Dataset Information

Revision Proximal Tibiofibular Joint Reconstruction for the Treatment of Chronic Instability Secondary to Suture Button Construct Failure.

ABSTRACT: Recurrent proximal tibiofibular joint (PTFJ) instability can result from nonanatomic repair using a suture button construct. During initial reconstruction, proper identification of anatomic landmarks is critical for proper placement of suture button construct components and successful patient outcomes. In cases of symptomatic recurrent instability, a PTFJ reconstruction revision is warranted to alleviate symptoms of pain and instability. This Technical Note describes a technique for performing an anatomic PTFJ reconstruction revision and fibular collateral ligament reconstruction in which the semitendinosus is used as a graft for both the FCL and posterior ligamentous complex of the PTFJ. The biceps femoris is also repaired following a tear that resulted from a misplaced suture button.

SUBMITTER: Rodriguez AN

PROVIDER: S-EPMC8897651 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Revision Proximal Tibiofibular Joint Reconstruction for the Treatment of Chronic Instability Secondary to Suture Button Construct Failure.

Rodriguez Ariel N AN Schreier Foley F Carlson Gregory B GB LaPrade Robert F RF

Arthroscopy techniques 20220228 3

Recurrent proximal tibiofibular joint (PTFJ) instability can result from nonanatomic repair using a suture button construct. During initial reconstruction, proper identification of anatomic landmarks is critical for proper placement of suture button construct components and successful patient outcomes. In cases of symptomatic recurrent instability, a PTFJ reconstruction revision is warranted to alleviate symptoms of pain and instability. This Technical Note describes a technique for performing a ...[more]

PMID: 35256991

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Project description:BackgroundDistal radioulnar joint (DRUJ) instability is a common post-traumatic complication, often leading to chronic pain and dysfunction. Current reconstructive techniques, such as the single suture button construct, offer suboptimal stabilization in certain motions. This study aimed to evaluate whether a double suture button construct provides greater stability than the single construct in a cadaver model of DRUJ instability. We hypothesized that the double suture button construct would more effectively minimize dorsal translation of the radius relative to the ulna.MethodsWe used nine freshly frozen human cadaver upper extremities, destabilized the DRUJ, and then reconstructed the joint using three different suture button constructs: single transverse, double (transverse + oblique), and single oblique. The specimens were secured in a custom-designed testing apparatus to measure dorsal translation of the radius. The study proceeded in five stages: stable DRUJ, unstable DRUJ, and reconstruction using a single transverse, double (transverse + oblique), and single oblique suture button construct. Dorsal translation was measured at neutral, 45° pronation, and 45° supination. Statistical comparisons of mean values were conducted for each stage.ResultsReconstruction with the transverse, transverse plus oblique, and oblique suture button constructs resulted in statistically significant reductions in dorsal translation compared to the unstable DRUJ (p < 0.001 for all). The double-suture button construct significantly minimized dorsal translation in all positions, restoring stability comparable to a stable DRUJ: neutral (p = 1.000), pronation (p = 0.963), and supination (p = 1.000). In contrast, single constructs failed to fully restore stability in pronation and supination.ConclusionThe double suture button construct provides significantly greater stabilization of the DRUJ compared to the single construct. These findings suggest that the double construct could be a more effective option for treating DRUJ instability, particularly in restoring normal joint function during various motions. Further research is warranted to confirm these results in clinical settings.

Dataset Information

Revision Proximal Tibiofibular Joint Reconstruction for the Treatment of Chronic Instability Secondary to Suture Button Construct Failure.

Publications

Revision Proximal Tibiofibular Joint Reconstruction for the Treatment of Chronic Instability Secondary to Suture Button Construct Failure.

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