Ligament Augmentation in Lateral Ankle

Ligament augmentation in lateral ankle reconstructions got a big boost with the publication of a Level 1 paper showing superior two- and five-year outcomes when using a ligament augment. Since then, the market has expanded with offerings from Stryker (Artelon), Arthrex (Internal Brace), Conmed (BioRez), and Medline (ForceWeb).

Augment use in ortho foot and ankle

In an online survey of American Orthopaedic Foot & Ankle Society (AOFAS), 85.7% reported using ligament augments. North American surgeons were significantly more likely to use them than those outside of North America (89% vs. 72%). The most augmented ligament was the anterior talofibular ligament ATFL (98.1%), followed by the syndesmosis (59.8%) and the deltoid ligament (58.4%). 

Faster return to sport

The most commonly cited reason for ligament augment use was to enable faster return to sport (136 respondents, 65.1%). This contention is supported by Kulwin et al., whose multicenter, prospective, randomized trial found that augmentation can facilitate an earlier return to athletic activity.