Comparative Study of Concurrent Arthroscopic Anterior Talofibular Ligament Repair and Posterior Ankle Debridement: Novel Adjustable Lateral Floating Position versus Traditional Repositioning with Re-preparation.

Abstract

The goal of this study was to compare our novel adjustable lateral floating position with traditional repositioning and re-prepping for concurrent arthroscopic anterior talofibular ligament (ATFL) repair and posterior ankle debridement. Retrospective control study. From 2019 to 2022, fifty-four cases underwent concurrent arthroscopic ATFL repair and posterior ankle debridement were retrospectively analyzed. According to the intraoperative position, 26 cases were assigned to group A (novel adjustable lateral floating position) and 28 to group B (traditional repositioning). The Foot and Ankle Ability Measure scales [FAAM, including activities of daily living (FAAM-ADL) and sports subscales (FAAM-SS)] and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores were compared. The surgical time and complications were also evaluated. The average follow-up time was 26.2 ± 2.5 months (range, 24-28 months) without significant differences between the groups. There was no significant difference between FAAM-ADL, FAAM-SS, and AOFAS scores at the final follow-ups. No significant difference in complication rates was found. However, there is a significant difference in median and interquartile range (IQR) of the surgical time between both groups [58.0 (50.0, 74.0) vs. 78.0 (68.5, 88.5)], with a large effects size (Cohen's d = -0.75). It is notable that the surgical times of patients with postoperative deep vein thrombosis exceeded 110 minutes in both groups. For the concurrent arthroscopic ATFL repair and posterior ankle debridement, the novel adjustable lateral floating position is time-saving and reliable. This novel surgical positioning is also suitable for a younger or more junior surgeon. Level III.