Biomechanical consequences of anatomical reconstruction of the lateral ligaments to the ankle joint complex: an in vitro investigation

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Abstract

The three-dimensional kinematics of both the ankle and the subtalar joints was examined after cutting and subsequent repairing the lateral ligaments using three anatomical procedures: direct repair, tendon graft and carbon-fibre implant. All procedures restored the original kinematics of the subtalar joint, except the plantar/dorsiflexion. For the talocrural joint, the tendon graft and the carbon fibre implant left a minimal laxity for the inversion/eversion and internal/external rotation movements. The direct repair procedure restored the physiologic kinematics almost completely and gave the best results, allowing to restore almost completely the physiologic kinematics. Each procedure respected the insertion points and the directions of the original ligaments. However, the different results for the direct repair and the other two anatomical procedures show that this condition alone is not sufficient to restore the kinematics of the talocrural and subtalar joints perfectly. None of the procedures caused a movement restriction. Thus, we recommend the direct repair of the ligaments as the method of choice. If the quality or the conditions of the ligaments do not allow a direct repair, we recommend to use another anatomical reconstruction.

About the authors

R. Shmidt

Bundeswehrkrankenhaus Ulm

Author for correspondence.
Email: doc.r.schmidt@t-online.de
Россия

S. Benesh

Bundeswehrkrankenhaus Ulm

Email: noemail@neicon.ru
Россия

References

  1. Andersen E., Hvass I. Treatment of lateral instability of the ankle — a new modification of the Evans repair. Arch. Orthop. Trauma Surg. 1986;106:15-17.
  2. Becker H.P., Rosenbaum D. Functional disorders of the foot after tenodeses: is the method still currently acceptable? Sportverletz. Sportschaden. 1996;10:94-99.
  3. Becker H.P., Rosenbaum D. Chronic recurrent ligament instability on the lateral ankle. Orthopäde.1999;28:483-492.
  4. Becker H.P., Schmidt R., Gutcke A., Gerngross H. Current status of diagnosis and therapy of chronic collateral ligament instability of the ankle joint: results of a survey of 267 German clinics in 1994. Unfallchirurg. 1995;98:493-499.
  5. Becker H.P., Zeithammel G., Danz B., Rosenbaum D., Gerngross H. Clinical and roentgenologic 5 year follow-up of modified Evans-plasty in chronic lateral instability of the ankle joint. Unfallchirurg. 1995;98:333-337.
  6. Bennett W.F. Lateral ankle sprains. Part II: Acute and chronic treatment see comments. Orthop. Rev. 1994;23:504-510.
  7. Bjorkenheim J.M., Sandelin J., Santavirta S. Evans' procedure in the treatment of chronic instability of the ankle. Injury. 1988;19:70-72.
  8. Brostrom L. Sprained ankles. VI. Surgical treatment of «chronic» ligament ruptures. Acta Chir. Scand. 1966;132:551-565.
  9. Burri C., Neugebauer R. Carbon fiber replacement of the ligaments of the shoulder girdle and the treatment of lateral instability of the ankle joint. Clin. Orthop. 1985;196:112-117.
  10. Chen J., Siegler S., Schneck C.D. The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joint--Part II: Flexibility characteristics. J. Biomech. Eng. 1988;110:374-385.
  11. Colville M.R., Marder R.A., Zarins B. Reconstruction of the lateral ankle ligaments. A biomechanical analysis. Am. J. Sports Med. 1992;20:594-600.
  12. Devanne H., Maton B. Role of proprioceptive information in the temporal coordination between joints. Exp. Brain Res. 1998;119 () 58-64.
  13. Fernandes N., Allison G.T., Hopper D. Peroneal latency in normal and injured ankles at varying angles of perturbation. Clin. Orthop. 2000;193-201.
  14. Fritschy D., Junet C., Bonvin J.C. Functional Treatment of Severe Ankle Sprain. 1987;131-136.
  15. Garrick J.G. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J. Sports Med.1977;5:241-242.
  16. Hollis J.M., Blasier R.D., Flahiff C.M. Simulated lateral ankle ligamentous injury. Change in ankle stability. Am J. Sports Med. 1995;23:672-677.
  17. Hollis J.M., Blasier R.D., Flahiff C.M., Hofmann O.E. Biomechanical comparison of reconstruction techniques in simulated lateral ankle ligament injury. Am J. Sports Med. 1995;23:678-682.
  18. Jerosch J., Bischof M. The effect of proprioception on functional stability of the upper ankle joint with special reference to stabilizing aids. Sportverletz Sportschaden. 1994;8:111-121.
  19. Jerosch J., Schoppe R. Midterm effects of ankle joint supports on sensomotor and sport- specific capabilities In Process Citation. Knee Surg Sports Traumatol Arthrosc.2000;8:252-259.
  20. Kaikkonen A., Lehtonen H., Kannus P., Jarvinen M. Long-term functional outcome after surgery of chronic ankle instability. A 5-year follow-up study of the modified Evans procedure. Scand J. Med Sci Sports.1999;9:239-244.
  21. Karlsson J., Bergsten T., Lansinger O., Peterson L. Lateral instability of the ankle treated by the Evans procedure. A long- term clinical and radiological follow-up. J. Bone Joint Surg. Br.1988;70:476-480.
  22. Karlsson J., Bergsten T., Lansinger O., Peterson L. Surgical treatment of chronic lateral instability of the ankle joint. A new procedure. Am J. Sports Med. 1989;17:268-273; discussion 273-274.
  23. Karlsson J., Eriksson B.I., Bergsten T., Rudholm O., Sward L. Comparison of two anatomic reconstructions for chronic lateral instability of the ankle joint. Am J. Sports Med.1997;25:48-53.
  24. Karlsson J., Lansinger O. Lateral instability of the ankle joint. Clin. Orthop. 1992:253-261.
  25. Karlsson J., Lansinger O. Chronic lateral instability of the ankle in athletes. Sports Med.1993;16:355-365.
  26. Karlsson J., Lansinger O., Faxen E. Lateral instability of the ankle joint (2). Active training programs can prevent surgery. Lakartidningen.1991;88:1404-1407.
  27. Kjaersgaard-Andersen P., Madsen F., Frich L.H., Wethelund J.O., Sojbjerg J.O: Lateral hindfoot instability treated with the Evans tenodesis: a biomechanical analysis. J. Foot Surg.1990;29:25-32.
  28. Kjaersgaard-Andersen P., Sojbjerg J.O., Wethelund J.O., Helmig P., Madsen F.: Watson-Jones tenodesis for ankle instability. A mechanical analysis in amputation specimens. Acta Orthop Scand 60 (1989) 477-480
  29. Krips R., van Dijk C.N., Halasi T., Lehtonen H., Moyen B., Lanzetta A., Farkas T., Karlsson J. Anatomical reconstruction versus tenodesis for the treatment of chronic anterolateral instability of the ankle joint: a 2- to 10-year follow- up, multicenter study. Knee Surg. Sports Traumatol. Arthrosc. 2000;8:173-179
  30. Lipke K., Tannheimer M., Benesch S., Gerngross H., Becker H.P., Schmidt R. Die Peroneale Reaktionszeit: Untersuchung in einem Normalkollektiv. Unfallchirurg.2001
  31. Liu S.H., Baker C.L. Comparison of lateral ankle ligamentous reconstruction procedures. Am J. Sports Med.1994;22:313-317.
  32. Liu S.H., Jacobson K.E. A new operation for chronic lateral ankle instability. J. Bone Joint Surg. Br 1995;77:55-59.
  33. Lundberg A., Goldie I., Kalin B., Selvik G. Kinematics of the ankle/foot complex: plantarflexion and dorsiflexion. Foot Ankle.1989;9:194-200.
  34. Ottosson L.: Lateral instability of the ankle treated by a modified Evans procedure. Acta Orthop. Scand. 1978;49:302-305.
  35. Paar O., Rieck B., Bernett P. Experimental studies on load-bearing pressure and contact areas in the ankle joint. Unfallheilkunde.1983;86:531-534.
  36. Rosenbaum D., Becker H.P., Sterk J., Gerngross H., Claes L. Long-term results of the modified Evans repair for chronic ankle instability. Orthopedics.1996;19:451-455.
  37. Rosenbaum D., Becker H.P., Sterk J., Gerngross H., Claes L. Functional evaluation of the 10-year outcome after modified Evans repair for chronic ankle instability. Foot Ankle Int.1997;18:765-771.
  38. Rosenbaum D., Becker H.P., Wilke H.J., Claes L.E. Tenodeses destroy the kinematic coupling of the ankle joint complex. A three-dimensional in vitro analysis of joint movement see comments. J. Bone Joint Surg. Br.1998;80:162-168.
  39. Rudert M., Wulker N., Wirth C.J. Fibular ligament rupture-conservative or surgical treatment? Z Orthop Ihre Grenzgeb.1997;135:Oa25-26.
  40. Schmidt R., Becker H.P., Gerngross H. Surgical treatment of chronic ankle joint instability--many variations in German clinics. Analysis of a 1994 German survey. Sportverletz Sportschaden.1997;11:21-26.
  41. Siegler S., Chen J., Schneck C.D. The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joints--Part I: Kinematics. J Biomech Eng.1988;110:364-373.
  42. Siegler S., Chen J., Schneck C.D. The effect of damage to the lateral collateral ligaments on the mechanical characteristics of the ankle joint--an in vitro study. J Biomech Eng.1990;112:129-137.
  43. Siegler S., Wang D., Plasha E., Berman A.T. Technique for in vivo measurement of the three-dimensional kinematics and laxity characteristics of the ankle joint complex. J. Orthop. Res.1994;12:421-431.
  44. Steinbräck K. Fibulo-talare Bandverletzungen beim Sportler. Sporttherapie-Sporttraumatologie.1996:1-8.
  45. Verhagen R.A., de Keizer G., van Dijk C.N. Long-term follow-up of inversion trauma of the ankle. Arch. Orthop. Trauma Surg.1995; 114: 92-96.
  46. Wilke H.J. Möglichkeiten und Grenzen der biomechanischen in vitro Testung von Wirbelsäulenimplantaten. Habilitationsschrift. Medizinische Fakultät der Universität Ulm. 1996.
  47. Wirth C.J., Kusswetter W., Jager M. Biomechanics and pathomechanics of the ankle joint. Hefte Unfallheilkd.1978; 131:10-22.
  48. Younes C., Fowles J.V., Fallaha M., Antoun R. Long-term results of surgical reconstruction for chronic lateral instability of the ankle: comparison of Watson-Jones and Evans techniques. J. Trauma.1988; 28:1330-1334.
  49. Zwipp H., Tscherne H. Treatment of chronic anterolateral instability of the upper ankle joint: direct ligament reconstruction-periosteal flap-tenodesis. Unfallheilkd.1984; 87:405-415.

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