Abstract
BackgroundInversion sprains of the lateral ankle ligaments often result in symptomatic lateral ankle instability, and some patients need lateral reconstruction surgeries to reduce pain, improve function, and prevent subsequent injuries. Although anatomically reconstructed ligaments should behave in a biomechanically normal manner, previous studies have not measured the strain patterns of the anterior talofibular (ATFL) and calcaneofibular ligaments (CFL) after anatomical reconstruction. This study aimed to measure the strain patterns of normal and reconstructed ATFL and CFLs using a miniaturization ligament performance probe (MLPP) system.MethodsThe MLPP was sutured into the ligamentous bands of the ATFLs and CTLs of three fresh-frozen, lower extremity, cadaveric specimens. Each ankle was manually moved from 15° dorsiflexion to 30° plantar flexion, and a 1.2-N m force was applied to the ankle and subtalar joint complex.ResultsThe normal and reconstructed ATFLs exhibited maximal strain (100) during supination in three-dimensional motion. Although the normal ATFLs were not strained during pronation, the reconstructed ATFLs demonstrated relative strain values of 16–36. During axial motion, the normal ATFLs began to gradually tense at 0° plantarflexion, with the strain increasing, as the plantarflexion angle increased, to a maximal value (100) at 30° plantarflexion; the reconstructed ATFLs showed similar strain patterns. The normal CFLs exhibited maximum strain (100) during plantarflexion-abduction and relative strain measurements of 30–52 during dorsiflexion in three-dimensional motion. The reconstructed CFLs exhibited the most strain during dorsiflexion-adduction and demonstrated relative strain measurements of 29–62 during plantarflexion-abduction. During axial motion, the normal CFLs began to gradually tense at 20° plantarflexion and 5° dorsiflexion.ConclusionOur results showed that the strain patterns of reconstructed ATFLs and CFLs are not exactly the same as those in the normal ligaments.
Arthroscopic anatomical reconstruction of the lateral ankle ligaments: A technical simplification
