Arthroscopic anterior deltoid plication with bone anchor is an effective procedure to control residual talar anterior translation after lateral ligament repair.

Autor: Vega J; Foot and Ankle Unit, iMove Traumatology, Barcelona, and Olympia, Madrid, Spain.; Laboratory of Arthroscopic and Surgical Anatomy, Department of Pathology and Experimental Therapeutics (Human Anatomy Unit), University of Barcelona, Barcelona, Spain.; MIFAS by GRECMIP, Merignac, France., Malagelada F; Department of Trauma and Orthopedic Surgery, Royal London Hospital, Barts Health NHS Trust, London, UK., Guelfi M; Casa di Cura Villa Montallegro, Genoa, Italy.; Department of Orthopaedic Surgery 'Gruppo Policlinico di Monza', Clinica Salus, Alessandria, Italy., Dalmau-Pastor M; Laboratory of Arthroscopic and Surgical Anatomy, Department of Pathology and Experimental Therapeutics (Human Anatomy Unit), University of Barcelona, Barcelona, Spain.; MIFAS by GRECMIP, Merignac, France.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Aug; Vol. 32 (8), pp. 2178-2183. Date of Electronic Publication: 2024 Jun 21.
DOI: 10.1002/ksa.12328
Abstrakt: Purpose: Residual symptoms can be observed after ankle lateral ligament repairs commonly due to hyperlaxity, severe ankle instability or a failed stabilization. In order to increase joint stability, ligament or capsular-ligament plication has been used in other joints. Given that the anterior portion of the deltoid is a stabilizer against anterior talar translation, it could be used as an augmentation to restrict anterior talar translation. The aim of this study was to describe an arthroscopic anterior deltoid plication with a bony anchor as an augmentation to the lateral stabilization. The results in a series of eight patients were presented.
Methods: Eight patients (seven males, median age 31 [range, 22-43] years) presented residual instability after arthroscopic all inside lateral collateral ligament repair. Arthroscopic anterior deltoid ligament plication was performed in these patients. Median follow-up was 22 (range, 15-27) months. Using an automatic suture passer and a knotless anchor, the anterior deltoid was arthroscopically plicated to the anterior aspect of the medial malleolus.
Results: During the arthroscopic procedure, only an isolated detachment of the anterior talofibular ligament was observed without any deltoid open-book injury in any case. All patients reported subjective improvement in their ankle instability after the arthroscopic all-inside ligament repair and the anterior deltoid plication with a bony anchor. On clinical examination, the anterior drawer test was negative in all patients. The median American Orthopedic Foot and Ankle Society score increased from 68 (range, 64-70) preoperatively to 100 (range, 90-100) at final follow-up.
Conclusion: The arthroscopic anterior deltoid plication is a feasible procedure to augment stability and control anterior talar translation when treating chronic ankle instability in cases of residual excessive talar translation.
Level of Evidence: Level IV.
(© 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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