Clinical outcomes of arthroscopic all-inside anterior talofibular ligament suture augmentation repair versus modified suture augmentation repair for chronic ankle instability patients

Abstract

Background: To compare the clinical efficacies of arthroscopic anterior talofibular ligament suture augmentation repair and modified suture augmentation repair in patients with chronic ankle instability (CAI).

Methods: From October 2019 to August 2020, 100 patients with CAI were enrolled after propensity score matching analysis and observed for two years. Among them, 50 underwent modified suture augmentation repair and the other 50 underwent suture augmentation repair. The clinical efficacies of CAI treatments were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) clinical rating scale, visual analog scale (VAS), and anterior drawer test scores.

Results: The postoperative AOFAS score of the modified suture augmentation repair group (83.8 ± 11.3) was significantly higher than that of the suture augmentation repair group (76.3 ± 11.3; P = 0.001). The VAS (P = 0.863) and anterior drawer test (P = 0.617) scores were not significantly different between the two treatment groups.

Conclusion: Both the modified suture augmentation repair and suture augmentation repair demonstrated good clinical efficacies. The AOFAS score of the modified suture augmentation repair group was superior to that of the conventional suture augmentation repair group. Thus, modified suture augmentation repair is a feasible and practical surgical technique for CAI treatment.

Keywords: Anterior talofibular ligament; Arthroscopy; Augmentation repair; Chronic ankle instability; Modified suture augmentation repair; Outcomes.

Fig. 1

The operation diagram for modified suture augmentation repair. A, B, C, D: The No. 0 non-absorbable suture was introduced through the inferior fascicle of ATFL; E, F, G, H: The knotless anchor was introduced, and ATFL was repaired. ATFL: Anterior Talofibular Ligament. f: fibula; t: talus; ①: suturing the upper and lower tracts of the ATFL as a whole

Fig. 2

The operation diagram for suture augmentation repair. A: The operation diagram. B: Arthroscopic operation. ②: only repaired the damaged upper tract of ATFL

Fig. 3

Trial profile

Fig. 4

The violin figure of AOFAS scores in the two groups at final follow-up after the operation. AOFAS: The American Orthopedic Foot & Ankle Society; SA: Suture Augmentation Repair; MSA: Modified Suture Augmentation Repair. The bar indicates SD (**P < 0.01)