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Magnetic Resonance Imaging Analysis of Biological Ligament Healing after Suture-Tape Augmentation for Chronic Lateral Ankle Instability
J Korean Foot Ankle Soc 2021;25:117-125
Published online September 15, 2021;
© 2021 Korean Foot and Ankle Society

Byung-Ki Cho, Min-Yong An, Yoon-Ho Kim, Byung-Hyun Ahn

Department of Orthopedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea
Correspondence to: Byung-Ki Cho
Department of Orthopedic Surgery, Chungbuk National University Hospital, 776, 1sunhwan-ro, Seowon-gu, Cheongju 28644, Korea
Tel: 82-43-269-6077, Fax: 82-43-274-8719, E-mail:
Received February 9, 2021; Revised March 23, 2021; Accepted April 1, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: The aim of this study was to evaluate biological ligament healing quantitatively after suture-tape augmentation for chronic lateral ankle instability.
Materials and Methods: Thirty-two patients underwent magnetic resonance imaging (MRI) at a minimum of 2 years after lateral ligament augmentation using suture-tape. Signal/noise ratios (SNRs) and widths of anterior talofibular ligaments (ATFLs) were measured on preoperative and postoperative MRI by three researchers. ATFL biological healing degrees were analyzed using changes in SNRs and widths of ATFLs and by comparing these metrics with those of normal contralateral ankles. Clinical evaluations were performed using foot and ankle outcome scores (FAOSs), Foot and Ankle Ability Measure (FAAM) scores, and ankle stress radiographs.
Results: Mean FAOS and FAAM scores improved significantly from 62.4 to 93.6 and 58.3 to 92.3, respectively, at final follow-up (p<0.001). Mean SNRs and ATFL widths improved insignificantly from 8.49 to 8.21 and 2.07 to 2.15 mm, respectively, at final followup (p=0.424, p=0.718). Significant differences in mean SNRs and ATFL widths were found between ipsilateral and contralateral sides (p<0.001, p=0.002). Spearman’s correlation analysis revealed no significant association between clinical outcomes and degrees of biological healing of ATFLs based on MRI findings.
Conclusion: Despite improvements in clinical outcome measures, the effects of suture-tape augmentation for chronic lateral ankle instability on biological ligament healing were insignificant. In addition, no significant correlation was found between clinical outcomes and degrees of biological healing of ATFLs.
Keywords : Ankle, Instability, Suture tape, Augmentation, Healing

September 2021, 25 (3)
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