Biomechanical analysis of an arthroscopic Broström ankle ligament repair and a suture anchor-augmented repair

Eric Giza, Scott R. Whitlow, Brady T. Williams, Jorge I. Acevedo, Peter G. Mangone, C. Thomas Haytmanek, Eugene E. Curry, Travis Lee Turnbull, Robert F. Laprade, Coen A. Wijdicks, Thomas O. Clanton

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Secondary surgical repair of ankle ligaments is often indicated in cases of chronic lateral ankle instability. Recently, arthroscopic Broström techniques have been described, but biomechanical information is limited. The purpose of the present study was to analyze the biomechanical properties of an arthroscopic Broström repair and augmented repair with a proximally placed suture anchor. It was hypothesized that the arthroscopic Broström repairs would compare favorably to open techniques and that augmentation would increase the mean repair strength at time zero. Methods: Twenty (10 matched pairs) fresh-frozen foot and ankle cadaveric specimens were obtained. After sectioning of the lateral ankle ligaments, an arthroscopic Broström procedure was performed on each ankle using two 3.0-mm suture anchors with #0 braided polyethylene/polyester multifilament sutures. One specimen from each pair was augmented with a 2.9-mm suture anchor placed 3 cm proximal to the inferior tip of the lateral malleolus. Repairs were isolated and positioned in 20 degrees of inversion and 10 degrees of plantarflexion and loaded to failure using a dynamic tensile testing machine. Maximum load (N), stiffness (N/mm), and displacement at maximum load (mm) were recorded. Results: There were no significant differences between standard arthroscopic repairs and the augmented repairs for mean maximum load and stiffness (154.4 ± 60.3 N, 9.8 ± 2.6 N/mm vs 194.2 ± 157.7 N, 10.5 ± 4.7 N/mm, P = .222, P = .685). Conclusions: Repair augmentation did not confer a significantly higher mean strength or stiffness at time zero. Clinical Relevance: Mean strength and stiffness for the arthroscopic Broström repair compared favorably with previous similarly tested open repair and reconstruction methods, validating the clinical feasibility of an arthroscopic repair. However, augmentation with an additional proximal suture anchor did not significantly strengthen the repair.

Original languageEnglish (US)
Pages (from-to)836-841
Number of pages6
JournalFoot and Ankle International
Volume36
Issue number7
DOIs
StatePublished - Jul 11 2015

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Suture Anchors
Ligaments
Ankle
Ankle Lateral Ligament
Polyesters
Polyethylene
Sutures
Foot

Keywords

  • Ankle sprains
  • anterior talofibular ligament
  • arthroscopy
  • lateral ankle ligaments

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Giza, E., Whitlow, S. R., Williams, B. T., Acevedo, J. I., Mangone, P. G., Haytmanek, C. T., ... Clanton, T. O. (2015). Biomechanical analysis of an arthroscopic Broström ankle ligament repair and a suture anchor-augmented repair. Foot and Ankle International, 36(7), 836-841. https://doi.org/10.1177/1071100715576539

Biomechanical analysis of an arthroscopic Broström ankle ligament repair and a suture anchor-augmented repair. / Giza, Eric; Whitlow, Scott R.; Williams, Brady T.; Acevedo, Jorge I.; Mangone, Peter G.; Haytmanek, C. Thomas; Curry, Eugene E.; Turnbull, Travis Lee; Laprade, Robert F.; Wijdicks, Coen A.; Clanton, Thomas O.

In: Foot and Ankle International, Vol. 36, No. 7, 11.07.2015, p. 836-841.

Research output: Contribution to journalArticle

Giza, E, Whitlow, SR, Williams, BT, Acevedo, JI, Mangone, PG, Haytmanek, CT, Curry, EE, Turnbull, TL, Laprade, RF, Wijdicks, CA & Clanton, TO 2015, 'Biomechanical analysis of an arthroscopic Broström ankle ligament repair and a suture anchor-augmented repair', Foot and Ankle International, vol. 36, no. 7, pp. 836-841. https://doi.org/10.1177/1071100715576539
Giza, Eric ; Whitlow, Scott R. ; Williams, Brady T. ; Acevedo, Jorge I. ; Mangone, Peter G. ; Haytmanek, C. Thomas ; Curry, Eugene E. ; Turnbull, Travis Lee ; Laprade, Robert F. ; Wijdicks, Coen A. ; Clanton, Thomas O. / Biomechanical analysis of an arthroscopic Broström ankle ligament repair and a suture anchor-augmented repair. In: Foot and Ankle International. 2015 ; Vol. 36, No. 7. pp. 836-841.
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abstract = "Background: Secondary surgical repair of ankle ligaments is often indicated in cases of chronic lateral ankle instability. Recently, arthroscopic Brostr{\"o}m techniques have been described, but biomechanical information is limited. The purpose of the present study was to analyze the biomechanical properties of an arthroscopic Brostr{\"o}m repair and augmented repair with a proximally placed suture anchor. It was hypothesized that the arthroscopic Brostr{\"o}m repairs would compare favorably to open techniques and that augmentation would increase the mean repair strength at time zero. Methods: Twenty (10 matched pairs) fresh-frozen foot and ankle cadaveric specimens were obtained. After sectioning of the lateral ankle ligaments, an arthroscopic Brostr{\"o}m procedure was performed on each ankle using two 3.0-mm suture anchors with #0 braided polyethylene/polyester multifilament sutures. One specimen from each pair was augmented with a 2.9-mm suture anchor placed 3 cm proximal to the inferior tip of the lateral malleolus. Repairs were isolated and positioned in 20 degrees of inversion and 10 degrees of plantarflexion and loaded to failure using a dynamic tensile testing machine. Maximum load (N), stiffness (N/mm), and displacement at maximum load (mm) were recorded. Results: There were no significant differences between standard arthroscopic repairs and the augmented repairs for mean maximum load and stiffness (154.4 ± 60.3 N, 9.8 ± 2.6 N/mm vs 194.2 ± 157.7 N, 10.5 ± 4.7 N/mm, P = .222, P = .685). Conclusions: Repair augmentation did not confer a significantly higher mean strength or stiffness at time zero. Clinical Relevance: Mean strength and stiffness for the arthroscopic Brostr{\"o}m repair compared favorably with previous similarly tested open repair and reconstruction methods, validating the clinical feasibility of an arthroscopic repair. However, augmentation with an additional proximal suture anchor did not significantly strengthen the repair.",
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AU - Acevedo, Jorge I.

AU - Mangone, Peter G.

AU - Haytmanek, C. Thomas

AU - Curry, Eugene E.

AU - Turnbull, Travis Lee

AU - Laprade, Robert F.

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