Orthopedics & Orthopedic Surgery
Area of Focus: Foot & Ankle and Sports Medicine
The goal of lateral ankle ligament reconstruction should be to permit early functional rehabilitation after surgery and to prevent recurrent injury during strenuous activity. However, published series document recurrent ankle sprains in post-Broström ligament reconstruction patients. Additionally, previous authors have demonstrated good efficacy of an anatomic ankle ligament reconstruction technique utilizing gracilis allograft or autograft with interference anchors for lateral ankle ligament stabilization, but morbidity of knee tendon harvest and the added expense and rejection of allograft continues. In an effort to reduce these issues, the authors of this video have modified an augmented Broström technique for lateral ankle ligament reconstruction in highly athletic patients.
The procedure uses a free strip of peroneus longus tendon harvested with a tendon stripper from above the superior peroneal retinaculum. The ends of the tendon are anchored at the origin of the CFL, taken through a tunnel in the fibula, and then anchored into the anterolateral talar neck at the ATFL insertion with interference anchors. A two-year followup study--conducted in this highly athletic patient population using AAOS-validated measurement scores for both physical and mental components--demonstrates significantly improved post-operative function. Many patients in this athletic population were able to return to running marathons and participating in triathlons without any recorded incident of recurrent sprains. Patients who have inverted their ankles post-operatively have noted recovery within days.