Vilá-Rico Jesús, Cabestany-Castellà Josep María, Cabestany-Perich Bernat, Núñez-Samper César, Ojeda-Thies Cristina
Hospital Universitario Doce de Octubre, Madrid, Spain; Department of Surgery, Universidad Complutense, Madrid, Spain.
CBS Medicina Avanzada, Barcelona, Spain.
Foot Ankle Surg. 2019 Feb;25(1):24-30. doi: 10.1016/j.fas.2017.12.008. Epub 2017 Dec 23.
Anatomic graft reconstruction of the anterior talo-fibular ligament is an alternative for patients who are bad candidates for standard procedures such as a Broström-Gould reconstruction (high-demand athletes, obesity, hyperlaxity or collagen disorders, capsular insufficiency or talar avulsions). The purpose of this study is to describe an all-inside arthroscopic technique for ATFL reconstruction, and the results in a series of patients with chronic ankle instability.
We reviewed patients with chronic ATFL ruptures treated with an all-inside arthroscopic allograft reconstruction of the ATFL, with a minimum 2-year follow-up. Twenty-two patients with lateral ankle instability were included. Mean follow-up was 34±2.5 months.
The mean AOFAS score improved from 62.3±6.7 points preoperatively to 97.2±3.2 points at final follow-up. Three patients suffered complications: one case each of ankle rigidity, superficial peroneal nerve injury and fibular fracture.
Chronic ATFL injuries are amenable to all-inside arthroscopic allograft reconstruction fixed with tenodesis screws. This procedure simplifies other reported techniques in that it facilitates identification and bone tunnel placement of the talar ATFL insertion.
距腓前韧带的解剖移植重建是那些不适合进行标准手术（如布罗斯特伦-古尔德重建术）的患者的一种替代方案（高需求运动员、肥胖、关节过度松弛或胶原紊乱、关节囊功能不全或距骨撕脱）。本研究的目的是描述一种用于距腓前韧带重建的全关节镜技术，以及一系列慢性踝关节不稳患者的治疗结果。
我们回顾了采用全关节镜同种异体移植重建距腓前韧带治疗的慢性距腓前韧带断裂患者，随访时间至少为2年。纳入22例踝关节外侧不稳患者。平均随访时间为34±2.5个月。
美国足踝外科协会（AOFAS）平均评分从术前的62.3±6.7分提高到末次随访时的97.2±3.2分。3例患者出现并发症：踝关节僵硬、腓浅神经损伤和腓骨骨折各1例。
慢性距腓前韧带损伤适合采用全关节镜同种异体移植并用固定螺钉进行重建。该手术简化了其他已报道的技术，因为它便于识别距骨距腓前韧带附着点并进行骨隧道定位。
