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The lasso-loop technique is equivalent to the simple suture technique in arthroscopic anterior talofibular ligament repair

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare the clinical outcomes of the lasso-loop and simple suture techniques in arthroscopic anterior talofibular ligament (ATFL) repair for the treatment of chronic lateral ankle instability (CLAI).

Methods

From 2018 to 2020, patients with CLAI who underwent arthroscopic ATFL repair using the lasso-loop or simple suture technique were matched 1:1 (arthroscopic lasso-loop [AL] group, n = 29; simple arthroscopic suture [AS] group, n = 29) based on age, sex, affected side, body mass index, and follow-up duration using propensity score matching and retrospectively evaluated. Karlsson score, visual analogue scale (VAS) score, Tegner score, anterior drawer test (ADT) results, complications, patient-reported satisfaction, and magnetic resonance (MR) re-evaluation findings of ATFL quality were used to describe the outcomes.

Results

The patient characteristics or follow-up durations did not significantly differ between the two groups. The Karlsson score, VAS score, and Tegner score improved significantly in both groups after a mean follow-up duration of 29.6 ± 2.8 months. The postoperative clinical scores, ADT results, satisfaction rates, complication rates and MR re-evaluation findings were not significantly different between the two groups at the latest follow-up.

Conclusion

The lasso-loop technique was equivalent to the simple suture technique in arthroscopic ATFL repair for the treatment of CLAI after a minimum follow-up of 2 years, suggesting that the simple suture technique is sufficient for arthroscopic ATFL repair in most patients without the need to add a lasso loop.

Level of evidence

Level III.

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Data availability

The data that support the findings of this study are available from the corresponding author, ZC, upon reasonable request.

References

  1. Acevedo JI, Mangone PG (2021) Arthroscopic surgical technique for lateral ankle ligament instability. Foot Ankle Clin 26:65–85

    Article  PubMed  Google Scholar 

  2. Aicale R, Maffulli N (2020) Chronic lateral ankle instability: topical review. Foot Ankle Int 41:1571–1581

    Article  PubMed  Google Scholar 

  3. Brown AJ, Shimozono Y, Hurley ET, Kennedy JG (2020) Arthroscopic versus open repair of lateral ankle ligament for chronic lateral ankle instability: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 28:1611–1618

    Article  PubMed  Google Scholar 

  4. Cordier G, Nunes GA, Vega J, Roure F, Dalmau-Pastor M (2021) Connecting fibers between ATFL’s inferior fascicle and CFL transmit tension between both ligaments. Knee Surg Sports Traumatol Arthrosc 29:2511–2516

    Article  PubMed  Google Scholar 

  5. Drakos M, Hansen O, Kukadia S (2022) Ankle instability. Foot Ankle Clin 27:371–384

    Article  PubMed  Google Scholar 

  6. Giza E, Shin EC, Wong SE et al (2013) Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study. Am J Sports Med 41:2567–2572

    Article  PubMed  Google Scholar 

  7. Gribble PA, Delahunt E, Bleakley C et al (2013) Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the international ankle Consortium. J Orthop Sports Phys Ther 43:585–591

    Article  PubMed  Google Scholar 

  8. Guo H, Huang WQ, Lin XJ, Chen BT, Zeng CJ (2020) Validation of a Chinese translation of the identification of functional ankle instability questionnaire. Chin Med J (Engl) 133:2261–2262

    Article  PubMed  Google Scholar 

  9. Herzog MM, Kerr ZY, Marshall SW, Wikstrom EA (2019) Epidemiology of ankle sprains and chronic ankle instability. J Athl Train 54:603–610

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hunt KJ, Hurwit D (2013) Use of patient-reported outcome measures in foot and ankle research. J Bone Jt Surg Am 95:e118(1-9)

    Article  Google Scholar 

  11. Li H, Hua Y, Li H, Ma K, Li S, Chen S (2017) Activity level and function 2 years after anterior talofibular ligament repair: a comparison between arthroscopic repair and open repair procedures. Am J Sports Med 45:2044–2051

    Article  PubMed  Google Scholar 

  12. Malinowski K, Paszkowski J, Goralczyk A, Giza E, Hermanowicz K (2020) Arthroscopic anatomic anterior talofibular ligament repair for anterolateral ankle instability. Arthrosc Tech 9:e29–e33

    Article  PubMed  Google Scholar 

  13. Mederake M, Hofmann UK, Ipach I (2022) Arthroscopic modified Broström operation versus open reconstruction with local periosteal flap in chronic ankle instability. Arch Orthop Trauma Surg 142:3581–3588

    Article  PubMed  Google Scholar 

  14. Michels F, Pereira H, Calder J et al (2018) Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert. Knee Surg Sports Traumatol Arthrosc 26:2095–2102

    Article  PubMed  Google Scholar 

  15. Nery C, Raduan F, Del Buono A, Asaumi ID, Cohen M, Maffulli N (2011) Arthroscopic-assisted Broström-Gould for chronic ankle instability: a long-term follow-up. Am J Sports Med 39:2381–2388

    Article  PubMed  Google Scholar 

  16. Nishimura A, Nakazora S, Senga Y et al (2021) Arthroscopic internal brace augmentation with arthroscopic modified Broström operation for chronic ankle instability. Arthrosc Tech 10:e995–e1000

    Article  PubMed  PubMed Central  Google Scholar 

  17. Pacheco J, Guerra-Pinto F, Araujo L et al (2021) Chronic ankle instability has no correlation with the number of ruptured ligaments in severe anterolateral sprain: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 29:3512–3524

    Article  PubMed  Google Scholar 

  18. Pellegrini MJ, Sevillano J, Ortiz C, Giza E, Carcuro G (2019) Knotless modified arthroscopic-Broström technique for ankle instability. Foot Ankle Int 40:475–483

    Article  PubMed  Google Scholar 

  19. Ponce BA, Hosemann CD, Raghava P, Tate JP, Eberhardt AW, Lafosse L (2011) Biomechanical evaluation of 3 arthroscopic self-cinching stitches for shoulder arthroscopy: the lasso-loop, lasso-mattress, and double-cinch stitches. Am J Sports Med 39:188–194

    Article  PubMed  Google Scholar 

  20. Samejima Y, Inokuchi R, Iwashita K et al (2021) Arthroscopic ankle lateral ligament repair alone versus arthroscopic ankle lateral ligament repair with reinforcement by inferior extensor retinaculum. Arch Orthop Trauma Surg 141:987–995

    Article  PubMed  Google Scholar 

  21. Takao M, Inokuchi R, Jujo Y et al (2021) Clinical outcomes of concurrent surgery with weight bearing after modified lasso-loop stitch arthroscopic ankle stabilization. Knee Surg Sports Traumatol Arthrosc 29:2006–2014

    Article  PubMed  Google Scholar 

  22. Takao M, Matsui K, Stone JW et al (2016) Arthroscopic anterior talofibular ligament repair for lateral instability of the ankle. Knee Surg Sports Traumatol Arthrosc 24:1003–1006

    Article  PubMed  Google Scholar 

  23. Woo BJ, Lai MC, Koo K (2020) Arthroscopic versus open Broström-Gould repair for chronic ankle instability. Foot Ankle Int 41:647–653

    Article  PubMed  Google Scholar 

  24. Yeo ED, Park SB, Lee SW et al (2021) Knotless all-inside arthroscopic modified Broström procedure for lateral ankle instability. J Foot Ankle Surg 60:541–547

    Article  PubMed  Google Scholar 

  25. Zeng G, Hu X, Liu W et al (2020) Open Broström-Gould repair vs arthroscopic anatomical repair of the anterior talofibular ligament for chronic lateral ankle instability. Foot Ankle Int 41:44–49

    Article  PubMed  Google Scholar 

  26. Zhi X, Zhang Y, Li W et al (2022) Absorbable suture anchor and knotless anchor techniques produced similar outcomes in arthroscopic anterior talofibular ligament repair. Knee Surg Sports Traumatol Arthrosc 30:2158–2165

    Article  PubMed  Google Scholar 

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Funding

This study was supported by President Foundation of The Third Affiliated Hospital of Southern Medical University.

Author information

Author notes

  1. Hao Guo and Botao Chen have contributed equally to the paper, Guangrong Ji and Canjun Zeng are both corresponding authors.

Authors and Affiliations

  1. Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, 183 West Zhongshan Road, Tianhe District, Guangzhou, 510630, People’s Republic of China

    Hao Guo, Botao Chen, Zhuhong Chen, Nian Sun & Canjun Zeng

  2. Department of Orthopedic Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, 2000 East Xiang’an Road, Xiang’an District, Xiamen, 361101, People’s Republic of China

    Botao Chen & Guangrong Ji

Authors
  1. Hao Guo
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  2. Botao Chen
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  3. Zhuhong Chen
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  4. Nian Sun
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  5. Guangrong Ji
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  6. Canjun Zeng
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Contributions

HG, ZC and GJ conceived the study. BC initiated the study design. All coauthors contributed to the refinement of the study protocol and to the implementation of the study. HG and BC drafted the manuscript. All authors have reviewed and given their final approval of the submitted version.

Corresponding authors

Correspondence to Guangrong Ji or Canjun Zeng.

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Conflict of interest

None.

Ethical approval

This retrospective comparative study was approved by the Ethics Committee of The Third Affiliated Hospital of Southern Medical University (approval number 2022-Lunshen-042).

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All participating patients have signed an informed consent form.

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Guo, H., Chen, B., Chen, Z. et al. The lasso-loop technique is equivalent to the simple suture technique in arthroscopic anterior talofibular ligament repair. Knee Surg Sports Traumatol Arthrosc 31, 2174–2182 (2023). https://doi.org/10.1007/s00167-022-07283-x

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  • DOI: https://doi.org/10.1007/s00167-022-07283-x

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