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Endoscopic Spring Ligament Repair: Classification and Surgical Technique

Héctor José Masaragian Masaragian, Leonel Rega, Fernando Perin and Nicolas Ameriso

Background: Spring ligament lesions have been proposed as a cause of adult flatfoot deformities. Series of isolated injuries have been published in the literature. An alternative endoscopic surgical technique and a classification related to treatment for spring ligament injuries is proposed.

Methods: A cadaveric study with 6 feet was performed, recreating a spring ligament lesion with a bipolar radio frequency probe and subsequent endoscopic repair of the injury. Specimens were dissected to assess correct repair.

Results: Spring ligament anatomy was restored after endoscopic procedure in all feet. Accessory portal was needed only in one foot.

Conclusion: Spring Ligament endoscopic repair is an effective technique for diagnosis and treatment. It allows direct visualization of the ligament and posterior tibialis tendon, as well as treatment in the same procedure. We also present an endoscopic classification, related to our treatment of choice.