Minimally Invasive Lateral Ligaments Reconstruction With Autograft in Patients With Chronic Ankle Instability

Abstract

Category: Sports Introduction/Purpose: Persistent instability following an acute lateral ankle sprain has been reported to vary in incidence from 15% to 48. Many surgical procedures have been described to reestablish lateral ankle stability, varying from direct in situ repair of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) to augmented reconstructions with either autograft or allograft tissue. Anatomic reconstructions for lateral ankle instability utilizing tissue augmentation have gained recent popularity. The purpose of this retrospective study was to assess the results of a novel surgical percutaneous technique for the treatment of chronic lateral ankle instability using a free semitendinosus tendon transfer to reconstruct anatomically the anterior talofibular and calcaneofibular ligaments. Methods: Between November 2011 and January 2014, 18 patients (18 ankles) underwent an anatomic reconstruction of the lateral ankle ligaments for chronic ankle instability. Patients were clinically assessed preoperatively and at 6 and 12 months postoperatively and annualy there after (range, 12-49 months). Radiographic examination included pre-operative MRI and weight- bearing plain radiographs and post-operative weight-bearing plain radiographs scan obtained 3 months after surgery. Outcomes were assessed by comparison of preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score, the Sf-12 score and visual analog pain score. Results: Eighteen patients (18 ankles) (100%) returned for final evaluation. Good or excellent outcome was noted on physical examination, radiographs, visual anlog pain score, SF-12 score and AOFAS score at final follow-up in all patients. Ankle range of motion was not affected by lateral ankle reconstruction. Conclusion: In the present study, lateral ankle reconstruction with a free semitendinosus tendon graft augmentation performed percutaneously resulted in a high percentage of successful results, excellent ankle stability with a minimal loss of ankle or hindfoot motion, and marked reduction of pain at a minimum follow-up of 12 months.