Arthroscopic suture anchor repair of the lateral ligament ankle complex: A cadaveric study

Eric Giza, Edward C. Shin, Stephanie E. Wong, Jorge I. Acevedo, Peter G. Mangone, Kirstina Olson, Matthew J. Anderson

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: Operative treatment of mechanical ankle instability is indicated for patients with multiple sprains and continued episodes of instability. Open repair of the lateral ankle ligaments involves exposure of the attenuated ligaments and advancement back to their anatomic insertions on the fibula using bone tunnels or suture implants. Hypothesis: Open and arthroscopic fixation are equal in strength to failure for anatomic Broström repair. Study Design: Controlled laboratory study. Methods: Seven matched pairs of human cadaveric ankle specimens were randomized into 2 groups of anatomic Broström repair: open or arthroscopic. The calcaneofibular ligament and anterior talofibular ligament were excised from their origin on the fibula. In the open repair group, 2 suture anchors were used to reattach the ligaments to their anatomic origins. In the arthroscopic repair group, identical suture anchors were used for repair via an arthroscopic technique. The ligaments were cyclically loaded 20 times and then tested to failure. Torque to failure, degrees to failure, initial stiffness, and working stiffness were measured. A matched-pair analysis was performed. Power analysis of 0.8 demonstrated that 7 pairs needed to show a difference of 30%, with a 15% standard error at a significance level of a = .05. Results: There was no difference in the degrees to failure, torque to failure, or stiffness for the repaired ligament complex. Nine of 14 specimens failed at the suture anchor. Conclusion: There is no statistical difference in strength or stiffness of a traditional open repair as compared with an arthroscopic anatomic repair of the lateral ligaments of the ankle. Clinical Relevance: An arthroscopic technique can be considered for lateral ligament stabilization in patients with mild to moderate mechanical instability.

Original languageEnglish (US)
Pages (from-to)2567-2572
Number of pages6
JournalAmerican Journal of Sports Medicine
Volume41
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Ankle Lateral Ligament
Suture Anchors
Ligaments
Fibula
Torque
Ankle
Sprains and Strains
Matched-Pair Analysis
Collateral Ligaments
Sutures
Bone and Bones

Keywords

  • ankle
  • arthroscopic ankle lateral ligament repair
  • Broström repair
  • ligaments
  • suture anchor

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

Giza, E., Shin, E. C., Wong, S. E., Acevedo, J. I., Mangone, P. G., Olson, K., & Anderson, M. J. (2013). Arthroscopic suture anchor repair of the lateral ligament ankle complex: A cadaveric study. American Journal of Sports Medicine, 41(11), 2567-2572. https://doi.org/10.1177/0363546513500639

Arthroscopic suture anchor repair of the lateral ligament ankle complex : A cadaveric study. / Giza, Eric; Shin, Edward C.; Wong, Stephanie E.; Acevedo, Jorge I.; Mangone, Peter G.; Olson, Kirstina; Anderson, Matthew J.

In: American Journal of Sports Medicine, Vol. 41, No. 11, 11.2013, p. 2567-2572.

Research output: Contribution to journalArticle

Giza, E, Shin, EC, Wong, SE, Acevedo, JI, Mangone, PG, Olson, K & Anderson, MJ 2013, 'Arthroscopic suture anchor repair of the lateral ligament ankle complex: A cadaveric study', American Journal of Sports Medicine, vol. 41, no. 11, pp. 2567-2572. https://doi.org/10.1177/0363546513500639
Giza, Eric ; Shin, Edward C. ; Wong, Stephanie E. ; Acevedo, Jorge I. ; Mangone, Peter G. ; Olson, Kirstina ; Anderson, Matthew J. / Arthroscopic suture anchor repair of the lateral ligament ankle complex : A cadaveric study. In: American Journal of Sports Medicine. 2013 ; Vol. 41, No. 11. pp. 2567-2572.
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abstract = "Background: Operative treatment of mechanical ankle instability is indicated for patients with multiple sprains and continued episodes of instability. Open repair of the lateral ankle ligaments involves exposure of the attenuated ligaments and advancement back to their anatomic insertions on the fibula using bone tunnels or suture implants. Hypothesis: Open and arthroscopic fixation are equal in strength to failure for anatomic Brostr{\"o}m repair. Study Design: Controlled laboratory study. Methods: Seven matched pairs of human cadaveric ankle specimens were randomized into 2 groups of anatomic Brostr{\"o}m repair: open or arthroscopic. The calcaneofibular ligament and anterior talofibular ligament were excised from their origin on the fibula. In the open repair group, 2 suture anchors were used to reattach the ligaments to their anatomic origins. In the arthroscopic repair group, identical suture anchors were used for repair via an arthroscopic technique. The ligaments were cyclically loaded 20 times and then tested to failure. Torque to failure, degrees to failure, initial stiffness, and working stiffness were measured. A matched-pair analysis was performed. Power analysis of 0.8 demonstrated that 7 pairs needed to show a difference of 30{\%}, with a 15{\%} standard error at a significance level of a = .05. Results: There was no difference in the degrees to failure, torque to failure, or stiffness for the repaired ligament complex. Nine of 14 specimens failed at the suture anchor. Conclusion: There is no statistical difference in strength or stiffness of a traditional open repair as compared with an arthroscopic anatomic repair of the lateral ligaments of the ankle. Clinical Relevance: An arthroscopic technique can be considered for lateral ligament stabilization in patients with mild to moderate mechanical instability.",
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