RETRACTED: Surgical Treatment of Subtalar Joint Instability With Reconstruction of the Interosseous Talocalcaneal Ligament: Safety and Accuracy of a New Technique in a Cadaver Model.

Abstract

New surgical strategies to treat symptomatic subtalar joint (STJ) instability are evolving. Most reconstruction options focus on the interosseous talocalcaneal ligament (ITCL.) We modified a previously described reconstruction strategy and then refined our new surgical technique through simulated surgery and subsequent cadaver dissections. Our purpose was to develop an ITCL reconstruction technique that could easily and safely be performed with commonly available and familiar technology. A percutaneous fluoroscopically guided tunnel for the purpose of ITCL reconstruction was created in 10 cadaveric below-knee specimens. Accuracy of the tunnel with relation to the anatomic boundaries of the ITCL attachment sites as well as damage to relevant structures at risk were recorded. Two sets of 5 surgeries were performed to assess for improvement in technique. Mean distances from the tunnel to ITCL on the calcaneus improved between groups 1 and 2: 4.04 mm and 1.80 mm, respectively (P = .04). Mean distances from the tunnel to ITCL on the talus improved between groups 1 and 2: 6.23 mm and 1.84 mm, respectively (P = .08). With information obtained from this study, an osseous tunnel can be safely placed within 2 mm of the ITCL footprints. Levels of Evidence: Level V: Experimental research, Expert opinion.