Comparison of Outcomes Between Knotless Anchor Repair and Knot Anchor Repair for All- Arthroscopic Anterior Talofibular Ligament Repair in Chronic Ankle Instability

Abstract

Category: Arthroscopy; Ankle; Sports Introduction/Purpose: Arthroscopic anterior talofibular ligament (ATFL) repair using a suture anchor is effective and has excellent short- to mid-term patient outcomes reported in previous studies. Recent study suggested that knotless suture anchor had advantage compare to knot suture anchor. The aim of this study is to compare clinical outcomes after knot anchor versus knotless anchor repair for all-arthroscopic ATFL repair in patients with chronic lateral ankle instability. Methods: Between 2017 and 2018, patients who underwent arthroscopic ATFL repair using knot or knotless suture anchors and were available at least 2 years follow up were included in this study. Total, 68 patients were included, and sorted to 2 groups according to characteristics of anchor. (KL group (n=42): knotless anchor, K group (n=26): knot anchor). Clinical outcomes were compared using a visual analog scale (VAS), Foot and Ankle Outcome Score (FAOS), and Karlsson score. Radiologic outcome evaluations were performed preoperatively and at 2 years postoperatively using stress radiographs and axial view MRI. Results: There were no significant differences between 2 groups in clinical scores and radiologic findings. There were 3 knot irritation (11.5%) and 1 SPN neuropathy (3.8%) in K group, but there were no statistical differences. Conclusion: Arthroscopic ATFL repair using knotless suture anchor showed comparable outcomes to knot anchor, without complication due to knot.