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All-arthroscopic anatomical reconstruction of anterior talofibular ligament using semitendinosus autografts

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Abstract

Purpose

We introduced a new technique of all-arthroscopic anatomical anterior talofibular ligament (ATFL) reconstruction using semitendinosus autografts.

Methods

From June 2012 to June 2013, 28 patients with chronic ATFL rupture underwent arthroscopic anatomic reconstruction of the ATFL. They were divided into the Broström group (n = 16) and reconstruction group (n = 12). The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue score (VAS) was recorded before the operation, 12 months after the operation and 30 months after the operation. Physical examination and radiographs were performed in follow-ups.

Results

The patients had higher AOFAS score after the operation in both the Broström group and the reconstruction group. 12 months after operation, the patients in the reconstruction group showed significantly higher AOFAS score and lower VAS score than those in the Broström group (P = 0.003 and 0.001, respectively), while the difference between the two groups was not statistically significant 30 months later (P = 0.425 and 0.323, respectively). Contemporary numbness of the lateral dorsal part of the foot appeared in one (8.3%) patient in the reconstruction group and two (12.5%) patients in the Broström group, and the symptoms diminished after neurotrophic treatment. No other complications, including recurrent instability, were encountered. No donor-side morbidity such as infection or delayed wound healing was observed.

Conclusions

The novel surgical technique enhanced post-operative rehabilitation by providing better ankle joint function than modified Broström procedure at 12 months after operation, while the advantage was not statistically significant 30 months later. The long-term outcome requires further investigation. The technique of all-arthroscopic anatomical ATFL reconstruction using semitendinosus autografts proved to be a viable option for ATFL injuries.

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Acknowledgments

We have received no funding for this study.

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Authors and Affiliations

  1. Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, 510120, Guangzhou, Guangdong, China

    Bin Song, Zhong Chen, Yunfeng Zhou & Weiping Li

  2. Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, 510120, Guangzhou, Guangdong, China

    Changchuan Li & Yan Zhang

  3. Department of GCP, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, 510120, Guangzhou, Guangdong, China

    Na Chen

Authors
  1. Bin Song
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  2. Changchuan Li
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  3. Na Chen
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  4. Zhong Chen
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  5. Yan Zhang
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  6. Yunfeng Zhou
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  7. Weiping Li
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Correspondence to Weiping Li.

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The authors declare that they have no conflict of interest.

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This is a retrospective case-control study. For this type of study, formal consent is not required.

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Song, B., Li, C., Chen, N. et al. All-arthroscopic anatomical reconstruction of anterior talofibular ligament using semitendinosus autografts. International Orthopaedics (SICOT) 41, 975–982 (2017). https://doi.org/10.1007/s00264-017-3410-9

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  • DOI: https://doi.org/10.1007/s00264-017-3410-9

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