Christian Colcuc1,2, Marc Blank3, Thomas Stein4,5, Florian Raimann6, Sanjay Weber-Spickschen7, Sebastian Fischer8, Reinhard Hoffmann3. 1. Department of Trauma and Orthopaedic Surgery, Evangelical Hospital Bethel, Bielefeld, Germany. ChrisCol@gmx.de. 2. Department for Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany. ChrisCol@gmx.de. 3. Department for Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany. 4. Department of Sporttraumatology - Knee- and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany. 5. Department of Sports Science, University of Bielefeld, Bielefeld, Germany. 6. University Hospital Frankfurt am Main, Frankfurt, Germany. 7. Institute of Sports Medicine and Trauma Department, Hannover Medical School, Hannover, Germany. 8. Department of Foot and Ankle Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany.
Abstract
PURPOSE: Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization, but complications including knot irritation have been reported. No randomized trials of the new knotless suture button devices have been performed. We hypothesized that knotless suture button devices eliminate knot irritation and facilitate quicker return to sports. This study was performed to compare the clinical outcomes, complication rates, and time to return to sports between a new knotless suture button device and syndesmotic screw fixation. METHODS: This study included 54 patients treated for ankle syndesmotic injury from 2012 to 2014 with aknotless suture button device or syndesmotic screw fixation. Clinical outcomes were measured using the American Orthopaedics Foot and Ankle Society score, Foot and Ankle Disability Index, Olerud and Molander score, and visual analog scale for pain and function. Secondary outcome measures were the complication rate and time required to return to sports. Patients underwent clinical and radiological evaluations preoperatively and three times during the 1-year postoperative follow-up. RESULTS: 54 of 62 eligible patients were analyzed, median age 37 (18-60) and underwent the 1-year follow-up. The screw fixation and knotless suture button groups comprised 26 and 28 patients, respectively. The complication rate was significantly lower (p = 0.03) and time to return to sports was significantly shorter in the knotless suture button than screw fixation group (average, 14 versus 19 weeks, respectively; p = 0.006). No significant differences were identified in clinical outcomes or visual analog scale scores for pain and function between the groups. Age, injury mechanism, and body mass index did not significantly affect the time required to return to sports activities. The type of fixation was the only independent variable that reached statistical significance (p = 0.006). CONCLUSION:Syndesmotic screw fixation and the new knotless suture button device both resulted in good clinical results. Lower complication rate and the earlier time to return to sports make the new knotless suture button device recommendable especially for highly active patients. LEVEL OF EVIDENCE: Randomized controlled trial, Level I.
RCT Entities:
PURPOSE: Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization, but complications including knot irritation have been reported. No randomized trials of the new knotless suture button devices have been performed. We hypothesized that knotless suture button devices eliminate knot irritation and facilitate quicker return to sports. This study was performed to compare the clinical outcomes, complication rates, and time to return to sports between a new knotless suture button device and syndesmotic screw fixation. METHODS: This study included 54 patients treated for ankle syndesmotic injury from 2012 to 2014 with a knotless suture button device or syndesmotic screw fixation. Clinical outcomes were measured using the American Orthopaedics Foot and Ankle Society score, Foot and Ankle Disability Index, Olerud and Molander score, and visual analog scale for pain and function. Secondary outcome measures were the complication rate and time required to return to sports. Patients underwent clinical and radiological evaluations preoperatively and three times during the 1-year postoperative follow-up. RESULTS: 54 of 62 eligible patients were analyzed, median age 37 (18-60) and underwent the 1-year follow-up. The screw fixation and knotless suture button groups comprised 26 and 28 patients, respectively. The complication rate was significantly lower (p = 0.03) and time to return to sports was significantly shorter in the knotless suture button than screw fixation group (average, 14 versus 19 weeks, respectively; p = 0.006). No significant differences were identified in clinical outcomes or visual analog scale scores for pain and function between the groups. Age, injury mechanism, and body mass index did not significantly affect the time required to return to sports activities. The type of fixation was the only independent variable that reached statistical significance (p = 0.006). CONCLUSION: Syndesmotic screw fixation and the new knotless suture button device both resulted in good clinical results. Lower complication rate and the earlier time to return to sports make the new knotless suture button device recommendable especially for highly active patients. LEVEL OF EVIDENCE: Randomized controlled trial, Level I.
Entities:
Keywords:
Ankle syndesmosis; Complication rate; Functional outcome; Knotless suture button device; Syndesmotic screw; Time to return to sports
Authors: Mélissa Laflamme; Etienne L Belzile; Luc Bédard; Michel P J van den Bekerom; Mark Glazebrook; Stéphane Pelet Journal: J Orthop Trauma Date: 2015-05 Impact factor: 2.512
Authors: Harri J Pakarinen; Tapio E Flinkkilä; Pasi P Ohtonen; Pekka H Hyvönen; Martti T Lakovaara; Juhana I Leppilahti; Jukka Y Ristiniemi Journal: Foot Ankle Int Date: 2011-12 Impact factor: 2.827
Authors: Jan Niklas Altmeppen; Christian Colcuc; Christian Balser; Yves Gramlich; Alexander Klug; Oliver Neun; Sebastian Manegold; Reinhard Hoffmann; Sebastian Fischer Journal: J Clin Med Date: 2022-04-30 Impact factor: 4.964