scholarly journals A Novel Technique of Arthroscopic Ankle Lateral Ligament Repair Using a Knotless Suture Anchor

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096207
Author(s):  
Noriyuki Kanzaki ◽  
Nobuaki Chinzei ◽  
Takahiro Yamashita ◽  
Tsukasa Kumai ◽  
Ryosuke Kuroda
Keyword(s):  
Suture Anchor ◽  
Case Series ◽  
Well Being ◽  
Clinical Results ◽  
Lateral Ligament ◽  
Ligament Repair ◽  
Novel Technique ◽  
Patient Reported ◽  
Anterolateral Portal ◽  
Knotless Suture Anchor

Background: Although arthroscopic lateral ligament repair (ALLR) with suture anchors for chronic lateral ankle instability has become widely accepted, some complications have been reported as well. Establishment of a new technique is essential for better clinical outcomes after ALLR. Purpose To report a novel technique and good clinical results of ALLR using a knotless suture anchor. Study Design: Case series; Level of evidence, 4. Methods: We examined 30 patients (16 men and 14 women) who underwent ALLR. The mean age of the patients was 30.0 years, and the average period of postoperative monitoring was 21 months. The Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale was used for clinical evaluation postoperatively, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) for patient-reported results. Surgical complications were also examined. Results: The JSSF ankle-hindfoot scale showed a significant improvement from preoperatively to follow-up (from 72.1 to 96.1; P < 0.001), and the SAFE-Q was significantly improved in all subscales (pain and pain-related, physical function and daily living, social function, shoe-related, and general health and well-being; P < 0.004 for all). Complications included residual joint pain due to remaining osteophytes in 1 case, scar pain of the accessory anterolateral portal in 2 cases, and positive Tinel sign indicative of superficial peroneal nerve irritation at the anterolateral portal in 1 case. Conclusion: The clinical results of the novel ALLR technique were overall satisfactory. Knot-related complications, one of the main reasons for postoperative complications, were reduced by using a knotless suture anchor.

Transmucosal diverticular myotomy for the treatment of oesophageal diverticula associated with spastic motility disorders

Gut ◽  
2020 ◽  
Vol 69 (9) ◽  
pp. 1552-1554 ◽  
Author(s):  
Mayenaaz Sidhu ◽  
David J Tate ◽  
Michael J Bourke
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Motility Disorder ◽  
Adverse Outcomes ◽  
The Novel ◽  
Significant Morbidity ◽  
Motility Disorders ◽  
Endoscopic Techniques ◽  
Novel Technique

Thoracic oesophageal diverticula are often associated with spastic motility disorders. Despite correction of the underlying motility disorder, in a subgroup of patients, symptoms persist, primarily regurgitation. Surgical diverticulectomy is then proposed; however, as the approach is thoracoscopic or via thoracotomy, it is associated with significant morbidity and cost. Descriptions of endoscopic techniques for the treatment of symptomatic midoesophageal diverticula are few. We propose the novel technique of diverticular myotomy (DM) to treat this disorder. In this case series, we describe two patients who successfully underwent DM with no adverse outcomes and excellent clinical results at 24-month follow-up.

All-inside Arthroscopic Lateral Collateral Ligament Repair for Ankle Instability With a Knotless Suture Anchor Technique

2013 ◽  
Vol 34 (12) ◽  
pp. 1701-1709 ◽  
Author(s):  
Jordi Vega ◽  
Pau Golanó ◽  
Alexandro Pellegrino ◽  
Eduard Rabat ◽  
Fernando Peña
Keyword(s):  
Suture Anchor ◽  
Ankle Instability ◽  
Lateral Collateral Ligament ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Knotless Suture Anchor

Functional Results of Open Broström Ankle Ligament Repair Augmented With a Suture Tape

2018 ◽  
Vol 39 (3) ◽  
pp. 304-310 ◽  
Author(s):  
J. Chris Coetzee ◽  
J. Kent Ellington ◽  
James A. Ronan ◽  
Rebecca M. Stone
Keyword(s):  
Plantar Flexion ◽  
Case Series ◽  
Return To Sport ◽  
Contralateral Side ◽  
Normal Function ◽  
Lateral Ligament ◽  
Ligament Repair ◽  
Level Of Evidence ◽  
Chronic Instability ◽  
Significant Difference

Background: The Broström procedure is the most commonly used lateral ligament repair for chronic instability, but there is concern about the strength of the repair and the risk of reinjury. Currently, the InternalBraceTM ligament augmentation repair is an accepted augmentation method for management of a Broström procedure. Our hypothesis was that augmentation of the Broström repair with an InternalBraceTM would allow accelerated rehabilitation and return to activity and would aid in stability of the repair without a tendency to stretch. Methods: Eighty-one patients with lateral ankle instability procedures repaired with a Broström and InternalBraceTM augmentation were evaluated at a one-time postoperative visit between 6 and 24 months. Outcomes included demographics, surgical time, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, Veterans Rand 12-Item Health Survey (VR-12), Foot and Ankle Ability Measure (FAAM), Visual Analog Scale (VAS), satisfaction, and objective clinical measurements. Eighty-one patients were analyzed including 30 males and 51 females. Median age was 34 years (range, 18-62 years) with a median return for follow-up of 11.5 months (range, 6-27 months). Results: Average postoperative VAS and satisfaction were 0.8 ± 1.4 and 9.1 ± 1.6, respectively. Mean return to sport (n = 68) was 84.1 days. Average AOFAS Ankle-Hindfoot score was 94.3. A score of 90 or higher on the FAAM Sports subscale was seen in 79.0% of the subjects. The single-leg hop test (Limb Symmetry Index %) showed that 86.4% of patients returned to normal or near normal function. The tape measure method and ankle dorsiflexion comparisons showed a significant difference: 9.2 ± 3.3 cm (operative side) and 10.4 ± 3.7 cm (contralateral side) ( P = .034). Ankle plantar flexion comparison (goniometer) was 48.5 ± 11.5 degrees (operative side) and 49.7 ± 11.9 degrees (contralateral side), showing no difference ( P = .506). Conclusion: These results suggest that InternalBraceTM augmentation of a Broström procedure is a safe and efficacious procedure that produces favorable outcomes in patients in terms of preventing recurrent instability in the ankle in the short term. Level of Evidence: Level IV, case series.

scholarly journals Outcomes following surgical management of complex terrible triad injuries of the elbow: a single surgeon case series

2017 ◽  
Vol 10 (3) ◽  
pp. 216-222 ◽  
Author(s):  
Peter Domos ◽  
Emmet Griffiths ◽  
Andrew White
Keyword(s):  
Surgical Management ◽  
Case Series ◽  
Lateral Ligament ◽  
Joint Stability ◽  
Terrible Triad ◽  
Subsequent Removal ◽  
Ligament Repair ◽  
Flexion Extension ◽  
The Mean

Background Terrible triad injuries of the elbow are complex injuries to treat and we report our outcomes following surgical management. Methods Twenty-two consecutive patients who underwent fixation of terrible triad injuries between 2007 and 2012 were identified. Clinical outcomes were assessed by examination, visual analogue scores (VAS), Oxford Elbow Score (OES), Mayo Elbow Performance Index (MEPI) and QuickDash score (QD). Results The mean age of patients was 47 years, with a mean follow-up of 32 months. All patients underwent lateral ligament repair, with additional medial ligament repair in four cases. Thirteen patients required repair of the coronoid and 18 patients required surgery to the radial head. The mean flexion–extension arc was 113°, with mean prono-supination of 136°. The functional elbow scores revealed good outcomes in the majority (mean OES of 37, MEPI of 79 and QD of 21). The overall complication rate was 41%. In total, 23% required reoperation, with one patient requiring fasciotomy for acute compartment syndrome and four requiring subsequent removal of metalwork as a result of stiffness. Conclusions Recognition of this complex injury pattern and appropriate restoration of the joint stability are the prerequisites. Systematic surgical approach is effective and can provide both stability and good function, in most cases.

Suture Tape Augmented Broström Procedure and Early Accelerated Rehabilitation

2020 ◽  
pp. 107110072095901
Author(s):  
Kevin D. Martin ◽  
Nolan N. Andres ◽  
William H. Robinson
Keyword(s):  
Case Series ◽  
Lateral Ligament ◽  
Anterior Talofibular Ligament ◽  
Military Population ◽  
Retrospective Case ◽  
Functional Rehabilitation ◽  
Level Of Evidence ◽  
Patient Reported ◽  
The Mean ◽  
Suture Tape

Background: Immediately following a lateral ligament reconstruction of the ankle, the strength of the repair is far less than that of the native anterior talofibular ligament (ATFL). Additionally, early functional rehabilitation has been shown to increase laxity of the repair. We hypothesized that a Broström procedure augmented with a suture-tape construct would allow early functional rehabilitation while maintaining patient reported outcomes within a military population. Methods: This study is a retrospective study of 93 consecutive patients with chronic lateral ankle instability that were treated with a Broström procedure augmented with a suture-tape construct. Subjects were evaluated at 2, 6, and 12 weeks postoperatively, with yearly satisfaction reviews. Demographics and functional outcomes including Foot and Ankle Disability Index (FADI), visual analog scale (VAS), satisfaction score, and clinical measures including single-leg hop and single-leg heel raise were recorded. Our patients included 75 males and 18 females with a mean age of 30 ± 7 (range, 19-51) years; our mean follow-up was 19 (range, 3-48) months. Results: The mean FADI score improved from 67 preoperatively to 87 and 90 at 6 and 12 weeks ( P < .001), with 60 patients (65%) obtaining a score greater than 90. The mean VAS scores improved from 4.8 preoperatively to 1.4 and 1.3 at 6 and 12 weeks ( P < .001). Eighty-two (96%) of the patients asked were able to complete a single-leg hop and single-leg heel raise at 6 weeks. The 12-, 24-, 36-, and 48-month satisfaction scores were 8.5, 9.8, 9.2, and 8.9, respectively. Demographics collected did not impact results. Conclusion: This study suggests that a Broström procedure augmented with suture tape enabled early safe functional rehabilitation without subsequent failure. Our data also demonstrated a sustained high level of patient satisfaction while preventing reoccurrence within a high-demand military population. Level of Evidence: Level IV, retrospective case series.

Short-Term Complications, Reoperations, and Radiographic Outcomes of a New Fixed-Bearing Total Ankle Arthroplasty

2018 ◽  
Vol 39 (7) ◽  
pp. 787-794 ◽  
Author(s):  
Guilherme H. Saito ◽  
Austin E. Sanders ◽  
Cesar de Cesar Netto ◽  
Martin J. O’Malley ◽  
Scott J. Ellis ◽  
...  
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Radiographic Outcomes ◽  
Implant Positioning ◽  
Patient Reported

Background: With the increasing use of total ankle arthroplasty (TAA), new implants with varied configurations are being developed every year. This study aimed to assess the early complications, reoperations, and radiographic and clinical outcomes of the Infinity TAA. To date, clinical results of this novel implant have not been published. Methods: A retrospective analysis of 64 consecutive ankles that underwent a primary Infinity TAA from July 2014 to April 2016 was performed. Patients had an average follow-up of 24.5 (range, 18-39) months. Medical records were reviewed to determine the incidence of complications, reoperations, and revisions. Radiographic outcomes included preoperative and postoperative tibiotalar alignment, tibial implant positioning, the presence of periprosthetic radiolucency and cysts, and evidence of subsidence or loosening. Additionally, patient-reported outcomes were analyzed with the Foot and Ankle Outcome Score (FAOS). Results: Survivorship of the implant was 95.3%. Fourteen ankles (21.8%) presented a total of 17 complications. A total of 12 reoperations were necessary in 11 ankles (17.1%). Revision surgery was indicated for 3 ankles (4.7%) as a result of subsidence of the implant. Tibiotalar coronal deformity was significantly improved after surgery ( P < .0001) and maintained during latest follow-up ( P = .81). Periprosthetic radiolucent lines were observed around the tibial component in 20 ankles (31%) and around the talar component in 2 ankles (3.1%). A tibial cyst was observed in 1 ankle (1.5%). Outcome scores were significantly improved for all FAOS components analyzed ( P < .0001), from 39.0 to 83.3 for pain, from 34.0 to 65.2 for symptoms, from 52.3 to 87.5 for activities of daily living, and from 15.7 to 64.2 for quality of life. Conclusion: Most complications observed in the study were minor and successfully treated with a single reoperation procedure or nonoperatively. Failures and radiographic abnormalities were most commonly related to the tibial implant. Further studies with longer follow-up are needed to evaluate the survivorship of the tibial implant in the long term. Level of evidence: Level IV, retrospective case series.

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