Ankle lateral ligament injuries are one of the most common sporting injuries, with the majority being successfully treated conservatively. However, reconstruction is required if this fails. We present the clinical results of a newly described surgical technique of triple-breasting the lateral ligament complex using suture anchors. Sixteen patients (18 ankles) were treated with this new technique. The mean duration of symptoms was 77 months. The mean follow-up was 25 months. All patients underwent an arthroscopy followed by lateral ligament reconstruction by this new technique. Additional pathology included osteoarthritis (2), ankle impingement due to anterior cheilus (2), osteochondral defects (3) and non-union of fracture of anterior process of calcaneus. Additional procedures above diagnostic arthroscopy, soft tissue debridement and modified Broström-Gould repair included debridement and microfracture (3), open excision of anterior calcaneal process (1) and arthroscopic anterior ankle cheilectomy (2). At final follow-up, all ankles were subjectively and objectively stable. Mean AOFAS score improved from 53 to 88. This was statistically significant (p<0.05). Eight patients had resumed normal pre-injury level of activities (including sports), 8 had some reduction in normal level of activity. The early results of our modification show it to be safe, successful and comparable with previously published series with all patients having objectively and subjectively stable ankles at final follow-up.
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http://dx.doi.org/10.1016/j.fas.2014.01.002 | DOI Listing |
J Exp Orthop
January 2025
Department of Orthopaedic Surgery and Trauma University Center of Montpellier, University of Montpellier Montpellier France.
Purpose: Gap-balanced total knee arthroplasty (TKA) technique relies on initial ligament evaluation, particularly in patient-specific implantation using computer-assisted technologies. This cadaveric study aimed to compare the reproducibility and reliability of medial and lateral gap measurements between manual stress testing and dynamic ligament balancer.
Methods: Initial gap acquisitions were assessed from eight cadaveric knees (four specimens) during the same navigated TKA procedure by five differently skilled surgeons (three seniors and two juniors).
Orthop Traumatol Surg Res
January 2025
Department of orthopedic surgery, Clinique du Sport, 36 Boulevard Saint-Marcel, 75005 Paris, France.
Background: Many techniques have been described for lateral ankle ligament reconstruction. Although the biomechanical properties of gracilis tendons are different from those of ligaments, the use of a gracilis tendon autograft is a popular option for anatomical reconstruction. Graft maturation and the biomechanical processes over time remain unclear.
View Article and Find Full Text PDFSICOT J
January 2025
Department of Orthopaedic Surgery, Joint Replacement Unit, Kuala Lumpur Hospital, Ministry of Health Malaysia, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
Introduction: Extraarticular deformity (EAD) with knee arthritis is a complex condition involving tri-planar bone deformity with pathological malalignment and chronic soft tissue contracture or laxity in the knee joint. Intraarticular correction by TKA, which was previously performed with conventional manual jig by mechanical alignment technique, had its limits and difficulties especially extensive soft tissue release and risk of jeopardizing the collateral ligaments. Robotic technology allows for reproducible and precise execution of surgical plan and allows adjustment to various new personalised alignment philosophy including functional alignment (FA).
View Article and Find Full Text PDFJ Orthop
July 2025
Department of Orthopaedic Surgery, Rush University Medical Center, Il, USA.
Background: This study investigates the association between intra-operative balance and 2-year outcomes within subgroups defined by demographics and pre-operative joint balance. Our hypothesis is that patient demographics and the pre-operative state of the joint will impact patient sensitivity to post-operative balance and laxity and subsequent impact on outcome.
Methods: A retrospective analysis of prospectively captured data across 5 sites with 5 surgeons was performed.
J Med Ultrasound
April 2024
Department of Anesthesiology, The School of Clinical Medicine, Fujian Madical University, The First Hospital of Putian City, Fujian, China.
Background: To test the novel ultrasound (US)-guided bilateral anterior quadratus lumborum block (QLBA) at the lateral supra-arcuate ligament (supra-LAL) technique combined with postoperative intravenous analgesia was a viable alternative approach of conventional thoracic epidural analgesia (TEA) for laparoscopic radical gastrectomy (LRG).
Methods: Three hundred and four patients scheduled for LRG were randomized 1:1 into QLBA group: receiving a novel pathway of US-guided bilateral QLBA at the supra-LAL before general anesthesia (GA) and patient-controlled intravenous analgesia (PCIA) after surgery, and TEA group: receiving TEA before GA and patient-controlled epidural analgesia following surgery. The difference in procedure time between the treatment groups was set as the primary endpoint.
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