Orthopedic and Traumatology Department, Hopital Cochin, 27, rue du Faubourg Saint-Jacques, Paris, France.
Orthopedic and Traumatology Department, Hopital Cochin, 27, rue du Faubourg Saint-Jacques, Paris, France.
Orthop Traumatol Surg Res. 2021 Oct;107(6):102882. doi: 10.1016/j.otsr.2021.102882. Epub 2021 Mar 6.
Arthroscopic anatomical reconstruction of the lateral ankle ligaments is an emerging technique for treating chronic ankle instability. One of the known complications of arthroscopic anterior cruciate ligament reconstruction is tunnel widening; this makes revision more complicated. The aim of this study was to look for tunnel widening in the postoperative course of arthroscopic ankle ligament reconstruction. We hypothesized that significant widening of the bone tunnels is present 1 year after anatomical ankle ligament reconstruction.
Twenty-one patients who underwent arthroscopic anatomical reconstruction of the lateral ankle ligaments with a gracilis graft were included prospectively. A CT-scan with 1-mm thick slices with multiplanar reconstruction was done 1 year after the surgery. The size and shape of the tunnels was analyzed, and the ratio of the preoperative to postoperative diameter was calculated. Based on this ratio, the tunnels were given a grade as described by Struewer. Tunnel widening was defined as a grade III tunnel, thus a ratio ≥ 1.3. The tunnel shape was classified as described by Peyrache as cone type, cavity type, line type.
None of the tunnels had widened 1 year after arthroscopic anatomical reconstruction of the lateral ankle ligaments. At the fibula, 81% of tunnels were grade I and 19% were grade II; 57% were cone type and 43% were line type. At the talus, 86% of tunnels were grade I and 14% were grade II. All were line type. At the calcaneus, 86% of tunnels were grade I and 14% were grade II; 57% were cone type and 43% were line type.
The main finding of this study was the absence of tunnel widening 1 year after arthroscopic reconstruction of the lateral ankle ligaments.
IV; retrospective study.
关节镜下解剖重建外侧踝关节韧带是治疗慢性踝关节不稳定的新兴技术。关节镜下前交叉韧带重建术已知的并发症之一是隧道增宽；这使得翻修更加复杂。本研究旨在观察关节镜下踝关节韧带重建术后的隧道增宽情况。我们假设在解剖性踝关节韧带重建术后 1 年，骨隧道会出现明显的增宽。
前瞻性纳入 21 例接受关节镜下解剖重建外侧踝关节韧带（使用股薄肌腱）的患者。术后 1 年进行 CT 扫描，层厚 1mm，多平面重建。分析隧道的大小和形状，并计算术前与术后直径的比值。根据此比值，采用 Struewer 描述的分级对隧道进行分级。隧道增宽定义为 III 级隧道，即比值≥1.3。根据 Peyrache 的描述，将隧道形状分为锥形、腔型和线型。
关节镜下解剖重建外侧踝关节韧带术后 1 年，无隧道增宽。在腓骨，81%的隧道为 I 级，19%为 II 级；57%为锥形，43%为线型。在距骨，86%的隧道为 I 级，14%为 II 级。均为线型。在跟骨，86%的隧道为 I 级，14%为 II 级；57%为锥形，43%为线型。
本研究的主要发现是关节镜下重建外侧踝关节韧带后 1 年无隧道增宽。
IV；回顾性研究。
