BIOMECHANICS OF ANKLE LIGAMENT RECONSTRUCTION - AN IN-VITRO COMPARISON OF THE BROSTROM-REPAIR, WATSON-JONES-RECONSTRUCTION, AND A NEW ANATOMIC RECONSTRUCTION TECHNIQUE
R. Bahr et al., BIOMECHANICS OF ANKLE LIGAMENT RECONSTRUCTION - AN IN-VITRO COMPARISON OF THE BROSTROM-REPAIR, WATSON-JONES-RECONSTRUCTION, AND A NEW ANATOMIC RECONSTRUCTION TECHNIQUE, American journal of sports medicine, 25(4), 1997, pp. 424-432
We wanted to use biomechanical testing in a cadaveric model to compare
the Brostrom repair, the Watson-Jones reconstruction, and a new anato
mic reconstruction method. Eight specimens were held in a specially de
signed testing apparatus in which the ankle position (dorsiflexion-pla
ntar flexion and supination-pronation) could be varied in a controlled
manner. Testing was done with intact ligaments and was repeated after
sectioning of the anterior talofibular ligament and the calcaneofibul
ar ligament and after a Brostrom repair, a Watson-Jones reconstruction
, and a new anatomic reconstruction were performed. An anterior drawer
test was performed using an anterior translating force of 10 to 50 N,
and a talar tilt test was performed using a supination torque of 1.1
to 3.4 N-m. The forces in the anterior talofibular ligament and calcan
eofibular ligament were measured with buckle transducers, and tibiotal
ar motion and total ankle joint motion were measured with an instrumen
ted spatial linkage. The increase in ankle joint laxity observed after
sectioning of both the anterior talofibular and calcaneofibular ligam
ents was significantly reduced by the three reconstructive techniques,
although not always to the level of the intact ankle. Joint motion wa
s restricted after the Watson-Jones procedure compared with that in th
e intact ankle. Unlike the Watson-Jones procedure, the ligament or gra
ft force patterns observed during loading after the Brostrom repair an
d the new anatomic technique resembled those observed in the intact an
kle.