Foot & Ankle International - 2017 FAI Supplement - 46S

Chronic Deltoid Ligament Insufficiency
Repair with Internal Brace™
Augmentation

Conclusion: Our results suggest that deltoid ligament
repair with Internal Brace™ augmentation in patients with
CDLI is a reliable option with good functional outcomes
and high satisfaction grade in short term follow-up.

Manuel Pellegrini, MD, Giovanni Carcuro, MD,
Natalio Cuchacovic, Marcelo Somarriva, MD,
Mario Escudero Heldt, MD, Nicolas Torres, MD,
Eddie Birman, MD, Gerardo Muñoz, MD
Category: Ankle, Arthroscopy, Sports
Keywords: medial ankle instability, deltoid ligament,
arthroscopy
Introduction/Purpose: Patients with chronic deltoid ligament insufficiency (CDLI) present a challenging situation
in foot and ankle surgery. Although numerous surgical procedures have been described, optimal treatment is still a
matter of debate. While the treatment armamentarium
ranges from simple ligament repair to complex deltoid
reconstructions with or without realignment osteotomies,
direct repair augmented with an Internal Brace™ (Arthrex,
Inc., Naples FL, USA) device appears to be an attractive
intermediate option. We investigated functional outcomes
and complications in patients with CDLI operated on using
Internal Brace™ augmentation.
Methods: After IRB approval, a prospective study was conducted. Patients were included if they were older than 18
years, presented medial ankle pain and/or giving way,
exhibited asymmetric flexible hindfoot valgus, failed conservative treatment, and had a positive MRI evaluated by an
independent radiologist. Patients with less than six months
of follow-up, stage IV flatfoot deformity, neuropathy and/or
inflammatory arthritis were excluded from the study. CDLI
diagnosis was confirmed intraoperatively with the
arthroscopic ankle drive-through sign. Patients were evaluated preoperatively and postoperatively using foot and
ankle ability measure (FAAM) score, 36-item short form
survey (SF-36), and grade of satisfaction. Paired t-tests
were used to assess the pre- and postoperative FAAM and
SF-36 scores.
Results: Eleven patients met inclusion criteria. Nine
patients were male and two female, with a mean age of 32
(18-61). Six ankles were right and five left. 88% presented
with medial ankle pain, 67% medial drawer, 88% asymmetric hindfoot valgus, and 44% multidirectional ankle instability. No patient was lost to follow-up, with a mean
follow-up time of 13.5 months (6-21). Preoperative FAAM
and SF-36 scores improved from 58.7 to 75.3 and from 60.2
to 84.4 postoperatively, respectively (p<0.05). Two implant
failures were observed, with no apparent compromise of
construct stability. No patient was re-operated.
46S

Foot & Ankle International, 38(S1)
DOI: 10.1177/1071100717S00043
©The Author(s) 2017

Matrix-Associated Stem Cell
Transplantation (MAST) in Chondral
Defects of the Ankle is Safe and
Effective: 5-Year-Followup
Martinus Richter, MD, PhD, Stefan Meissner,
Stefan Zech, MD
Category: Ankle, Arthroscopy, Sports
Keywords: Ankle; Matrix-Associated
Transplantation (MAST);Chondral Defect

Stem

Cell

Introduction/Purpose: The aim of the study was to assess
the 5-year-follow-up of matrix-associated stem cell transplantation (MAST) in chondral defects of the ankle.
Methods: In a prospective consecutive non-controlled
clinical follow-up study, all patients with chondral defect
that were treated with MAST from April1 2009 to
September 30, 2011 were analyzed. Size and location of
the chondral defects and the Visual-Analogue-Scale Foot
and Ankle (VAS FA) before treatment and at follow-up
were analysed. Stem cell-rich blood was harvested during
the procedure from the ipsilateral pelvic bone marrow
with a Jamshidi needle (10 x 3mm, Cardinal, Dublin, OH,
USA) and a special syringe (Arthrex-ACP, Arthrex,
Foot & Ankle International 38(1S)

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