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Arthroscopic anterior talofibular ligament repair with Internal Brace and lasso-loop technique for chronic ankle lateral instability

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Abstract

Objective

To introduce the surgical technique and clinical outcomes of arthroscopic anterior talofibular ligament (ATFL) repair using the Internal Brace and lasso-loop technique for chronic ankle lateral instability.

Methods

A retrospective study was performed on 29 patients who underwent all-arthroscopic ATFL repair with the Internal Brace and lasso-loop technique from January to August 2020. The patients included 24 males and five females, with a mean age of 30.17 years. Through the accessory anterolateral (AAL) portal, we drilled the bone tunnels and fixed the tape with 4.75 mm and 3.5 mm “SwiveLock” anchors and reattached the torn ligament by the lasso-loop technique.

Results

All 29 patients underwent all-arthroscopic procedures smoothly without serious complications, such as infection and important nerve or vessel injuries. There were eight cases of lateral malleolar avulsion fractures and ten cases of talus cartilage injury. The visual analog scale (VAS), Karlsson-Peterson, Tegner, and American Orthopedic Foot and Ankle Society (AOFAS) scores were used to evaluate the clinical consequences. All the patients were followed up for 18.66 ± 4.85 months on average. The average pre-operative VAS score was 4.69 ± 1.04, which was significantly higher than the average post-operative VAS score of 1.14 ± 1.56. At the final follow-up appointments, the averages of Karlsson-Peterson, AOFAS, and Tenger scores were 75.83 ± 9.44, 88.31 ± 6.81, and 6.93 ± 1.79, respectively, which was significantly higher than that before the operation.

Conclusion

This arthroscopic anterior talofibular ligament repair with the Internal Brace and lasso-loop technique achieves satisfactory clinical outcomes with the benefits of high safety and reliability for chronic ankle lateral instability.

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Data availability

All available data were present in this study.

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Funding

This study is supported by the Scientific Research Project of Hunan Provincial Health Committee (202204072756).

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Authors and Affiliations

  1. Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, 410011, China

    Ding Li, Qi Tang, Qian Liu, Minzhi Mao, Ting Deng, Lele Liao & Weihong Zhu

  2. Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, 410011, China

    Junjiao Hu

Authors
  1. Ding Li
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  2. Qi Tang
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  3. Qian Liu
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  4. Junjiao Hu
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  5. Minzhi Mao
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  6. Ting Deng
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  7. Lele Liao
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  8. Weihong Zhu
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Contributions

Ding Li, Weihong Zhu, Lele Liao, and Qi Tang were the major contributors to writing the manuscript. Ding Li finished all the operations. Qian Liu and Minzhi Mao collected, analyzed, and interpreted all patient data. Junjiao Hu supported data collection process. Weihong Zhu and Lele Liao significantly contributed to the preparation of the manuscript. Qi Tang and Ting Deng were mainly responsible for the patient treatment. Weihong Zhu and Lele Liao contributed equally to this work as corresponding authors. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Lele Liao or Weihong Zhu.

Ethics declarations

Ethical approval

This study was approved by the Ethics Committee of the Second Xiangya Hospital, Central South University. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication.

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The authors declare no competing interests.

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Li, D., Tang, Q., Liu, Q. et al. Arthroscopic anterior talofibular ligament repair with Internal Brace and lasso-loop technique for chronic ankle lateral instability. International Orthopaedics (SICOT) 46, 2821–2828 (2022). https://doi.org/10.1007/s00264-022-05541-8

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  • DOI: https://doi.org/10.1007/s00264-022-05541-8

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