Re-injury after arthroscopic anatomical reconstruction by allograft tendon of the lateral ankle ligaments treated by a new arthroscopic anatomical allograft reconstruction: A case report

Julien Paquot MD, David Ancelin MD,Ph
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Abstract

Revision surgery after ligamentoplasty with anatomical reconstruction presents a complex challenge that remains underreported. This case report highlights a unique arthroscopic revision approach using a novel allograft technique, which has not been previously documented in the surgical literature. A 22-year-old female sustained trauma to her left ankle following a prior anatomical ligamentoplasty reconstruction of the anterior talofibular and calcaneofibular ligaments using an allograft. Persistent instability despite conservative management necessitated revision surgery. Clinical examination and MRI confirmed graft rupture and malposition of the talar tunnel. Arthroscopic revision ligamentoplasty was performed using a non-irradiated allograft with tunnel correction. A new blind talar tunnel (5 mm × 20 mm) was meticulously positioned in the "bare zone" of the talus, ensuring optimal biomechanical alignment. Postoperatively, the patient regained stability and resumed professional activities without recurrent instability episodes.
Relevance and Impact:
  • Correcting the improper placement of bone tunnels during revision surgery is critical for successful outcomes.
  • Arthroscopic approaches allow for comprehensive joint inspection while minimizing surgical morbidity.
  • The use of allografts in revision procedures avoids donor site morbidity while ensuring optimal functional recovery.
关节镜下同种异体解剖重建治疗踝关节外侧韧带肌腱重建后再损伤1例
韧带成形术与解剖重建后的翻修手术是一个复杂的挑战,但仍未被充分报道。本病例报告强调了一种独特的关节镜翻修方法,使用一种新颖的同种异体移植技术,这在以前的外科文献中没有记载。一位22岁的女性在先前使用同种异体移植对距腓骨前韧带和跟腓骨韧带进行解剖性韧带成形术重建后,左脚踝持续受伤。尽管保守治疗,但持续不稳定需要翻修手术。临床检查和MRI证实植骨破裂和距骨隧道错位。关节镜下翻修韧带成形术采用非辐照同种异体移植物进行隧道矫正。一个新的距骨盲隧道(5mm × 20mm)被精心定位在距骨的“裸露区”,确保最佳的生物力学对齐。术后,患者恢复稳定并恢复职业活动,无复发性不稳定发作。相关性和影响:•在翻修手术中纠正不正确的骨隧道放置对成功的结果至关重要。•关节镜入路允许全面的关节检查,同时最大限度地减少手术发病率。•在翻修手术中使用同种异体移植物避免了供体部位的发病率,同时确保了最佳的功能恢复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Foot & ankle surgery (New York, N.Y.)
Foot & ankle surgery (New York, N.Y.) Orthopedics, Sports Medicine and Rehabilitation, Podiatry
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审稿时长
75 days
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