title: Anterior talofibular ligament ruptures, part 2: biomechanical comparison of anterior talofibular ligament reconstruction using semitendinosus allografts with the intact ligament.
abstract: BACKGROUND
  Anatomic reconstructions of the lateral ankle ligaments with grafts have been proposed for patients with generalized ligamentous laxity, long-standing instability with attenuated native tissues, varus hindfoot misalignment, or failed prior lateral ligament surgery and for very large patients or elite athletes because of increased demands.
  
  
  OBJECTIVE
  Anatomic reconstruction of the anterior talofibular ligament (ATFL) using a semitendinosus allograft fixed with biocomposite interference fit screws would have similar biomechanical properties to the intact ATFL at time zero in a cadaveric model.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Allograft reconstruction of the ATFL was performed in 6 fresh-frozen cadaveric ankles. The specimens were loaded to failure to determine the strength and stiffness of the reconstruction and compared with data from 6 cadaveric specimens with intact ATFLs.
  
  
  RESULTS
  The mean ultimate load to failure of the allograft reconstruction (170.7 ± 54.8 N) was not significantly different from that of the intact ATFL (154.0 ± 63.7 N). The mean stiffness of the allograft reconstruction (23.1 ± 9.3 N/mm) was also not significantly different from that of the intact ATFL (14.5 ± 4.4 N/mm).
  
  
  CONCLUSIONS
  Anatomic reconstruction of the ATFL with allografts demonstrated similar strength and stiffness to the native ligament at time zero in a fresh-frozen cadaveric model.
  
  
  CONCLUSIONS
  This technique of anatomic reconstruction of the ATFL with allografts has biomechanical validation for use in clinical situations where a Broström repair of the lateral ankle ligaments is unlikely to be successful or has previously failed.
authors.affiliation: Thomas O. Clanton, Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO 81657. tclanton@thesteadmanclinic.com.
authors.forename: Thomas O
authors.initials: TO
authors.lastname: Clanton
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Viens
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Campbell
authors.forename: Robert F
authors.initials: RF
authors.lastname: Laprade
authors.forename: Coen A
authors.initials: CA
authors.lastname: Wijdicks
mesh_terms: D000328:Adult; D064591:Allografts; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011897:Random Allocation; D012421:Rupture / Q000503:physiopathology / Q000601:surgery; D053441:Suture Anchors; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*
keywords: Broström failure; allograft reconstruction; anterior talofibular ligament (ATFL); interference fit screws; lateral ankle ligament rupture; semitendinosus graft