BIOMECHANICAL COMPARISON OF RECONSTRUCTION TECHNIQUES IN SIMULATED LATERAL ANKLE LIGAMENT INJURY

Eighteen intact ankles were loaded with inversion-eversion and anterio r-posterior forces, and motions of the talus and calcaneus were measur ed. Ankles were tested in neutral, 15 degrees of dorsiflexion, and 15 degrees of plantar flexion. The anterior talofibular ligament was then sectioned and testing was repeated. In half the specimens the calcane ofibular ligament was also sectioned followed by repeat testing. The E vans, Watson-Jones, and Chrisman-Snook procedures were performed on ea ch ankle and testing was repeated. With inversion-eversion loading, on ly the Chrisman-Snook reconstruction resulted in a significantly more stable ankle joint complex than in the anterior talofibular ligament c ut ankles. All three reconstructions increased ankle stability over th e anterior talofibular and calcaneofibular ligament cut state. With an terior-posterior loading, all reconstructions resulted in a significan tly more stable ankle joint complex than the anterior talofibular liga ment cut ankles. The Evans and Chrisman-Snook procedures resulted in m ore stability than the anterior talofibular and calcaneofibular ligame nt cut ankles. There was no difference in subtalar joint motion with i nversion-eversion loading among ankles with the anterior talofibular l igament cut and those with any of the reconstructions. For the anterio r talofibular and calcaneofibular ligament cut ankles, subtalar joint motion was similar to that in intact ankles after each reconstruction. All three reconstructions resulted in ankles with significantly less subtalar joint motion with anterior-posterior loading than ankles with the anterior talofibular ligament cut or with the anterior talofibula r and calcaneofibular ligaments cut. The Chrisman-Snook procedure resu lted in ankles with significantly less motion than intact ankles.