgery, Sanmenxia Central Hospital, Sanmenxia, 472000, Henan, China

    Fan Yang

  4. Department of Rehabilitation Medicine, Huadong Hospital Affiliated To Fudan University, Shanghai, 200040, China

    Jie-Jiao Zheng

Authors
  1. Hong-Yun Li
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  2. Ao Guo
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  3. Fan Yang
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  4. Jie-Jiao Zheng
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  5. Ying-Hui Hua
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Corresponding author

Correspondence to Ying-Hui Hua.

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The authors declare that they have no potential confict of interest.

Ethical approval

This study was approved by the Research Ethics Committee of Huashan Hospital, Fudan University (KY2016-002).

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Li, HY., Guo, A., Yang, F. et al. The anterior talofibular ligament–posterior talofibular ligament angle decreased after ankle lateral stabilization surgery. Knee Surg Sports Traumatol Arthrosc 29, 1510–1515 (2021). https://doi.org/10.1007/s00167-020-06174-3

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  • DOI: https://doi.org/10.1007/s00167-020-06174-3

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