Sagittal instability with inversion is important to evaluate after syndesmosis injury and repair: a cadaveric robotic study

• Published in: Journal of experimental orthopaedics 2020-03, Vol.7 (1), p.18-18, Article 18
• Main Authors: Patel, Neel K., Murphy, Conor I., Pfeiffer, Thomas R., Naendrup, Jan-Hendrik, Zlotnicki, Jason P., Debski, Richard E., Hogan, MaCalus V., Musahl, Volker
• Format: Article
• Language: English
• Subjects: Ankle; Ankle syndesmosis; Arthritis; Cadavers; Distal tibiofibular kinematics; Injuries; Kinematics; Knee; Laboratories; Ligaments; Medicine; Medicine & Public Health; Motion capture; Orthopedics; Robotics; Suture button; Tricortical screw
• ISSN: 2197-1153; 2197-1153
• DOI: 10.1186/s40634-020-00234-w

Purpose Disruption of the syndesmosis, the anterior-inferior tibiofibular ligament (AITFL), the posterior-inferior tibiofibular ligament (PITFL), and the interosseous membrane (IOM), leads to residual symptoms after an ankle injury. The objective of this study was to quantify tibiofibular joint motion with isolated AITFL- and complete syndesmotic injury and with syndesmotic screw vs. suture button repair compared to the intact ankle. Methods Nine fresh-frozen human cadaveric specimens (mean age 60 yrs.; range 38–73 yrs.) were tested using a six degree-of-freedom robotic testing system and three-dimensional tibiofibular motion was quantified using an optical tracking system. A 5 Nm inversion moment was applied to the ankle at 0°, 15°, and 30° plantarflexion, and 10° dorsiflexion. Outcome measures included fibular medial-lateral translation, anterior-posterior translation, and external rotation in each ankle state: 1) intact ankle, 2) AITFL transected (isolated AITFL injury), 3) AITFL, PITFL, and IOM transected (complete injury), 4) tricortical screw fixation, and 5) suture button repair. Results Both isolated AITFL and complete injury caused significant increases in fibular posterior translation at 15° and 30° plantarflexion compared to the intact ankle ( p