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

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:

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  Correcting the improper placement of bone tunnels during revision surgery is critical for successful outcomes.
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  Arthroscopic approaches allow for comprehensive joint inspection while minimizing surgical morbidity.
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  The use of allografts in revision procedures avoids donor site morbidity while ensuring optimal functional recovery.