Academic literature on the topic 'Tape spring ligaments'

Background. Ankle sprains are one of the most common injuries in both athletes and the general population. A major problem accompanying ankle injury is the high rate of recurrence, with about 20% of acute ankle sprain patients developing chronic ankle instability. Unlike acute ankle sprain, chronic ankle instability usually needs surgical intervention. Various anatomic reconstruction techniques using the ruptured ends of the ligaments to restore stability have gained popularity. The purpose of this study was to evaluate the functional results of the treatment of chronic lateral ankle instability with anatomic repair of the injured ligaments and reinforcement with polyester tape. Material and methods. A prospective study of 30 consecutive patients who underwent anatomic reconstruction of the lateral ligaments using transosseous suturing and augmentation using a polyester tape done at a single centre by a single surgeon from 2016 to 2017. All patients were assessed preoperatively and postoperatively at 6 weeks, 3, 6 and 12 months. The American Orthopaedic Foot and Ankle Score (AOFAS) and Free Online Foot and Ankle Ability Measure (FAAM) were recorded and used for results analysis. Results. At 12 months’ follow-up, the AOFAS had improved from mean 52.47 ± 2.06 to 91.0 ± 6.03 (p< 0.001) .The FAAM mean score had improved from mean 55.21± 1.9 to 90.43 ± 4.02 Conclusion. The ankle ligament reconstruction with additional polyester tape augmentation is an effective technique in treating chronic ankle instability with a satisfactory surgical outcome.

Category: Flatfoot reconstruction Introduction/Purpose: Adult acquired flatfoot often results from posterior tibial tendon dysfunction followed by attenuation of the ligamentous support of the medial longitudinal arch of the foot. The spring ligament is the strongest ligamentous support for the talonavicular joint making it a viable target for flatfoot reconstruction procedures. There are concerns that direct repair of the spring ligament complex could result in failure as the already attenuated tissues of the ligament stretch out with mobilization and weight bearing. Suture tape augmentation of ligament repairs has shown greater loads to failure in biomechanical testing; however, there is a paucity of data surrounding clinical and radiographic outcomes of flatfoot reconstruction with augmented spring ligament repair. Methods: A retrospective review was performed of patients who underwent flatfoot reconstruction including spring ligament repair with suture tape augmentation between July 2014 and August 2017. Weight bearing radiographs were obtained for all patients both pre-operatively and at their last available follow-up. All radiographs were assessed by two surgeons for validated radiographic parameters including AP talocalcaneal angle, AP talo-first metatarsal angle, AP talar uncoverage, lateral talocalcaneal angle, lateral talo-first metatarsal (Meary) angle, lateral medial cuneiform-fifth metatarsal height, and lateral calcaneal pitch. Paired sample T-tests were used to compare pre-operative and post-operative radiographic measurements to assess for correction of these parameters. Results: 57 patients met inclusion criteria. The average time to final radiographic evaluation was 47 weeks (10 to 200 weeks). All radiographic parameters assessed showed significant correction when compared to pre-operative measurements. The average correction for each parameter included 6.02 degrees for AP talocalcaneal angle (p<0.001), 10.96 degrees for AP talo-first metatarsal angle (p<0.001), 12.65% for AP talar uncoverage percentage (p<0.001), 4.27 degrees for lateral talocalcaneal angle (p<0.001), 11.35 degrees for lateral talo-first metatarsal (Meary) angle (p<0.001), 8.31 mm for lateral medial cuneiform-fifth metatarsal height (p<0.001), and 2.91 degrees for lateral calcaneal pitch (p<0.001). Post-operative complications occurred in 5 patients. Conclusion: Reconstruction of adult acquired flatfoot with spring ligament repair using suture tape augmentation is a safe procedure that resulted in significant weight bearing radiographic correction at an average of 47 weeks follow-up.

Chronic lateral ankle instability (CLAI) is a condition that is characterized by persistent disability and recurrent ankle sprains while encompassing both functional and mechanical (laxity) instability. Failure of conservative treatment for CLAI often necessitates operative intervention to restore the stability of the ankle joint. The traditional or modified Broström techniques have been the gold standard operative approaches to address CLAI with satisfactory results; however, patients with generalized ligament laxity (GLL), prior unsuccessful repair, high body mass index, or high-demand athletes may experience suboptimal outcomes. Synthetic ligament constructs have been tested as an adjunct to orthopedic procedures to reinforce repaired or reconstructed ligaments or tendons with the hope of early mobilization, faster rehabilitation, and long-term prevention of instability. Suture tape augmentation is useful to address CLAI. Multiple operative techniques have been described. Because of the heterogeneity among the reported techniques and variability in postoperative rehabilitation protocols, it is difficult to evaluate whether the use of suture tape augmentation provides true clinical benefit in patients with CLAI. This review aims to provide a comprehensive outline of all the current techniques using suture tape augmentation for treatment of CLAI as well as present recent research aimed at guiding evidence-based protocols.

Category: Ankle; Sports; Other Introduction/Purpose: High ankle sprains, or injuries to the distal tibiofibular syndesmosis, are predictive of long-term ankle dysfunction. Our objectives were to evaluate ankle mortise stability, radiographically, and kinematically, using a cadaveric model with a simulated syndesmotic injury. We also measured the ability of a suture-button system to restore natural joint motion. Methods: Eight cadaveric specimens underwent serial sectioning of the anterior-inferior tibiofibular (AITFL), interosseous (IOL), posterior-inferior tibiofibular (PITFL), and deltoid ligaments. Specimens underwent external rotation and lateral translation testing after ligament release to obtain kinematic data (using a validated infrared LED motion capture system) and radiographic measurements. We then repeated external rotation and lateral translation testing after implementing a suture-button system. Repeated measures ANOVA with a Bonferroni/Dunn post-hoc test calculated the interspecimen comparisons. Results: Sectioning of each ligament, beginning with the AITFL, significantly increased talar external rotation. After releasing the AITFL and IOL, fibular external rotation increased significantly. Posterior displacement of the fibula began following the release of AITFL. Significant radiographic widening of the medial clear space and the syndesmosis occurred only after the release of the deltoid ligament. Syndesmotic and medial clear space widening was not significantly different from the intact state under lateral translation until after the release of the deltoid ligament. Placement of the suture-button system successfully reduced the medial clear space but was unable to restore the native stability of the ankle joint. Conclusion: This project addresses rotational and kinematic changes in the ankle after syndesmotic injury by quantifying the effect of ligamentous disruption on the tibiotalar articulation. The change in joint kinematics may explain why patients with moderate-to-severe syndesmosis injuries take longer to heal and develop long-term dysfunction. Significant talar rotation and posterior fibular displacement occur during external rotation, even with moderate syndesmosis injury, and before the disruption of the deltoid ligament. Stress radiography does not appear to be a reliable indicator of mild or moderate syndesmosis injuries.

Category: Arthroscopy; Ankle; Sports Introduction/Purpose: High ankle sprains or syndesmotic lesions can occur after an external rotation force in a dorsiflexed foot. These lesions may present isolated or combined with medial collateral ligaments lesions or fractures. Unstable lesions should be operatively treated since syndesmotic instability can cause pain, disability, chondral lesions and arthritis. A recent biomechanical cadaveric study suggested that syndesmosis suture button fixation with suture tape augmentation can restore stability to a pre injury level, while suture button alone was insufficient to restore stability and screw fixation was associated with overtightening of the syndesmosis. The purpose of this work is to describe a new minimally invasive arthroscopic technique that uses a synthetic tape to augment suture button fixation of syndesmotic instability. Methods: After arthroscopic debridement of the syndesmosis, one bone tunnel is made with a 4.0mm drill at the anterolateral distal tibia rim and at the anterior distal fibula just above the anterior talofibular ligament origin. A 4,75mm swivelock armed with a fibertape (Arthrex©) is introduced at the distal fibula hole. After obtaining adequate syndesmotic reduction with the help of a reduction clamp, suture button fixation was made through a mini lateral access. The fibertape was then appropriately tensioned and inserted at the distal tibia hole with another 4,75mm swivelock. Adequate reduction was observed with the Mercedes-Benz sign and stability was confirmed arthroscopically. Results: Only a few patients were submitted to this technique. At short follow up, none of them presented with complications or complaints Conclusion: We believe that unstable syndesmotic treatment using the suture button fixation and anterior inferior tibiofibular arthroscopic augmentation with suture-tape described in this work can restore syndesmotic stability to pre injury levels with low morbidity and lesser complication rates compared to other techniques. Nonetheless, comparative clinical studies are still needed to confirm our hypothesis.

BackgroundLateral ankle sprain is one of the most common musculoskeletal injuries, particularly among the sporting population. Due to such prevalence, many interventions have been tried to prevent initial, or further, ankle sprains. Current research shows that the use of traditional athletic tape can reduce the incidence of sprain recurrence, but this may be at a cost to athletic performance through restriction of motion. Kinesiology tape, which has become increasingly popular, is elastic in nature, and it is proposed by the manufacturers that it can correct ligament damage. Kinesiology tape, therefore, may be able to improve stability and reduce ankle sprain occurrence while overcoming the problems of traditional tape.AimTo assess the effect of kinesiology tape on ankle stability.Methods27 healthy individuals were recruited, and electromyography (EMG) measurements were recorded from the peroneus longus and tibialis anterior muscles. Recordings were taken from the muscles of the dominant leg during induced sudden ankle inversion perturbations using a custom-made tilting platform system. This was performed with and without using kinesiology tape and shoes, creating four different test conditions: barefoot(without tape), shoe(without tape), barefoot(with tape) and shoe(with tape). For each test condition, the peak muscle activity, average muscle activity and the muscle latency were calculated.ResultsNo significant difference (p>0.05) was found by using the kinesiology tape on any of the measured variables while the wearing of shoes significantly increased all the variables.ConclusionKinesiology tape has no effect on ankle stability and is unable to nullify the detrimental effects that shoes appear to have.

Category: Sports; Ankle; Other Introduction/Purpose: Surgical treatment of chronic lateral ankle instability (CLAI) with the Modified Brostrom-Gould (MB) procedure and suture tape ligament augmentation (+ST) has proven to be biomechanically and clinically successful. A concern regarding the MB + ST procedure is increased surgical costs and additional operating room time. To date, there are no available studies in the literature evaluating the cost-effectiveness of suture tape ligament augmentation of the Modified Brostrom-Gould procedure. The purpose of the present study is to evaluate and report the cost-effectiveness of the Modified Brostrom-Gould procedure, with and without suture tape ligament augmentation. Methods: This study followed the consensus-based recommendations made by the Panel on Cost-Effectiveness in Health and Medicine. The base case was assumed to be a healthy individual with symptomatic CLAI following recurrent ankle sprains requiring surgical intervention. The standard MB technique utilized two 2.4 mm BioComposite SutureTak anchors for direct anatomic repair of the disrupted anterior talofibular and calcaneofibular ligaments. This treatment was then compared to the Modified Brostrom-Gould procedure with the addition of suture tape ligament augmentation (MB + ST). A Markov Model was designed to evaluate the cost-effectiveness of the MB + ST procedure. Model input variables and parameters were derived from a prospective randomized clinical study which described the rate of return to previous activity level at 26 weeks postoperatively for the MB and MB + ST groups. Direct and indirect surgical costs were incorporated into the model to provide an accurate financial assessment of both procedures. Results: When only direct surgical costs were considered, the total cost of MB was $2,318.88 and the total effectiveness was 0.91 quality-adjusted-life-years (QALY) over the 26-week period. The total cost for MB + ST was $4,004.93 and the total effectiveness was 0.98 QALY's. Patients in the MB + ST group spent, on average, $1,686 more than those in the MB group, with a higher quality of life by 0.07 QALYs. To evaluate the impact of indirect surgical costs, a sensitivity analysis was performed which measured the additional costs associated with physical therapy and time off work. Patients in the MB group incurred an increased physical therapy cost of $4,212 assuming 4.2 extra weeks of treatment. Assuming those in the MB group returned to full duty work 4.2 weeks later than those in the MB + ST group, this resulted in a net loss of approximately $5,413.80 in wages. Conclusion: In the early postoperative period following lateral ligament reconstruction for CLAI, MB + ST technique yields a higher quality of life and lower overall expense despite a higher direct surgical cost when compared to MB alone. The cost effectiveness of the MB + ST technique was further supported through a sensitivity analysis which revealed that as indirect surgical costs were incorporated into the model, MB + ST became an even more cost effective option. This cost-effectiveness analysis adds to the growing literature in support of suture tape augmentation for the Modified Brostrom-Gould procedure.

This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury. The previous guideline provided evidence that the severity of ligament damage can be assessed most reliably by delayed physical examination (4–5 days post trauma). After correct diagnosis, it can be stated that even though a short time of immobilisation may be helpful in relieving pain and swelling, the patient with an acute lateral ankle ligament rupture benefits most from use of tape or a brace in combination with an exercise programme.New in this update: Participation in certain sports is associated with a heightened risk of sustaining a lateral ankle sprain. Care should be taken with non-steroidal anti-inflammatory drugs (NSAIDs) usage after an ankle sprain. They may be used to reduce pain and swelling, but usage is not without complications and NSAIDs may suppress the natural healing process. Concerning treatment, supervised exercise-based programmes preferred over passive modalities as it stimulates the recovery of functional joint stability. Surgery should be reserved for cases that do not respond to thorough and comprehensive exercise-based treatment. For the prevention of recurrent lateral ankle sprains, ankle braces should be considered as an efficacious option.

Background and Aims: Landing is a typical sports motion that can create impact force 2-12 times of body weight, and finally, it’s one of the main reasons for non-contact injuries in ankle ligaments. Specialized. The usual effects of Kinesio tape include increasing proprioception, health direction of joints, reducing pain, and raising pressure on nervous tissue. The study aimed to investigate the effect of Kinesio taping on ankle joint kinematics during landing on stiff and soft surfaces in ankle sprain and healthy persons. Methods: The method of the present study was quasi-experimental with a two-group design in control groups (without ankle sprain) and experimental (with an ankle sprain). A total of 30 male students of the Shahid Bahonar University of Kerman were purposefully and accessibly selected and divided into two groups with (15 students) and without ankle sprains (15 students). Then, they performed both landing operations on stable and unstable surfaces, with and without Kinesio tape. Maximum dorsi and plantar flexion, supination, pronation and maximum ankle angular velocity parameters were recorded by a three-dimensional motion analysis system. Statistical analysis was performed using independent t-test and repeated measures analysis of variance at the significant level of 0.05. Results: There was no significant reduction in plantar flexion of the ankle in healthy and twisted individuals while landing on stable and unstable surfaces with and without Kinesio tape (P≤0.07), but there was a significant reduction in the dorsiflexion in both groups(P≤0.001). On the other hand, there was no significant decrease in pronation (P≤0.66), but there was a significant decrease in foot supination (P≤0.001). Conclusion: Generally, Kinesio tape in recovery ankle movement is offered to persons for ankle sprain. Thus recommendation landing exercises fare with more flexion angle and less knee joint valgus and more dorsiflexion angle at ankle joint and preferable on the unstable surfaces.