Comparative Study of Spring Ligament Reconstructions Using Either Hamstring Allograft or Synthetic Ligament...

Area of Science:

• Orthopedic surgery
• Foot and ankle reconstruction
• Biomaterials in surgery

Background:

• Idiopathic flatfeet often result from medial soft tissue attenuation.
• The primary cause, spring ligament attenuation versus posterior tibial tendon dysfunction, remains debated.
• This study compares two spring ligament reconstruction techniques.

Purpose of the Study:

• To compare radiological and clinical outcomes of spring ligament reconstruction.
• To evaluate hamstring allografts versus synthetic ligament augmentation.
• To determine the optimal technique for idiopathic flatfeet correction.

Main Methods:

• Prospective comparative study of 33 spring ligament reconstructions (SLRs).
• Seventeen SLRs used synthetic ligament augmentation; 16 used hamstring allografts.
• Radiographic analysis and patient outcome scores were assessed at minimum 12-month follow-up.

Main Results:

• Both synthetic and hamstring graft SLRs significantly improved most radiological parameters (P < .05).
• Hamstring allograft SLR showed improvement in all parameters except Meary's line.
• Patient outcome scores at 12 months were significantly better in the synthetic ligament group.

Conclusions:

• Spring ligament reconstruction with either hamstring allograft or synthetic augmentation improves radiological alignment.
• Synthetic ligament augmentation yielded superior patient-reported outcomes compared to hamstring allografts.
• Synthetic augmentation is a promising option for spring ligament reconstruction in flatfeet.