Publication
Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments
| Summary: | Background and aim: Ankle sprains can lead to chronic lateral ankle instability (CLAI) in 10-50% of cases. While the anterior talofibular ligament (ATFL) is traditionally considered the primary structure affected, recent studies indicate a high incidence of combined injuries to the ATFL and the calcaneofibular ligament (CFL). Given the importance of the CFL, this study aims to evaluate the biomechanical efficacy of double tendon graft reconstruction of the ATFL and CFL in cases of CLAI. Materials and methods: This biomechanical study on cadaveric ankles compares two techniques: anatomical reconstruction using a double graft for both the ATFL and CFL versus isolated anatomical reconstruction of the ATFL with a single graft. Stability was assessed using specific examination maneuvers (anterior drawer, forced varus, and pivot shift) with an arthrometer measuring angular displacement across three spatial planes (horizontal, coronal, and sagittal). Four models were analyzed: intact ankle, sectioning of the ATFL and CFL, double graft reconstruction of the ATFL and CFL, and single graft reconstruction of the ATFL. Results: The results showed no significant differences between the double graft reconstruction and the intact ankle. Comparing the double graft with the single graft reconstruction revealed statistically significant differences, favoring the double graft for greater angular stability in the coronal plane during forced varus and external rotation maneuvers. Conclusions: Double graft reconstruction of the ATFL and CFL provides greater angular stability compared to isolated ATFL reconstruction, demonstrating significant benefits in lateral and rotational stabilization of the ankle in CLAI cases. |
|---|---|
| Main Authors: | Abarquero-Diezhandino, A. |
| Other Authors: | Mellado-Romero, M.; Muñoz de la Espada-López, M.; Diaz-Suárez, R.; García-Jarabo, E.; Núñez-García, A.; Sánchez-Morata, E. J.; Vázquez-Osorio, M. T.; Guerra-Pinto, F.; Vilá-Rico, J. |
| Subject: | Ankle instability Anterior talofibular ligament Biomechanics Calcaneofibular ligament Ligament reconstruction Surgery Orthopedics and Sports Medicine |
| Year: | 2025 |
| Country: | Portugal |
| Document type: | article |
| Access type: | open access |
| Associated institution: | Universidade Nova de Lisboa |
| Language: | English |
| Origin: | Repositório Institucional da UNL |
| _version_ | 1868982760933163008 |
|---|---|
| author | Abarquero-Diezhandino, A. |
| author2 | Mellado-Romero, M. Muñoz de la Espada-López, M. Diaz-Suárez, R. García-Jarabo, E. Núñez-García, A. Sánchez-Morata, E. J. Vázquez-Osorio, M. T. Guerra-Pinto, F. Vilá-Rico, J. |
| author2_role | author author author author author author author author author |
| author_facet | Abarquero-Diezhandino, A. Mellado-Romero, M. Muñoz de la Espada-López, M. Diaz-Suárez, R. García-Jarabo, E. Núñez-García, A. Sánchez-Morata, E. J. Vázquez-Osorio, M. T. Guerra-Pinto, F. Vilá-Rico, J. |
| author_role | author |
| contributor_name_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Ediciones Doyma, S.L. RUN |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Abarquero-Diezhandino, A.\"},{\"Person.name\":\"Mellado-Romero, M.\"},{\"Person.name\":\"Muñoz de la Espada-López, M.\"},{\"Person.name\":\"Diaz-Suárez, R.\"},{\"Person.name\":\"García-Jarabo, E.\"},{\"Person.name\":\"Núñez-García, A.\"},{\"Person.name\":\"Sánchez-Morata, E. J.\"},{\"Person.name\":\"Vázquez-Osorio, M. T.\"},{\"Person.name\":\"Guerra-Pinto, F.\"},{\"Person.name\":\"Vilá-Rico, J.\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Ediciones Doyma, S.L. RUN |
| datacite.creators.creator.creatorName.fl_str_mv | Abarquero-Diezhandino, A. Mellado-Romero, M. Muñoz de la Espada-López, M. Diaz-Suárez, R. García-Jarabo, E. Núñez-García, A. Sánchez-Morata, E. J. Vázquez-Osorio, M. T. Guerra-Pinto, F. Vilá-Rico, J. |
| datacite.date.Accepted.fl_str_mv | 2025-09-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2025-03-27T21:14:05Z |
| datacite.date.embargoed.fl_str_mv | 2025-03-27T21:14:05Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Ankle instability Anterior talofibular ligament Biomechanics Calcaneofibular ligament Ligament reconstruction Surgery Orthopedics and Sports Medicine |
| datacite.titles.title.fl_str_mv | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| dc.contributor.none.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Ediciones Doyma, S.L. RUN |
| dc.creator.none.fl_str_mv | Abarquero-Diezhandino, A. Mellado-Romero, M. Muñoz de la Espada-López, M. Diaz-Suárez, R. García-Jarabo, E. Núñez-García, A. Sánchez-Morata, E. J. Vázquez-Osorio, M. T. Guerra-Pinto, F. Vilá-Rico, J. |
| dc.date.Accepted.fl_str_mv | 2025-09-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2025-03-27T21:14:05Z |
| dc.date.embargoed.fl_str_mv | 2025-03-27T21:14:05Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10362/181554 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Ankle instability Anterior talofibular ligament Biomechanics Calcaneofibular ligament Ligament reconstruction Surgery Orthopedics and Sports Medicine |
| dc.title.fl_str_mv | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Background and aim: Ankle sprains can lead to chronic lateral ankle instability (CLAI) in 10-50% of cases. While the anterior talofibular ligament (ATFL) is traditionally considered the primary structure affected, recent studies indicate a high incidence of combined injuries to the ATFL and the calcaneofibular ligament (CFL). Given the importance of the CFL, this study aims to evaluate the biomechanical efficacy of double tendon graft reconstruction of the ATFL and CFL in cases of CLAI. Materials and methods: This biomechanical study on cadaveric ankles compares two techniques: anatomical reconstruction using a double graft for both the ATFL and CFL versus isolated anatomical reconstruction of the ATFL with a single graft. Stability was assessed using specific examination maneuvers (anterior drawer, forced varus, and pivot shift) with an arthrometer measuring angular displacement across three spatial planes (horizontal, coronal, and sagittal). Four models were analyzed: intact ankle, sectioning of the ATFL and CFL, double graft reconstruction of the ATFL and CFL, and single graft reconstruction of the ATFL. Results: The results showed no significant differences between the double graft reconstruction and the intact ankle. Comparing the double graft with the single graft reconstruction revealed statistically significant differences, favoring the double graft for greater angular stability in the coronal plane during forced varus and external rotation maneuvers. Conclusions: Double graft reconstruction of the ATFL and CFL provides greater angular stability compared to isolated ATFL reconstruction, demonstrating significant benefits in lateral and rotational stabilization of the ankle in CLAI cases. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://run.unl.pt/bitstreams/9b0e9796-a987-4b56-8cbc-ab2e25b198dd/download |
| id | run_fa6c71c0b08cfb9221d2f18657fa4e44 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10362/181554 |
| inst_facet_str | urn:organizationAcronym:unl{{{_:::_}}}Universidade Nova de Lisboa |
| instacron_str | unl |
| institution | Universidade Nova de Lisboa |
| instname_str | Universidade Nova de Lisboa |
| language | eng |
| network_acronym_str | run |
| network_name_str | Repositório Institucional da UNL |
| oai_identifier_str | oai:run.unl.pt:10362/181554 |
| organization_str_mv | urn:organizationAcronym:unl |
| person_str_mv | Abarquero-Diezhandino, A. Mellado-Romero, M. Muñoz de la Espada-López, M. Diaz-Suárez, R. García-Jarabo, E. Núñez-García, A. Sánchez-Morata, E. J. Vázquez-Osorio, M. T. Guerra-Pinto, F. Vilá-Rico, J. |
| publishDate | 2025 |
| repo_facet_str | urn:repositoryAcronym:run{{{_:::_}}}Repositório Institucional da UNL |
| reponame_str | Repositório Institucional da UNL |
| repository_id_str | urn:repositoryAcronym:run |
| service_str_mv | urn:repositoryAcronym:run |
| spelling | engenBackground and aim: Ankle sprains can lead to chronic lateral ankle instability (CLAI) in 10-50% of cases. While the anterior talofibular ligament (ATFL) is traditionally considered the primary structure affected, recent studies indicate a high incidence of combined injuries to the ATFL and the calcaneofibular ligament (CFL). Given the importance of the CFL, this study aims to evaluate the biomechanical efficacy of double tendon graft reconstruction of the ATFL and CFL in cases of CLAI. Materials and methods: This biomechanical study on cadaveric ankles compares two techniques: anatomical reconstruction using a double graft for both the ATFL and CFL versus isolated anatomical reconstruction of the ATFL with a single graft. Stability was assessed using specific examination maneuvers (anterior drawer, forced varus, and pivot shift) with an arthrometer measuring angular displacement across three spatial planes (horizontal, coronal, and sagittal). Four models were analyzed: intact ankle, sectioning of the ATFL and CFL, double graft reconstruction of the ATFL and CFL, and single graft reconstruction of the ATFL. Results: The results showed no significant differences between the double graft reconstruction and the intact ankle. Comparing the double graft with the single graft reconstruction revealed statistically significant differences, favoring the double graft for greater angular stability in the coronal plane during forced varus and external rotation maneuvers. Conclusions: Double graft reconstruction of the ATFL and CFL provides greater angular stability compared to isolated ATFL reconstruction, demonstrating significant benefits in lateral and rotational stabilization of the ankle in CLAI cases.application/pdfenBiomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligamentsAbarquero-Diezhandino, A.Mellado-Romero, M.Muñoz de la Espada-López, M.Diaz-Suárez, R.García-Jarabo, E.Núñez-García, A.Sánchez-Morata, E. J.Vázquez-Osorio, M. T.Guerra-Pinto, F.Vilá-Rico, J.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Ediciones Doyma, S.L.HostingInstitutionOrganizationalRUNe-mailmailto:run@unl.ptrun@unl.ptISSNIsPartOf1888-4415URNIsPartOfPURE: 113333830URNIsPartOfPURE UUID: 11a21708-0c37-4e79-a0a5-6ef907b35f54URNIsPartOfScopus: 86000369334URNIsPartOfPubMed: 39956362DOIIsPartOf10.1016/j.recot.2025.02.0042025-03-27T21:14:05Z2025-092025-09-01T00:00:00ZHandlehttp://hdl.handle.net/10362/181554http://purl.org/coar/access_right/c_abf2open accessAnkle instabilityAnterior talofibular ligamentBiomechanicsCalcaneofibular ligamentLigament reconstructionSurgeryOrthopedics and Sports Medicine3029691 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://run.unl.pt/bitstreams/9b0e9796-a987-4b56-8cbc-ab2e25b198dd/download |
| spellingShingle | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments Abarquero-Diezhandino, A. Ankle instability Anterior talofibular ligament Biomechanics Calcaneofibular ligament Ligament reconstruction Surgery Orthopedics and Sports Medicine |
| status | SINGLETON |
| subject.fl_str_mv | Ankle instability Anterior talofibular ligament Biomechanics Calcaneofibular ligament Ligament reconstruction Surgery Orthopedics and Sports Medicine |
| title | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| title_full | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| title_fullStr | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| title_full_unstemmed | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| title_short | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| title_sort | Biomechanical study on cadaveric reconstruction with graft of the anterior talofibular and calcaneofibular ligaments |
| topic | Ankle instability Anterior talofibular ligament Biomechanics Calcaneofibular ligament Ligament reconstruction Surgery Orthopedics and Sports Medicine |
| topic_facet | Ankle instability Anterior talofibular ligament Biomechanics Calcaneofibular ligament Ligament reconstruction Surgery Orthopedics and Sports Medicine |
| url | http://hdl.handle.net/10362/181554 |
| visible | 1 |