Anatomical Reconstruction of Lateral Ankle Ligaments Using Free Tendon Allografts and Biotenodesis Screws.
BACKGROUND
Lateral ankle instability is one of the most common musculoskeletal disorders and can result in ankle damage. This study reports on the results of the anatomical reconstruction of ligaments using semitendinosus tendon allograft and bioabsorbable tenodesis screws for chronic lateral ankle instability, as well as the functional and radiological results of this procedure.


METHODS
From February 2007 to January 2013, 70 patients (72 ankles) underwent this procedure. Six patients were lost to follow-up, and ultimately 64 patients (66 ankles) were evaluated. Visual Analog Scale (VAS) pain scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, Karlsson-Peterson ankle scores, and patient satisfaction were evaluated at a mean of 22.1 months (range, 12-68 months) postoperatively. The talar tilt angle and anterior translation were assessed radiographically in pre- and postoperative ankle stress views. The mean patient age at surgery was 30.1 years (range, 16-59 years).


RESULTS
The mean VAS pain score decreased from 5.5 to 1.3 (P < .05), and the mean AOFAS improved from 71.0 to 90.9 (P < .05). The mean Karlsson-Peterson score improved from 55.1 to 90.3, whereas talar tilt decreased from 14.8 degrees to 3.9 degrees. There was no significant difference in clinical outcomes between the pretensioned and nonpretensioned groups.


CONCLUSIONS
This procedure yielded successful results, including satisfactory ankle stability and clinical outcomes, in ankles with poor lateral ligament tissues.


METHODS
Level IV, case series.
Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea (ROK).
Hong-Geun
HG
Jung
Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea (ROK).
Min-Ho
MH
Shin
Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea (ROK).
Jong-Tae
JT
Park
Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea (ROK).
Joon-Sang
JS
Eom
Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea (ROK).
Dong-Oh
DO
Lee
Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea (ROK) skyroost@naver.com.
Sang-Hun
SH
Lee
D000293:Adolescent; D000328:Adult; D064591:Allografts; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001863:Bone Screws; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013585:Synovitis / Q000601:surgery; D013710:Tendons / Q000637:transplantation*; D064232:Visual Analog Scale; D055815:Young Adult
ATFL; CFL; anatomical reconstruction; biotenodesis screw; lateral ankle instability; pretensioning; semitendinosus tendon