Syntethic Neoligamentplasty with FiberTape has the Same Rigididy than Transarticular Screws in Lisfranc Subtle Lesions

Abstract

Category: Midfoot/Forefoot, Sports Introduction/Purpose: Lisfranc joint injuries occur due to direct or indirect trauma, where a twisting or axial force is transmitted to the foot. Recently, new treatment options are being sought in order to use methods that allow a more physiologic fixation of this joint. The purpose of this study was to analyze the stability of a cadaveric Lisfranc injury model fixed with a synthetic neoligamentplasty in comparison to the traditional trans-articular screw fixation. Methods: 24 fresh frozen lower leg cadaveric specimens were utilized. The medial (C1) and intermediate (C2) cuneiforms, first (M1) and second (M2) metatarsal bones were marked. A complete ligament injury was performed between C1-C2 and C1-M2 in 12 specimens (Group 1), and between C1-C2, C1-M2, C1-M1 and C2-M2 in 12 matched specimens (Group 2). The groups were further divided in fixation with screws (G1 Screws and G2 Screws) and with Tape (G1 Tape and G2 Tape). The tape fixation group used a fixation technique described by this group, using FiberTape (Arthrex, Inc.). After ligament lesion and fixation, the construct rigidity was measured with the help of a 3D Digitizer arm, comparing the distances between the marked bones over a stress condition (pronation and supination of the forefoot). Results: Distance C1-C2 increased 3 mm after ligament injury (23% increase) with supination motion. C1-M2 increased 4 mm after ligament injury (21% increase) with pronation motion. Distances between C1-M1 and C2-M2 only changed in Group 2, increasing 3 mm (14%) and 2 mm (16%) respectively. Rigidity between C1-C2, C1-M1 and C2-M2 did not differ between the fixation with screws and with tape. The fixation with screws presented more rigidity in C1-M2 distance (p=0,03), but only in pronation stress. Conclusion: Pronation and supination motion of the forefoot relative to the hindfoot produces measurable joint displacements. Tape and Screws can produce the same rigidity after repairing Lisfrac Ligament injuries, except for distance C1-M2 in pronation stress.