Technique for Arthroscopic Deltoid Ligament Repair With Description of Safe Zones
Jorge I. Acevedo, Christopher Kreulen, Andres A. Cedeno, Daniel Baumfeld, Caio Nery, Peter G. Mangone
Abstract
Repair of the deltoid ligaments is suggested in patients with medial ankle instability after a ligamentous injury or lateral malleolar fracture fixation. Arthroscopy can be a definitive mode of determining whether there is medial instability and, therefore, help to determine whether there is a need to repair the deltoid ligaments. The authors describe a technique for the arthroscopic repair of the deltoid ligaments, using a suture passer and suture anchors. Cadaveric analysis was utilized to establish safe zones and indicate that there is a relatively wide safe zone between the posterior tibialis tendon and the saphenous vein when performing the technique. The authors have performed more than 87 arthroscopic deltoid repairs, with a greater than 90% satisfaction rate among patients. However, future studies with validated outcome measures are needed. Level of Evidence: Level V, expert opinion.