Comparative Study of Concurrent Arthroscopic Anterior Talofibular Ligament Repair and Posterior Ankle Debridement: Novel Adjustable Lateral Floating Position versus Traditional Repositioning with Re-preparation.

Abstract

Purpose: The goal of this study was to compare our novel adjustable lateral floating position with traditional repositioning and re-prepping for concurrent arthroscopic anterior talofibular ligament (ATFL) repair and posterior ankle debridement.

Study design: Retrospective control study.

Methods: From 2019 to 2022, fifty-four cases underwent concurrent arthroscopic ATFL repair and posterior ankle debridement were retrospectively analyzed. According to the intraoperative position, 26 cases were assigned to group A (novel adjustable lateral floating position) and 28 to group B (traditional repositioning). The Foot and Ankle Ability Measure scales [FAAM, including activities of daily living (FAAM-ADL) and sports subscales (FAAM-SS)] and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores were compared. The surgical time and complications were also evaluated.

Results: The average follow-up time was 26.2 ± 2.5 months (range, 24-28 months) without significant differences between the groups. There was no significant difference between FAAM-ADL, FAAM-SS, and AOFAS scores at the final follow-ups. No significant difference in complication rates was found. However, there is a significant difference in median and interquartile range (IQR) of the surgical time between both groups [58.0 (50.0, 74.0) vs. 78.0 (68.5, 88.5)], with a large effects size (Cohen's d = -0.75). It is notable that the surgical times of patients with postoperative deep vein thrombosis exceeded 110 minutes in both groups.

Conclusion: For the concurrent arthroscopic ATFL repair and posterior ankle debridement, the novel adjustable lateral floating position is time-saving and reliable. This novel surgical positioning is also suitable for a younger or more junior surgeon.

Level of evidence: Level III.