目的介绍关节镜下采用内支撑套索环技术修复前距腓韧带(ATFL)治疗慢性踝关节外侧不稳定的手术方法及临床疗效。
对29例患者进行了回顾性研究,这些患者于2020年1月至8月接受了全关节镜下ATFL修复,采用了内部支撑和套索环技术。患者包括24名男性和5名女性,平均年龄30.17岁.通过附件前外侧(AAL)入口,我们钻了骨隧道,并用4.75毫米和3.5毫米的“SwiveLock”锚固定胶带,并通过套圈技术重新连接撕裂的韧带。
29例患者均顺利接受全关节镜检查,无严重并发症,如感染和重要的神经或血管损伤。外踝撕脱骨折8例,距骨软骨损伤10例。视觉模拟量表(VAS),卡尔松-彼得森,Tegner,和美国骨科足踝协会(AOFAS)评分用于评估临床后果。所有患者均获得随访,随访时间平均为18.66±4.85个月。术前平均VAS评分为4.69±1.04,明显高于术后平均VAS评分1.14±1.56。在最后的后续任命中,卡尔森-彼得森的平均数,AOFAS,和Tenger评分分别为75.83±9.44,88.31±6.81,6.93±1.79,明显高于手术前。
这种关节镜下使用内部支撑和套索环技术进行的距腓前韧带修复可获得令人满意的临床效果,并具有高安全性和可靠性,可治疗慢性踝关节外侧不稳定。
To introduce the surgical technique and clinical outcomes of arthroscopic anterior talofibular ligament (ATFL) repair using the Internal Brace and lasso-loop technique for chronic ankle lateral instability.
A retrospective study was performed on 29 patients who underwent all-arthroscopic ATFL repair with the Internal Brace and lasso-loop technique from January to August 2020. The patients included 24 males and five females, with a mean age of 30.17 years. Through the accessory anterolateral (AAL) portal, we drilled the bone tunnels and fixed the tape with 4.75 mm and 3.5 mm \"SwiveLock\" anchors and reattached the torn ligament by the lasso-loop technique.
All 29 patients underwent all-arthroscopic procedures smoothly without serious complications, such as infection and important nerve or vessel injuries. There were eight cases of lateral malleolar avulsion fractures and ten cases of talus cartilage injury. The visual analog scale (VAS), Karlsson-Peterson, Tegner, and American Orthopedic Foot and Ankle Society (AOFAS) scores were used to evaluate the clinical consequences. All the patients were followed up for 18.66 ± 4.85 months on average. The average pre-operative VAS score was 4.69 ± 1.04, which was significantly higher than the average post-operative VAS score of 1.14 ± 1.56. At the final follow-up appointments, the averages of Karlsson-Peterson, AOFAS, and Tenger scores were 75.83 ± 9.44, 88.31 ± 6.81, and 6.93 ± 1.79, respectively, which was significantly higher than that before the operation.
This arthroscopic anterior talofibular ligament repair with the Internal Brace and lasso-loop technique achieves satisfactory clinical outcomes with the benefits of high safety and reliability for chronic ankle lateral instability.