title: Use of an all-suture anchor for re-creation of the anterior talofibular ligament: a case report.
abstract: The lateral ankle ligament complex is typically injured during athletic activity caused by an inversion force on a plantar flexed foot. Numerous open surgical procedures to reconstruct the lateral ankle complex have been described. In contrast, we present a case report in which an all-suture anchor was used arthroscopically to re-create the anterior talofibular ligament in conjunction with ankle arthroscopy. A retrospective analysis of a 55-year-old male with a work-related inversion ankle sprain was performed with 14 months of follow-up. Objective and subjective assessments were obtained using range of motion measures, a strength assessment, and the Foot Function Index. An all-suture anchor was deployed through the anterolateral portal and secured in both the fibula and talus, re-creating the anterior talofibular ligament at its origin and insertion. Active range of motion physical therapy began at 2 weeks postoperatively. The patient started a neuromuscular re-education program at 5 weeks with minimal pain or discomfort. A return to full duty was achieved at 3 months postoperatively. To our knowledge, the use of an all-suture anchor has not been previously reported for lateral ankle complex re-creation. It is hoped that this approach to anterior talofibular ligament repair will decrease the incidence of complications and improve outcomes.
authors.affiliation: Associate Professor, Chief, Foot and Ankle Surgery, and Director, Podiatric Medicine and Surgery Residency, Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine at Jacksonville, Jacksonville, FL.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Piraino
authors.affiliation: Resident, St. Lukes University Health Network, Allentown, PA. Electronic address: busch.elliot@gmail.com.
authors.forename: Elliot L
authors.initials: EL
authors.lastname: Busch
authors.affiliation: Resident, Temple University Hospital, Philadelphia, PA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Sansosti
authors.affiliation: Assistant Professor, Temple University School of Podiatric Medicine, Philadelphia, PA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Pettineo
authors.affiliation: Resident, Temple University Hospital, Philadelphia, PA.
authors.forename: Corine
authors.initials: C
authors.lastname: Creech
mesh_terms: D016512:Ankle Injuries / Q000601:surgery*; D001182:Arthroscopy; D005360:Fibula / Q000601:surgery; D006801:Humans; D017844:Lateral Ligament, Ankle / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053441:Suture Anchors; D013536:Suture Techniques; D013628:Talus / Q000601:surgery
keywords: all-suture anchor; ankle; anterior talofibular ligament; arthroscopy; re-creation