Abstract
BackgroundThe concept of utilizing nonabsorbable suture tape fixed directly to bone to augment Brostrom repairs of the anterior talofibular ligament (ATFL) has been proposed. However, no clinical data are currently available regarding the arthroscopic modified Brostrom operation with an internal brace.Materials and methodsThis study involved 85 consecutive patients (22 in the with internal brace group; 63 in the without internal brace group) who could be followed up for >6 months after undergoing an arthroscopic modified Brostrom operation. The American Orthopaedic Foot & Ankle Society (AOFAS) score was administered to assess the functional status. At preoperation and at 24 weeks after surgery, the anterior drawer test was examined clinically.ResultsImprovement of mean AOFAS score in the internal brace group from before surgery to two weeks after surgery was statistically significant (p < 0.05). At 24-week follow-up, the anterior drawer test showed grade 0 laxity in 19 patients (86.4 %) and grade 1 in three patients (13.6 %). Improvement of AOFAS score in the group without an internal brace from before surgery to 6 weeks after surgery was not statistically significant (p = 0.001). At 24-week follow-up, the anterior drawer test showed grade 0 laxity in 54 patients (85.7 %) and grade 1 in nine patients (14.3 %).ConclusionPatients in the internal brace group were able to quickly return to activity and sports. We believe this technique could be a viable option for surgically treating chronic lateral ankle instability in patients who need an early return to activity and sports.Level of evidenceIII.
Highlights
Lateral ankle instability is a common pathological condition in recreational and professional athletes [1].Most foot and ankle surgeons perform an open modified Brostrom operation for treatment of lateral ankle instability, and good-to-excellent results have been reported [2, 3].Despite the value of the Brostrom procedure, limitations of this technique exist
Background The concept of utilizing nonabsorbable suture tape fixed directly to bone to augment Brostrom repairs of the anterior talofibular ligament (ATFL) has been proposed
Improvement of mean American Orthopaedic Foot & Ankle Society (AOFAS) score in the internal brace group from before surgery to two weeks after surgery was statistically significant (p \ 0.05)
Summary
Lateral ankle instability is a common pathological condition in recreational and professional athletes [1].Most foot and ankle surgeons perform an open modified Brostrom operation for treatment of lateral ankle instability, and good-to-excellent results have been reported [2, 3].Despite the value of the Brostrom procedure, limitations of this technique exist. In patients with long-standing lateral ankle instability with attenuated native tissue and in very large patients or athletes, both of whom are likely to place extra stress on their ankles, the adequacy of these repairs has been questioned [6, 7]. To address situations such as these, the concept of using highstrength nonabsorbable suture tape has been proposed, as described in previous literature for rotator cuff repairs [8,. At preoperation and at 24 weeks after surgery, the anterior drawer test was examined clinically
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