Zona Nathaniel E, Stark Samuel D, Vlasak Alexander, Alexeev Sergei O, Hunt Kenneth J
Department of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
University of South Carolina School of Medicine, Columbia, SC, USA.
Foot Ankle Orthop. 2025 Jul 23;10(3):24730114251346795. doi: 10.1177/24730114251346795. eCollection 2025 Jul.
Ligamentous pathologies and injuries of the foot and ankle commonly require surgical repair. Ligament augmentation techniques (LAT) use a synthetic ligament that spans the anatomic length of the injured ligament, anchoring to bone on both ends. Use of LAT in foot and ankle surgery is rapidly progressing, but the rates of usage and surgeon-specific indications are not well known. This study aims to provide an in-depth analysis of LAT use by foot and ankle surgeons.
An online survey was distributed to the surgeon members of the American Orthopaedic Foot & Ankle Society (AOFAS). Survey questions detailed demographics and practice details, current use of LATs, and the future trajectory of LATs. Responses were tabulated and summarized. Logistic regression and χ2 tests of independence compared trends in LAT use between North America and outside continent, years in practice, and type of practice.
Of 1895 invited surgeons, 244 (12.9%) completed the survey. Among respondents, 209 surgeons (85.7%) reported current LAT use, most of whom were based in North America (197, 80.7%). North American respondents were significantly more likely to report using LAT when compared to respondents outside of North America (89% vs 72% respectively) ( = .007). The 3 most common ligaments for LAT use were the ATFL (205, 98.1%) followed by the syndesmosis ligament (125, 59.8%) and the deltoid ligament (122, 58.4%). The most common reason for LAT use was faster return to sport (136, 65.1%). More than half of respondents (131, 53.6%) anticipate increased LAT in the future.
LAT use in foot and ankle surgery is multifactorial, influenced by patient demographics, regional practices, industry dynamics, and surgeon training. Ongoing debates about the cost-effectiveness and long-term outcomes of LAT suggest that further research is necessary to fully define its role in orthopaedic foot and ankle surgery.
Level V, therapeutic.
足踝部的韧带病变和损伤通常需要手术修复。韧带增强技术（LAT）使用一种合成韧带，其跨越受损韧带的解剖长度，并在两端锚固于骨。LAT在足踝手术中的应用正在迅速发展，但使用率和外科医生特定的适应证尚不明确。本研究旨在深入分析足踝外科医生对LAT的使用情况。
向美国足踝外科协会（AOFAS）的外科医生会员进行在线调查。调查问题详细涉及人口统计学和实践细节、LAT的当前使用情况以及LAT的未来发展轨迹。对回复进行列表和总结。采用逻辑回归和独立性χ²检验比较北美和其他地区、从业年限以及实践类型之间LAT使用趋势。
在1895名受邀外科医生中，244名（12.9%）完成了调查。在受访者中，209名外科医生（85.7%）报告当前使用LAT，其中大多数位于北美（197名，80.7%）。与北美以外的受访者相比，北美受访者报告使用LAT的可能性显著更高（分别为89%和72%）（P = 0.007）。LAT使用的3种最常见韧带依次为距腓前韧带（205名，98.1%），其次是下胫腓韧带（125名，59.8%）和三角韧带（122名，58.4%）。使用LAT最常见的原因是更快恢复运动（136名，65.1%）。超过一半的受访者（131名，53.6%）预计未来LAT的使用会增加。
足踝手术中LAT的使用是多因素的，受患者人口统计学、地区实践、行业动态和外科医生培训的影响。关于LAT成本效益和长期结果的持续争论表明，需要进一步研究以充分界定其在足踝骨科手术中的作用。
V级，治疗性。
