Arthroscopic Deltoid Ligament Surgery in Ankle Disorders: A Review

Biomedical Sciences | Review article | https://doi.org/10.47262/SL/13.1.132025120

Abdul Aleem Khan¹*, Mohammed Junaid Ali², Kaibin Zhang¹, Yang Li¹, Tianqi Tao¹, Jianchao Gui¹

¹Department of Orthopedics, Department of Sports Medicine, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, 210000, Nanjing, Jiangsu, China

²Department of Orthopedics, Sir Run Run Hospital, Nanjing Medical University, Longmian Road 109, 211100, Nanjing, Jiangsu, China

Abstract

Medial ankle stability relies heavily on deltoid ligaments and failure to treat these injuries could result in chronic instability, degenerative disease, or osteoarthritis. This article discusses deltoid ligament biomechanics, recent advancements in arthroscopic surgical techniques, clinical outcomes and emerging treatment trends. Biomechanics of the deltoid ligament is relevant for ankle stability and is influenced by age and sex. Injuries are also more common in women, particularly as they age. Recent studies have demonstrated that the ligament's superficial and deep layers are critical for sustaining ankle function and that supplementary ligament structures are hindering surgical repair attempts. The advent of arthroscopic techniques revolutionized deltoid ligament repair due to its minimally invasive nature, causing less blood loss, shorter hospital stays and fewer complications. These techniques facilitate accurate visualization of the ligament, further helping speed up recovery and decrease postoperative pain while addressing concomitant intra-articular pathologies. Clinical outcomes following arthroscopic repairs have been favorable, with marked improvements in pain relief, functional recovery and shortened return to activity. Any complications, such as recurrent instability or graft issues, remain relatively rare. Concerns about long-term complications, including osteoarthritis, remain, especially in severe cases. Advanced techniques, including biologic augmentation and robotic-assisted surgery, are improving ligament repair and rehabilitation. Biomechanical and regenerative medicine developments are set to propel deltoid ligament repair forward as well. Overall, arthroscopic deltoid ligament repair is a promising development that should yield a symptomatic and functional advantage over an open alternative, and further study will undoubtedly advance recovery and long-term outcome for patients.