Abstract
Chronic anterolateral ankle instability (CLAI) is a frequent pathology which might lead to incapacitating ankle dysfunction and/or pain either in athletes or general population. If neglected, CLAI can lead to late sequelae, such as impingement, cartilage damage, ankle arthritis, or deformities.
For patients who have failed conservative treatment, surgical management has been proposed with favorable outcome.
Nevertheless, several authors reported concerns with recurrent instability following acute reinjury and chronic damage of the repaired anterior talofibular ligament (ATFL).
Furthermore, the possibility of a more aggressive rehabilitation, enabling a faster return to activity, has also been pursuit.
These lead to the search of new “biomaterials” and possibly, advanced tissue engineering (in the future), in order to find possibilities to re-enforce ATFL repair, thus achieving “stronger” repairs, with lower failure risk and facilitating faster rehabilitation.
This chapter describes the possibility for high-molecular-weight polyethylene “suture-tape augmentation,” also known as “internal brace” (plus anchor/small inference screws), to augment ligament repair in modified Broström repair.
It has been reported that this augmentation enables greater resistance of the construct than the native ATFL (154 N). Still, it is not a biological approach at this time (acellular); thus, it has no positive effect in proprioception or vascularization. Biocompatibility of the material is of paramount importance.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Hunt KJ, Fuld RS, Sutphin BS, Pereira H, D’Hooghe P. Return to sport following lateral ankle ligament repair is under-reported: a systematic review. J ISAKOS Joint Disord Orthopaed Sports Med. 2017; https://doi.org/10.1136/jisakos-2016-000064.
van Dijk CN, Bossuyt PM, Marti RK. Medial ankle pain after lateral ligament rupture. J Bone Joint Surg Br. 1996;78(4):562–7.
Ferkel RD, Chams RN. Chronic lateral instability: arthroscopic findings and long-term results. Foot Ankle Int. 2007;28(1):24–31. https://doi.org/10.3113/fai.2007.0005.
Lee J, Hamilton G, Ford L. Associated intra-articular ankle pathologies in patients with chronic lateral ankle instability: arthroscopic findings at the time of lateral ankle reconstruction. Foot Ankle Spec. 2011;4(5):284–9.
Liszka H, Depukat P, Gadek A. Intra-articular pathologies associated with chronic ankle instability. Folia Med Cracov. 2016;56(2):95–100.
Harrington KD. Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability. J Bone Joint Surg Am. 1979;61(3):354–61.
Kobayashi T, Gamada K. Lateral ankle sprain and chronic ankle instability: a critical review. Foot Ankle Spec. 2014;7(4):298–326. https://doi.org/10.1177/1938640014539813.
Karlsson J, Rudholm O, Bergsten T, Faxen E, Styf J. Early range of motion training after ligament reconstruction of the ankle joint. Knee Surg Sports Traumatol Arthrosc. 1995;3(3):173–7. https://doi.org/10.1007/BF01565478.
Ramirez-Gomez VJ, Gomez-Carlin LA, Ortega-Orozco R, Zazueta-Arnaud CA, Patino-Fernandez JP. Clinical and functional results of Brostrom-Gould procedure with suture tape augmentation: an evaluation using three scales. J Foot Ankle Surg. 2020; https://doi.org/10.1053/j.jfas.2020.01.005.
Schuh R, Benca E, Willegger M, Hirtler L, Zandieh S, Holinka J, Windhager R. Comparison of Brostrom technique, suture anchor repair, and tape augmentation for reconstruction of the anterior talofibular ligament. Knee Surg Sports Traumatol Arthrosc. 2016;24(4):1101–7. https://doi.org/10.1007/s00167-015-3631-7.
Petrera M, Dwyer T, Theodoropoulos JS, Ogilvie-Harris DJ. Short- to medium-term outcomes after a modified Brostrom repair for lateral ankle instability with immediate postoperative weightbearing. Am J Sports Med. 2014;42(7):1542–8. https://doi.org/10.1177/0363546514530668.
Viens NA, Wijdicks CA, Campbell KJ, Laprade RF, Clanton TO. Anterior talofibular ligament ruptures, Part 1: Biomechanical comparison of augmented Brostrom repair techniques with the intact anterior talofibular ligament. Am J Sports Med. 2014;42(2):405–11. https://doi.org/10.1177/0363546513510141.
Willegger M, Benca E, Hirtler L, Hradecky K, Holinka J, Windhager R, Schuh R. Biomechanical stability of tape augmentation for anterior talofibular ligament (ATFL) repair compared to the native ATFL. Knee Surg Sports Traumatol Arthrosc. 2016;24(4):1015–21. https://doi.org/10.1007/s00167-016-4048-7.
Maffulli N, Del Buono A, Maffulli GD, Oliva F, Testa V, Capasso G, Denaro V. Isolated anterior talofibular ligament Brostrom repair for chronic lateral ankle instability: 9-year follow-up. Am J Sports Med. 2013;41(4):858–64. https://doi.org/10.1177/0363546512474967.
Cho BK, Kim YM, Choi SM, Park HW, SooHoo NF. Revision anatomical reconstruction of the lateral ligaments of the ankle augmented with suture tape for patients with a failed Brostrom procedure. Bone Joint J. 2017;99-B(9):1183–9. https://doi.org/10.1302/0301-620X.99B9.BJJ-2017-0144.R1.
Cho BK, Park KJ, Kim SW, Lee HJ, Choi SM. Minimal invasive suture-tape augmentation for chronic ankle instability. Foot Ankle Int. 2015;36(11):1330–8. https://doi.org/10.1177/1071100715592217.
Mackay GM, Blyth MJ, Anthony I, Hopper GP, Ribbans WJ. A review of ligament augmentation with the InternalBrace: the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented. Surg Technol Int. 2015;26:239–55.
Mackay GM, Ribbans WJ. The addition of an “internal brace” to augment the Brostrom technique for lateral ankle ligament instability. Tech Foot Ankle Surg. 2016;15(1):47–56.
Ulku TK, Kocaoglu B, Tok O, Irgit K, Nalbantoglu U. Arthroscopic suture-tape internal bracing is safe as arthroscopic modified Brostrom repair in the treatment of chronic ankle instability. Knee Surg Sports Traumatol Arthrosc. 2020;28(1):227–32. https://doi.org/10.1007/s00167-019-05552-w.
Pereira H, Correlo VM, Silva-Correia J, Oliveira JM, Reis RL, Espregueira-Mendes J. Migration of “bioabsorbable” screws in ACL repair. How much do we know? A systematic review. Knee Surg Sports Traumatol Arthrosc. 2013;21(4):986–94. https://doi.org/10.1007/s00167-013-2414-2.
Acevedo J, Vora A. Anatomical reconstruction of the spring ligament complex “internal brace” augmentation. Foot Ankle Spec. 2013;6(6):441–5. https://doi.org/10.1177/1938640013499404.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 ESSKA
About this chapter
Cite this chapter
Pereira, H. et al. (2021). Nonbiological Adjuncts for Ankle Stabilization. In: Pereira, H., et al. Lateral Ankle Instability. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62763-1_39
Download citation
DOI: https://doi.org/10.1007/978-3-662-62763-1_39
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-62762-4
Online ISBN: 978-3-662-62763-1
eBook Packages: MedicineMedicine (R0)