J Korean Orthop Assoc.  2011 Feb;46(1):10-17. 10.4055/jkoa.2011.46.1.10.

Anatomic Reconstruction of the Lateral Ankle Instability Using the Semitendinosus Allograft Tendon and Interference Screws

• Jung HG
• Park JY
• Bae EJ
• Kim TH

• KMID: 2106566
• DOI: http://doi.org/10.4055/jkoa.2011.46.1.10

Abstract

PURPOSE
To evaluate the clinical outcome of the anatomic reconstruction of the lateral ankle instability using the semitendinosus allograft tendon and the interference screws.
MATERIALS AND METHODS
This study is based on the 12 feet of lateral ankle instability that had been treated with anatomic reconstruction of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) using the semitendinosus allograft tendon and the interference screws. The majority of patients were young and physically active. We evaluated the patients' VAS pain scores, AOFAS scores and Karlsson-Peterson ankle scores for the 11 feet involved with at least 12 months follow up, both pre- and post-operative. In addition, we evaluated patient satisfaction. We measured the talar tilt angles and the talar anterior translations from ankle stress views.
RESULTS
The average age at surgery was 25.9 years old (19-57 years); patients had symptoms of recurrent sprain for average 31.4 months before surgery. The average follow up period was 14 months. For reconstruction, we used 4.0mm thick allograft semitendinosus tendon and interference screws. VAS pain scores decreased from 6.0 to 1.1 (p<0.05) and AOFAS scores improved from 70.4 to 90.4 postoperatively (p<0.05). Karlsson-Peterson ankle scores improved significantly from 54.6 to 92.4 (p<0.05). Radiographic talar tilt decreased from 15.7degrees to 3.2degrees postoperatively (p<0.05). Eighy-two percent of the patients were satisfied with the results and the patients had returned to their jobs by 3.7 months after surgery.
CONCLUSION
Anatomic reconstruction of the ATFL and the CFL in the lateral ankle instability patients using the semitendinosus tendon and the interference screws is an ideal surgical option especially for young athletes with high grade instabilities.

Keyword

lateral ankle instability; anatomic reconstruction; semitendinosus tendon; interference screw

MeSH Terms

Animals
Ankle
Athletes
Follow-Up Studies
Foot
Humans
Ligaments
Patient Satisfaction
Sprains and Strains
Tendons
Translations
Transplantation, Homologous

Figure

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  Figure 1 The semitendinosus allograft tendon was fixed with an interference screw at ATFL insertion site of anterior margin of lateral talar body.

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  Figure 2 Two fibular tunnels were made at ATFL and CFL attachment sites of distal fibula.

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  Figure 3 Schematic diagram of ATFL and CFL anatomic reconstruction with the semitendinosus allograft tendon and interference screws.

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  Figure 4 Varus stress radiograph of patient #6. Preoperative talar tilt of 17° (A) decreased to 3° at postoperative 18 months (B).

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