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Centre for Human Performance

Anatomic reconstruction of the anterior syndesmosis in elite athletes using suture tape (Internalbrace)

A prospective audit of a new anatomic surgical technique to reconstruct the anterior ankle syndesmosis in elite athletes.

The Challenge

The diagnosis and management of unstable ankle syndesmotic injuries remains controversial. The use of screws provides robust fixation allowing the ligament to repair but delays post-operative rehabilitation and usually requires a second procedure to remove the screw. The use of suture buttons allows earlier weight-bearing and rehabilitation and often avoids the need for a second surgical procedure, however recent studies have reported up to 44% complication rates. Anatomic reconstruction using suture tape (InternalBrace) has recently been described as an alternative to suture buttons. The aim of the audit was to assess the results of anatomic reconstruction of unstable syndesmotic injuries using suture tape.

The Approach

Twenty consecutive elite athletes with unstable ankle syndesmotic injuries were recruited into the prospective audit and offered anatomic reconstruction using suture tape (InternalBrace). Time to return to sports, AOFAS scores,Knee to wall distance and any complications were recorded.

The Impact

All patients returned to their pre-injury level of sports. The time taken to return to sports was as good if not better than anything in the published literature. There were no complications related to the use of the suture tape (InternalBrace). We have adopted this technique going forwards. Further biomechanical studies are needed to assess the mechanical strength of the suture tape construct. This may allow even earlier weight-bearing, rehabilitation and return to sports following injury.

Outputs

Harris, Nicholson, Pountos (2018) Stabilisation of the ankle syndesmosis using the internal brace. British Orthopaedic Foot & Ankle Society (BOFAS), Edinburgh, November 2018
Harris, Nicholson, Pountos (2018) Stabilisation of the ankle syndesmosis using the internal brace. British Orthopaedic Sports Trauma and Arthroscopy Society(BOSTAA), London, December 2018 – Best paper award
Harris, Nicholson, Pountos (2019) Stabilisation of the ankle syndesmosis using the internal brace. XXVIII Isokinetic Medical Group Conference, London, April 2019

Contact Gareth Nicholson

g.nicholson@leedsbeckett.ac.uk

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