PDF(Pubmed)
Abstract：
UNASSIGNED: Anterior talofibular ligament (ATFL) repair of the ankle is a common surgical procedure. Ultrasound (US)-guided anchor placement for ATFL repair can be performed anatomically and accurately. However, to our knowledge, no study has investigated ankle kinematics after US-guided ATFL repair.
UNASSIGNED: US-guided ATFL repair with and without inferior extensor retinaculum (IER) augmentation will restore ankle kinematics.
UNASSIGNED: Controlled laboratory study; Level of evidence, 4.
UNASSIGNED: A 6 degrees of freedom robotic testing system was used to apply multidirectional loads to fresh-frozen cadaveric ankles (N = 9). The following ankle states were evaluated: ATFL intact, ATFL deficient, combined ATFL repair and IER augmentation, and isolated US-guided ATFL repair. Three loading conditions (internal-external rotation torque, anterior-posterior load, and inversion-eversion torque) were applied at 4 ankle positions: 30° of plantarflexion, 15° of plantarflexion, 0° of plantarflexion, and 15° of dorsiflexion. The resulting kinematics were recorded and compared using a 1-way repeated-measures analysis of variance with the Benjamini-Hochberg test.
UNASSIGNED: Anterior translation in response to an internal rotation torque significantly increased in the ATFL-deficient state compared with the ATFL-intact state at 30° and 15° of plantarflexion (P = .022 and .03, respectively). After the combined US-guided ATFL repair and augmentation, anterior translation was reduced significantly compared with the ATFL-deficient state at 30° and 15° of plantarflexion (P = .0012 and .005, respectively). Anterior translation was not significantly different for the isolated ATFL-repair state compared with the ATFL-deficient or ATFL-intact states at 30° and 15° of plantarflexion.
UNASSIGNED: Combined US-guided ATFL repair with augmentation of the IER reduced lateral ankle laxity due to ATFL deficiency. Isolated US-guided ATFL repair did not reduce laxity due to ATFL deficiency, nor did it increase instability compared with the intact ankle.
UNASSIGNED: US-guided ATFL repair with IER augmentation is a minimally-invasive technique to reduce lateral ankle laxity due to ATFL deficiency. Isolated US-guided ATFL repair may be a viable option if accompanied by a period of immobilization.
UNASSIGNED: US-guided ATFL repair with and without inferior extensor retinaculum (IER) augmentation will restore ankle kinematics.
UNASSIGNED: Controlled laboratory study; Level of evidence, 4.
UNASSIGNED: A 6 degrees of freedom robotic testing system was used to apply multidirectional loads to fresh-frozen cadaveric ankles (N = 9). The following ankle states were evaluated: ATFL intact, ATFL deficient, combined ATFL repair and IER augmentation, and isolated US-guided ATFL repair. Three loading conditions (internal-external rotation torque, anterior-posterior load, and inversion-eversion torque) were applied at 4 ankle positions: 30° of plantarflexion, 15° of plantarflexion, 0° of plantarflexion, and 15° of dorsiflexion. The resulting kinematics were recorded and compared using a 1-way repeated-measures analysis of variance with the Benjamini-Hochberg test.
UNASSIGNED: Anterior translation in response to an internal rotation torque significantly increased in the ATFL-deficient state compared with the ATFL-intact state at 30° and 15° of plantarflexion (P = .022 and .03, respectively). After the combined US-guided ATFL repair and augmentation, anterior translation was reduced significantly compared with the ATFL-deficient state at 30° and 15° of plantarflexion (P = .0012 and .005, respectively). Anterior translation was not significantly different for the isolated ATFL-repair state compared with the ATFL-deficient or ATFL-intact states at 30° and 15° of plantarflexion.
UNASSIGNED: Combined US-guided ATFL repair with augmentation of the IER reduced lateral ankle laxity due to ATFL deficiency. Isolated US-guided ATFL repair did not reduce laxity due to ATFL deficiency, nor did it increase instability compared with the intact ankle.
UNASSIGNED: US-guided ATFL repair with IER augmentation is a minimally-invasive technique to reduce lateral ankle laxity due to ATFL deficiency. Isolated US-guided ATFL repair may be a viable option if accompanied by a period of immobilization.
摘要：
■踝关节前腓骨韧带（ATFL）修复是一种常见的外科手术。用于ATFL修复的超声(US)引导的锚钉放置可以在解剖学上和准确地进行。然而,根据我们的知识，没有研究调查美国指导的ATFL修复后的踝关节运动学.
■在有和没有下伸肌支持带（IER）增强的情况下，美国指导的ATFL修复将恢复踝关节运动学。
■对照实验室研究；证据水平，4.
■使用6自由度机器人测试系统对新鲜冷冻的尸体脚踝（N=9）施加多方向载荷。评估了以下脚踝状态：ATFL完整，ATFL缺陷,结合ATFL修复和IER增强，和孤立的美国指导的ATFL修复。三种加载条件（内外旋转扭矩，前后负荷,和内翻-外翻扭矩)施加在4个踝关节位置：足底弯曲30°，足底弯曲15°,足底弯曲0°,背屈15°。记录并使用单向重复测量方差分析与Benjamini-Hochberg检验进行比较。
■在足屈30°和15°时，与ATFL完整状态相比，在ATFL缺乏状态下响应内部旋转扭矩的前平移显着增加（P=.022和.03，分别）。在美国指导的联合ATFL修复和增强后，与足屈30°和15°时的ATFL缺乏状态相比，前平移显着降低（分别为P=.0012和.005）。孤立的ATFL修复状态与30°和15°的ATFL缺陷状态或ATFL完整状态相比，前翻译没有显着差异。
■美国指导的ATFL修复与IER增强相结合，可减少由于ATFL缺陷引起的踝关节外侧松弛。孤立的美国指导的ATFL修复并没有减少由于ATFL缺陷引起的松弛，与完整的脚踝相比，它也没有增加不稳定性。
■美国指导的带有IER增强的ATFL修复是一种微创技术，可减少由于ATFL缺陷而导致的外侧踝关节松弛。如果伴随一段时间的固定，隔离的US指导的ATFL修复可能是可行的选择。
■在有和没有下伸肌支持带（IER）增强的情况下，美国指导的ATFL修复将恢复踝关节运动学。
■对照实验室研究；证据水平，4.
■使用6自由度机器人测试系统对新鲜冷冻的尸体脚踝（N=9）施加多方向载荷。评估了以下脚踝状态：ATFL完整，ATFL缺陷,结合ATFL修复和IER增强，和孤立的美国指导的ATFL修复。三种加载条件（内外旋转扭矩，前后负荷,和内翻-外翻扭矩)施加在4个踝关节位置：足底弯曲30°，足底弯曲15°,足底弯曲0°,背屈15°。记录并使用单向重复测量方差分析与Benjamini-Hochberg检验进行比较。
■在足屈30°和15°时，与ATFL完整状态相比，在ATFL缺乏状态下响应内部旋转扭矩的前平移显着增加（P=.022和.03，分别）。在美国指导的联合ATFL修复和增强后，与足屈30°和15°时的ATFL缺乏状态相比，前平移显着降低（分别为P=.0012和.005）。孤立的ATFL修复状态与30°和15°的ATFL缺陷状态或ATFL完整状态相比，前翻译没有显着差异。
■美国指导的ATFL修复与IER增强相结合，可减少由于ATFL缺陷引起的踝关节外侧松弛。孤立的美国指导的ATFL修复并没有减少由于ATFL缺陷引起的松弛，与完整的脚踝相比，它也没有增加不稳定性。
■美国指导的带有IER增强的ATFL修复是一种微创技术，可减少由于ATFL缺陷而导致的外侧踝关节松弛。如果伴随一段时间的固定，隔离的US指导的ATFL修复可能是可行的选择。
