Chronic ankle instability

non anatomic augmentation technique with cryopreserved tendon allograft versus anatomic tenoplasty

Abstract

A nonanatomic augmentation technique is described to surgically treatment chronic ankle instability. Methods: By the implantation of a cryopreserved long peroneus tendon allograft, arranging it according to the design and layout of the Castaing II transosseous plasty, thus avoiding the use of autologous tendons, therefore allowing the foot to maintain normal muscle activity. A three-degree personal classification is also presented, based on the pathological anatomy of the lesion, whose reconstruction technique requires a thorough dissection of the pre, retro and inframaleolar areas before implanting the graft. Results: The results of the 31 patients operated on were statistically evaluated using the AOFAS score, observing an improvement of 17.1 points and good to excellent results in 94.5% of the cases. We also describe the anatomical technique of Broström-Gould performed using classic and arthroscopic Nery´s procedure and Dierckman´s anatomical substitution technique, to compare the results with our study. By using the AOFAS. score, we have been able to verify that the results are practically equal and superimposable with each other, with those obtained by the allograft technique. This favorable evolution over time has allowed us to ensure that the rate of complications and rejection is non-existent, making it easier for the patient to return to normal activity in a short period of time. Conclusion: From the comparative analysis of the results of the four techniques, we can assert that these procedures analysed to treat chronic instability of the ankle provide satisfactory results, as long as it respects the capsuloligamentous morphology and does not alter the biomechanics of the peritalar complex.