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  • Title: Analysis of Two Different Arthroscopic Broström Repair Constructs for Treatment of Chronic Lateral Ankle Instability in 110 Patients: A Retrospective Cohort Study.
    Author: Cottom JM, Baker J, Plemmons BS.
    Journal: J Foot Ankle Surg; 2018; 57(1):31-37. PubMed ID: 29103892.
    Abstract:
    Chronic lateral ankle instability is a common condition treated by most foot and ankle surgeons. Once conservative treatment has failed, patients often undergo surgical reconstruction, either anatomic or nonanatomic. The present retrospective cohort study compared the clinical outcomes of 2 different arthroscopic Broström procedures. A total of 110 patients (83 females [75.5%] and 27 males [24.5%]) were treated with 1 of the 2 lateral ankle stabilization techniques from October 1, 2014 to December 31, 2015. Of the 110 patients, 75 were included in the arthroscopic lateral ankle stabilization group with an additional suture anchor used proximally and 35 were included in the arthroscopic lateral ankle stabilization group using the knotless design. The age of the cohort was 46.05 ± 17.89 (range 12 to 83) years. The body mass index was 30.03 ± 7.42 (range 18.3 to 52.5) kg/m2. Of the 110 patients, 25 (22.7%) had undergone concomitant procedures during lateral ankle stabilization. Overall, postoperative complications occurred in 14 patients (12.7%). No statistically significant differences were found between the 2 groups regarding the complication rates, use of concomitant procedures, and the presence of diabetes and workers compensation claims. No statistically significant differences were found in the mean age, body mass index, or gender distribution between the 2 groups. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores were 50.85 ± 13.56 (range 18 to 76) and 51.26 ± 13.32 (range 18 to 69) in groups 1 and 2, respectively. The postoperative AOFAS Ankle-Hindfoot scores were 88.19 ± 10.72 (range 54 to 100) and 84 ± 15.41 (range 16 to 100) in groups 1 and 2, respectively. No statistically significant difference was found between these 2 groups. The preoperative visual analog scale score was 7.45 ± 1.39 (range 3 to 10) and 6.97 ± 1.25 (range 5 to 10), which had improved to 1.12 ± 1.38 (range 0 to 5) and 1.8 ± 1.98 (range 1 to 9) postoperatively for groups 1 and 2, respectively. The difference in the postoperative visual analog scale score between the 2 groups was statistically significant. The preoperative and postoperative AOFAS scale, Foot Function Index, and Karlsson-Peterson scores showed no statistically significant differences between the 2 groups. From our experience, either procedure is an acceptable treatment option for chronic lateral ankle instability, with the knotless technique showing a trend toward more complications.
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