Revision first metatarsophalangeal joint lateral collateral ligament reconstruction with polyurethane urea matrix in an elite athlete: A case report

Abstract

Case: A 26-year-old elite male swimmer presented with chronic, isolated, hallux metatarsophalangeal joint varus instability status post previous lateral collateral ligament repair. We report a novel surgical technique for revision first metatarsophalangeal joint (MTP-1) lateral collateral ligament reconstruction using soft tissue imbrication and augmentation with a degradable polycaprolactone-based polyurethane urea (PUUR) matrix. There is paucity in the literature describing the surgical management of revision lateral collateral ligament injury in these cases. Conclusion: Our reconstruction technique using degradable PUUR matrix restores natural soft tissue elasticity, provides a scaffolding for neocollagenesis, is bioinert, and delivers a low-profile reconstruction allowing the patient to return to high level competition with excellent patient outcomes at one year follow up.

Keywords

• Artelon
• Hallux ligament reconstruction
• revision hallux ligament reconstruction
• Hallux lateral collateral ligament reconstruction
• Flexband