Comparison of Mid-term Outcomes Between an Arthroscopic and an Open Modified Broström Procedure for Ankle Instability

Abstract

Category: Arthroscopy Introduction/Purpose: Although the short-term results of an all-inside arthroscopic Modified Broström operation (MBO) have been as satisfactory as open MBO, there is always a concern about the long-term stability of an arthroscopic MBO. The purpose of this study was to compare clinical and radiologic outcomes of all-inside arthroscopic and open MBOs at mid-term follow up. Methods: From August 2012 to July 2014, totally 87 patients underwent an arthroscopic MBO and an open MBO. Of these, we retrospectively reviewed 48 patients who had a more than 3 years follow-up period. They were divided into two groups: all-inside arthroscopic MBO goup (26 patients), open MBO group (22 patients). The American Orthopaedic Foot & Ankle Society (AOFAS) ankle–hindfoot score, visual analog scale (VAS) score, and Karlsson score were used to evaluate clinical outcomes. Anterior talar translation and talar tilt were used to evaluate radiologic outcomes. Clinical and radiologic outcome evaluations were performed preoperatively, at 12 months postoperatively, and at a final follow-up at a minimum of 36 months postoperatively. Results: Evaluations were performed for 26 ankles in the all-inside arthroscopic MBO group and 22 in the open MBO group. There was no difference in age, gender, symptom duration, preoperative AOFAS, VAS, Karlsson scores, anterior talar translation, or talar tilt between the 2 groups (all P > .05). At the final follow-up, the AOFAS, VAS, and the Karlsson scores had improved significantly in both groups (P < .001). There was no difference in the Karlsson, AOFAS, or VAS scores, anterior talar translation, or talar tilt between the 2 groups at final follow-up (all P > .05). Conclusion: There was no difference in the clinical and radiologic outcome between the all-inside arthroscopic MBO and open MBO for the treatment of lateral ankle instability at up to 3 years after surgery. An all-inside arthroscopic MBO should be a good treatment option in patients who have lateral ankle instability.