title: Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study.
abstract: BACKGROUND
  Operative treatment of mechanical ankle instability is indicated for patients with multiple sprains and continued episodes of instability. Open repair of the lateral ankle ligaments involves exposure of the attenuated ligaments and advancement back to their anatomic insertions on the fibula using bone tunnels or suture implants.
  
  
  OBJECTIVE
  Open and arthroscopic fixation are equal in strength to failure for anatomic Broström repair.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Seven matched pairs of human cadaveric ankle specimens were randomized into 2 groups of anatomic Broström repair: open or arthroscopic. The calcaneofibular ligament and anterior talofibular ligament were excised from their origin on the fibula. In the open repair group, 2 suture anchors were used to reattach the ligaments to their anatomic origins. In the arthroscopic repair group, identical suture anchors were used for repair via an arthroscopic technique. The ligaments were cyclically loaded 20 times and then tested to failure. Torque to failure, degrees to failure, initial stiffness, and working stiffness were measured. A matched-pair analysis was performed. Power analysis of 0.8 demonstrated that 7 pairs needed to show a difference of 30%, with a 15% standard error at a significance level of α = .05.
  
  
  RESULTS
  There was no difference in the degrees to failure, torque to failure, or stiffness for the repaired ligament complex. Nine of 14 specimens failed at the suture anchor.
  
  
  CONCLUSIONS
  There is no statistical difference in strength or stiffness of a traditional open repair as compared with an arthroscopic anatomic repair of the lateral ligaments of the ankle.
  
  
  CONCLUSIONS
  An arthroscopic technique can be considered for lateral ligament stabilization in patients with mild to moderate mechanical instability.
authors: Eric Giza, University of California, Davis, 4860 Y Street, Suite 3800, Sacramento, CA 95817. ericgiza@gmail.com.
authors: Eric
authors: E
authors: Giza
authors: Edward C
authors: EC
authors: Shin
authors: Stephanie E
authors: SE
authors: Wong
authors: Jorge I
authors: JI
authors: Acevedo
authors: Peter G
authors: PG
authors: Mangone
authors: Kirstina
authors: K
authors: Olson
authors: Matthew J
authors: MJ
authors: Anderson
mesh_terms: D016512:Ankle Injuries / Q000601:surgery*; D001182:Arthroscopy; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D017844:Lateral Ligament, Ankle / Q000293:injuries / Q000601:surgery*; D011897:Random Allocation; D013536:Suture Techniques
keywords: Broström repair; ankle; arthroscopic ankle lateral ligament repair; ligaments; suture anchor