Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 8893-8905
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.8893
Arthroscopic anatomical reconstruction of lateral collateral ligaments with ligament advanced reinforcement system artificial ligament for chronic ankle instability
Yu Wang, Jun-Xu Zhu
Yu Wang, Jun-Xu Zhu, Department of Orthopaedics, The General Hospital of Northern Theater Command, Shenyang 110016, Liaoning Province, China
Jun-Xu Zhu, Department of Orthopaedics, Xiangyang Hospital of Traditional Chinese Medicine, Xiangyang 441000, Hubei Province, China
Author contributions: Zhu JX is the first author; Wang Y is the corresponding author.
Institutional review board statement: Ethical review (Scientific Research) No. S2021-036-09
Clinical trial registration statement: This study is registered at Clinical hospital center of The General Hospital of Northern Theater Command. The registration identification number is EP-13127/12-07. A separate document was uploaded as a proof of registry.
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that there is no conflict of interest.
Data sharing statement: There is no additional data available.
CONSORT 2010 statement: The authors have read the CONSORT Statement—checklist of items, and the manuscript was prepared and revised according to the CONSORT Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Wang, BMed, Associate Chief Physician, Department of Orthopaedics, The General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang 110016, Liaoning Province, China. wangyu1983doc@qq.com
Received: September 29, 2021
Peer-review started: September 29, 2021
First decision: November 11, 2021
Revised: July 27, 2022
Article in press: July 27, 2022
Published online: September 6, 2022
Processing time: 330 Days and 16.9 Hours
Abstract
BACKGROUND

Recently, the use of ligament advanced reinforcement system (LARS) artificial ligament, a new graft which has several unique advantages such as no donor-site morbidity, early recovery and no risk of disease transmission which has been a significant breakthrough for anatomical ligament reconstruction. Growing studies suggested that the special design of the LARS ligament with open fibers in its intra-articular part was believed to be more resistant to torsional fatigue and wearing. However, the safety and efficacy of LARS artificial ligament for ankle joint lateral collateral ankle ligament reconstruction has not been defined to date.

AIM

To evaluate the clinical results of all-arthroscopic anatomical reconstruction of ankle joint lateral collateral ligaments with the LARS artificial ligament for chronic ankle instability.

METHODS

Twenty-two patients with chronic lateral instability underwent anatomical reconstruction of the lateral collateral ligaments of ankle with LARS artificial ligament. The visual analogue score (VAS), American Orthopaedic Foot and Ankle Society score (AOFAS score) and Karlsson score were used to evaluate the clinical results before and after surgery.

RESULTS

A total of 22 patients (22 ankles) were followed up for a mean of 12 mo. All patients reported significant improvement compared to their preoperative status. The mean AOFAS score improved from 42.3 ± 4.9 preoperatively to 90.4 ± 6.7 postoperatively. The mean Karlsson score improved from 38.5 ± 3.2 preoperatively to 90.1 ± 7.8 postoperatively. The mean VAS score improved from 1.9 ± 2.5 preoperatively to 0.8 ± 1.7 postoperatively.

CONCLUSION

All-arthroscopic anatomical reconstruction of the lateral collateral ligaments with LARS artificial ligament achieved a satisfactory surgical outcome for chronic ankle instability.

Keywords: Chronic ankle instability, Lateral collateral ankle ligament, Anatomical reconstruction, Arthroscopy, Ligament advanced reinforcement system

Core Tip: Chronic lateral ankle instability is usually caused directly by lateral collateral ligament injury. The ligament advanced reinforcement system (LARS) is a new graft with unique advantages such as low postoperative complication rates, early rehabilitation and its design makes it more resistant to torsional fatigue and wearing. However, the safety and efficacy of LARS artificial ligament for ankle joint lateral collateral ankle ligament reconstruction have not been determined to date. The purpose of this study was to evaluate this anatomical reconstructive surgery for chronic ankle instability by using LARS artificial ligament under all-arthroscopic conditions.