Anatomical reconstruction of the lateral ligaments using Gracillis tendon in chronic ankle instability; a new technique.
BACKGROUND
Many surgical technique have been described to assess the outcome of anatomical reconstruction of the lateral ligaments using Gracillis tendon. This technique aims to restore the stability of the ankle by reconstruction of the talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) using the Gracillis tendon.


METHODS
From January 2004 to February 2008; inclusive, 16 patients; 11 male and 5 female, underwent an anatomic reconstruction of the lateral ankle ligament for chronic ankle instability. Their ages ranged from 18 to 29 giving a mean age of 25 years. Patients were then subjected to radiologic and clinical assessments for a period of at least 33.5 months. For pain scoring the Americans Orthopaedic Foot and Ankle Society (AOFAS) scores were used; whilst subjective symptom was evaluated using the Olerud and Molander ankle scoring system.


RESULTS
All patients returned for the final evaluation and subjective excellent or good results were recorded on self-assessment, pain scores, AOFAS and Karissons scores. Additionally Olerud and Molander ankle scoring was also done. During the final follow-up, the mean post-operative AOFAS score was 96 (range 80-100), the Visual analog score was 6 (range 0-4), Karissons score was 94.7 (range 80-100) and last but not least Olerud and Molander score was 87.5 (range 70-100). It was noted that the ankle range of motion was not affected by lateral ankle reconstruction. The talar tilt was reduced from a mean of 12-4° (p<0.0001) and the anterior drawer was reduced from a mean of 11-4mm (p<0.001) by the ankle ligament reconstruction.


CONCLUSIONS
Anatomical reconstruction of the lateral ligaments of chronic ankle instability using Gracillis tendon graft resulted in successful results, excellent ankle stability, significant reduction in pain and negligible loss of ankle and hind foot motion.
Al Razi Orthopaedic Hospital, Sports Medical Centre, Clinical Tutor Medical School, Kuwait University, Kuwait. samirabdulrazik@yahoo.com
S A
SA
Ibrahim
F
F
Hamido
A K
AK
Al Misfer
S A
SA
Ghafar
A
A
Awad
H Kh
HKh
Salem
H
H
Alhran
S
S
Khirait
D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D013710:Tendons / Q000637:transplantation*; D055815:Young Adult