Park Younguk, Han DaeHyun, Lee Myungsub, Seo Young Wook
Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Republic of Korea.
Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Republic of Korea.
J Orthop Sci. 2025 Jul 23. doi: 10.1016/j.jos.2025.06.015.
With significant advancements in arthroscopic surgical techniques, the frequency of arthroscopic lateral ankle ligament repair procedures has increased. However, anchor positioning accuracy remains uncertain, with studies suggesting a higher probability of the anchor being fixed in non-anatomical positions, such as insertion proximal to the fibular obscure tubercle (FOT). Using ultrasound guidance, anchors can be positioned more anatomically. This study aimed to analyze anchor position in arthroscopic all-inside lateral ligament repair using ultrasound.
Thirty-three patients with chronic ankle instability were prospectively enrolled and underwent ultrasound-guided, arthroscopic all-inside lateral ankle ligament repair, termed Arthroscopic Ultrasound-Assisted All-Inside Repair of the Lateral Ankle Ligament (AURA). Postoperative computed tomography (CT) scans were taken to analyze anchor positions, with the FOT as the reference point. Subsequently, the anchor positions were classified as anatomic, sub-anatomic, and nonanatomic based on the relationship between the fibular anterior tubercle and the FOT.
The mean distance between anchor position and the fibular obscure tubercle (FOT) was 2.08 mm (range, 0-12 mm). Based on postoperative CT analysis, anchor placements were classified relative to the FOT: 28 of 33 cases (84.8 %) were within 25 % of the fibular length distal to the FOT (anatomic zone), 4 cases (12.2 %) were positioned between 25-50 % (sub-anatomic zone), and 1 case (3.0 %) was beyond 50 % (non-anatomic zone).
The ultrasound-assisted technique demonstrated high anatomical accuracy in anchor placement, as confirmed by postoperative 3D-CT evaluation.
IV, case study.
随着关节镜手术技术的显著进步，关节镜下外侧踝关节韧带修复手术的频率有所增加。然而，锚钉定位的准确性仍不确定，研究表明锚钉固定在非解剖位置的可能性更高，例如在腓骨隐窝结节（FOT）近端插入。使用超声引导，可以使锚钉定位更符合解剖结构。本研究旨在分析超声引导下关节镜全关节内外侧韧带修复中锚钉的位置。
前瞻性纳入33例慢性踝关节不稳患者，接受超声引导下的关节镜全关节内外侧踝关节韧带修复，即关节镜超声辅助全关节内外侧踝关节韧带修复（AURA）。术后进行计算机断层扫描（CT）以分析锚钉位置，以FOT作为参考点。随后，根据腓骨前结节与FOT的关系，将锚钉位置分为解剖位置、亚解剖位置和非解剖位置。
锚钉位置与腓骨隐窝结节（FOT）之间的平均距离为2.08mm（范围为0-12mm）。根据术后CT分析，相对于FOT对锚钉位置进行分类：33例中有28例（84.8%）位于FOT远端腓骨长度的25%以内（解剖区域），4例（12.2%）位于25%-50%之间（亚解剖区域），1例（3.0%）超过50%（非解剖区域）。
术后三维CT评估证实，超声辅助技术在锚钉置入方面显示出较高的解剖准确性。
IV，病例研究。
